Donepezil

Donepezil is used to treat Alzheimer's disease (AD; a brain disease that affects memory, thinking, and behavior). Donepezil is in a class of medications called cholinesterase inhibitors. It works by increasing the amount of a certain naturally occurring substance in the brain that play a role in mental function.

Donepezil comes as a tablet and an orally disintegrating tablet (tablet that dissolves quickly in the mouth) to take by mouth. Take once a day with or without food, in the evening just before bedtime. Take donepezil at around the same time every day.  

Take donepezil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the 23-mg tablet whole; do not split, crush or chew it. Tell your doctor if you are unable to swallow the tablet whole.

To take the orally disintegrating tablet, place the tablet on your tongue and wait for it to dissolve. Drink some water after the tablet dissolves.

Your doctor may start you on a low dose of donepezil and increase your dose after 4 to 6 weeks. Your doctor may increase your dose again 3 or more months later.

Donepezil controls the symptoms of Alzheimer's disease but does not cure it. Continue to take donepezil even if you feel well. Do not stop taking donepezil without talking to your doctor.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking donepezil,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• you should know that some medications should not be taken with donepezil. Other medications may cause dosing changes or extra monitoring when taken with donepezil. Make sure you have discussed any medications you are currently taking or plan to take before starting donepezil with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking donepezil, please get the advice of your doctor or pharmacist. 
• you should know the following nonprescription or herbal products may interact with donepezil: aspirin, ibuprofen, naproxen, diphenhydramine, brompheniramine, chlorpheniramine, doxylamine, dimenhydrinate, meclizine, loperamide. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking donepezil. Do not start any of these medications while taking donepezil without discussing with your healthcare provider.
• tell your doctor if you have or have ever had bleeding in your stomach or intestines; an ulcer; heart problems or an irregular, slow, or fast heartbeat, seizures; difficulty urinating; asthma;chronic obstructive pulmonary disease (a group of lung disease including chronic bronchitis or emphysema); or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking donepezil, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking donepezil.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you do not take donepezil for 1 week or longer, you should call your doctor before starting to take this medication again.

Donepezil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• diarrhea
• loss of appetite
• weight loss
• frequent urination
• difficulty controlling urination
• muscle cramps
• joint pain, swelling, or stiffness
• pain
• excessive tiredness
• difficulty falling asleep or staying asleep
• headache
• dizziness
• nervousness
• depression
• confusion
• changes in behavior or mood
• hallucinations (seeing things or hearing voices that do not exist)
• abnormal dreams
• red, scaling, itchy skin
• discoloration or bruising of the skin

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• fainting,slow heartbeat,chest pain
• new or worsening breathing problems
• new or worsening stomach pain or heartburn, black or tarry stools, red blood in stools, bloody vomit, vomit that looks like coffee grounds
• difficulty urinating or pain when urinating, lower back pain, fever
• seizures

Donepezil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• nausea
• vomiting
• drooling
• sweating
• slow heartbeat
• difficulty breathing
• muscle weakness
• fainting
• seizures

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

• Aricept^®
• Aricept^® ODT^¶
• Namzaric^®(as a combination product containing Donepezil, Memantine)