Pronunciation: don-eh-pee-zill
Generic name: donepezil
Brand names: Aricept, Aricept ODT
Dosage forms: Tablets (5 mg, 10 mg, 23 mg), ODT Tablets (5 mg, 10 mg)
Drug class: Cholinesterase inhibitors

Medically reviewed by Carmen Pope, BPharm. Last updated on Jul 4, 2024.

What is Donepezil?

Donepezil (brand name Aricept) may be used to treat dementia caused by Alzheimer's disease. Donepezil can help improve attention, memory, behavior, and ability to do daily activities in dementia patients.

Donepezil is not a cure for Alzheimer's disease; it may help improve symptoms, but the condition will progress over time, even in people who take this medicine. Research has determined that donepezil is effective in mild, moderate, and severe Alzheimer's disease.

Donepezil improves the function of nerve cells in the brain and works by preventing the breakdown of a chemical called acetylcholine (ah SEET il KOE leen). People with dementia usually have lower levels of this chemical, which is important for memory, thinking, and reasoning. Donepezil is from the drug class cholinesterase inhibitors.

Donepezil was FDA-approved on November 25, 1996, under the brand name Aricept. Generic donepezil became available in 2009.

Donepezil side effects

The most common side effects of donepezil are:

• nausea
• diarrhea
• not sleeping well
• vomiting
• muscle cramps
• feeling tired
• not wanting to eat.

These side effects may get better after you take donepezil for a while. This is not a complete list of side
effects. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA1088. 

Serious side effects and warnings

Get emergency medical help if you have signs of an allergic reaction which may include symptoms such as hives, difficulty breathing, and swelling of your face, lips, tongue, or throat.

Donepezil can cause serious side effects including:

Slow heartbeat and fainting. This happens more often in people with heart problems. Call your doctor right away if you feel faint or lightheaded while taking donepezil.

More stomach acid. This raises the chance of ulcers and bleeding, especially when taking higher dosages of donepezil. The risk is higher for people who have had stomach ulcers or also take aspirin or other NSAIDs.

Worsening of lung problems in people with asthma or other lung disease.

Donepezil may also exaggerate the response to certain muscle relaxants during surgery.

There is a risk of generalized convulsive seizures, gastrointestinal bleeding, and difficulty passing urine in people taking donepezil.

Donepezil can cause vomiting which may be severe. Your healthcare provider will monitor you for this.

Stop using this medicine and call your doctor at once if you have:

• severe or ongoing vomiting
• a light-headed feeling, like you might pass out
• slow heartbeats
• seizure (convulsions)
• painful or difficult urination
• new or worsening breathing problems or
• signs of stomach bleeding - severe heartburn or stomach pain, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

This is not a complete list of side effects of donepezil, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking this medicine

You should not use this medicine if you are allergic to donepezil, Aricept, or any inactive ingredients in the medicine. Tell your doctor if you have any allergies to medicines.

To make sure this medicine is safe for you, tell your doctor if you have:

• a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats)
• an enlarged prostate
• urination problems
• a seizure disorder such as epilepsy
• a history of stomach ulcers
• liver or kidney disease
• trouble swallowing
• asthma, chronic obstructive pulmonary disease (COPD), or another breathing disorder
• are pregnant or intending to become pregnant
• are breastfeeding.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking Donepezil.

Pregnancy

It is not known whether donepezil will harm an unborn baby. 

Breastfeeding

It is not known whether donepezil passes into breast milk or if it could harm a nursing baby. 

How should I take donepezil?

Take donepezil exactly as it was prescribed for you. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

• Take donepezil one time each day.
• You may take donepezil with or without food.

Regular tablets: Do not crush, chew, or break the regular tablet. Swallow it whole.

How to take donepezil ODT (orally disintegrating tablet):

• Keep the tablet in its blister pack until you are ready to take it. Open the package and peel or cut the backing from the tablet blister. Do not push a tablet through the backing or you may damage the tablet.
• Use dry hands to remove the tablet and place it in your mouth.
• Do not swallow the tablet whole. Allow it to dissolve on your tongue.
• Swallow several times as the tablet dissolves. After the tablet dissolves completely, drink a glass of water.

If you need surgery or dental work, tell the surgeon ahead of time that you are using donepezil. You may need to stop using the medicine for a short time.

• Do should not stop using donepezil without your doctor's advice.

Donepezil dosing information

Mild to moderate Alzheimer's disease

Initial dose: donepezil 5 mg orally once a day, in the evening before going to bed.

Maintenance dose: donepezil 10 mg orally once a day after the patient has been on an initial dose of 5 mg once a day for 4 to 6 weeks.

Moderate to severe Alzheimer's disease

Initial dose: donepezil 5 mg orally once a day, in the evening before going to bed.

Maintenance dose: donepezil 10 mg orally once a day after the patient has been on an initial dose of 5 mg once a day for 4 to 6 weeks.

• This dosage may be increased to a maximum of donepezil 23 mg once a day if needed and the person has been taking donepezil 10 mg once a day for at least 3 months.

Comments: A higher dose of 10 mg may or may not provide a statistically significantly greater clinical benefit than a 5 mg dose. Prescriber and patient's preferences should be considered.

Donepezil dosage forms

Donepezil is available as tablets (5 mg, 10 mg, 23 mg) and orally disintegrating tablets (ODT) (5 mg, 10 mg).

What happens if I miss a dose?

Take the missed donepezil dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up for the missed dose.

If you miss your doses for more than 7 days in a row, call your doctor before taking the medicine again.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe nausea, vomiting, drooling, sweating, blurred vision, feeling light-headed, slow heartbeat, shallow breathing, muscle weakness, fainting, or seizure (convulsions).

What to avoid

Donepezil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What other drugs will affect Donepezil?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Donepezil, especially:

• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others
• Anticholinergics such as benztropine or scopolamine
• Succinylcholine, similar neuromuscular blocking agents, or cholinergic agonists (such as varenicline).

This list is not complete. Other drugs may interact with donepezil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Storage

Store at room temperature between 59° to 86°F (15° to 30°C). 

Ingredients

Active ingredient: donepezil hydrochloride

Inactive ingredients: These vary depending on the manufacturer. Refer to the donepezil package insert with your medicine for more information.

Who makes donepezil?

Various manufacturers make donepezil tablets. Examples include:

Aricept -- Eisai Inc.

Generics -- Camber Pharmaceuticals, Quallent Pharmaceuticals Health LLC, Alembic Pharmaceuticals Limited, and others.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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