Aricept (donepezil hydrochloride) is a prescription medication specifically formulated for the treatment of dementia related to Alzheimer’s disease. As a centrally acting reversible acetylcholinesterase inhibitor, it works by increasing acetylcholine levels in the brain, which is crucial for memory, thinking, and reasoning. This medication is clinically proven to help stabilize or improve cognitive function, potentially slowing disease progression and supporting daily functioning in diagnosed patients. It represents a cornerstone in the pharmacological management of mild to moderate Alzheimer’s symptoms.

Features

• Active ingredient: Donepezil hydrochloride
• Available in 5 mg and 10 mg oral tablets
• Also offered as 23 mg extended-release tablets for appropriate patients
• Orally disintegrating tablet formulation available for ease of administration
• Once-daily dosing regimen for patient convenience
• FDA-approved for treatment of dementia of the Alzheimer’s type

Benefits

• Helps improve memory, attention, and reason
• Supports the ability to perform daily activities
• May slow the progression of cognitive decline
• Enhances global functioning in Alzheimer’s patients
• Can contribute to maintained independence longer
• Provides a well-tolerated treatment option with extensive clinical data

Common use

Aricept is primarily indicated for the treatment of dementia associated with Alzheimer’s disease. It is used in patients with mild, moderate, and severe Alzheimer’s, though the 23 mg formulation is specifically indicated for moderate to severe disease after patients have been on the 10 mg dose for at least three months. Healthcare providers may also consider its use in other forms of dementia, though this would be off-label and requires careful clinical judgment.

Dosage and direction

The recommended initial dose for most patients is 5 mg taken orally once daily, preferably at bedtime. After 4-6 weeks, if well tolerated, the dose may be increased to 10 mg once daily. For patients with moderate to severe Alzheimer’s disease who have been on 10 mg daily for at least three months, healthcare providers may consider transitioning to 23 mg once daily if deemed appropriate. Tablets should be swallowed whole with water and may be taken with or without food. The orally disintegrating formulation should be placed on the tongue and allowed to dissolve before swallowing.

Precautions

Patients should be monitored for gastrointestinal effects, including nausea, vomiting, and diarrhea, particularly during dose escalation. Caution is advised in patients with cardiac conduction abnormalities, asthma, or chronic obstructive pulmonary disease. Those with a history of peptic ulcer disease should use Aricept with caution due to potential increased gastric acid secretion. Patients with bladder outflow obstruction or seizure disorders require careful monitoring. Regular assessment of cognitive and functional status is recommended throughout treatment.

Contraindications

Aricept is contraindicated in patients with known hypersensitivity to donepezil hydrochloride or piperidine derivatives. It should not be used in patients with demonstrated allergic reactions to any components of the formulation. The 23 mg formulation is contraindicated in patients with moderate to severe hepatic impairment. Concomitant use with other cholinergic agents or cholinesterase inhibitors is not recommended due to additive effects.

Possible side effects

The most common adverse reactions include nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue, and anorexia. These effects are often dose-related and may diminish with continued treatment. Less frequently reported side effects include bradycardia, syncope, seizures, and bladder outflow obstruction. Some patients may experience vivid dreams or nightmares. Weight loss has been observed in some clinical trials. Serious but rare side effects include gastrointestinal bleeding and neuroleptic malignant syndrome.

Drug interaction

Aricept may potentiate the effects of succinylcholine-type muscle relaxants during anesthesia. Concurrent use with anticholinergic medications may reduce its efficacy. CYP3A4 and CYP2D6 inhibitors (such as ketoconazole, quinidine) may increase donepezil concentrations. Beta-blockers may enhance the bradycardic effects of Aricept. NSAIDs may increase the risk of gastrointestinal bleeding when used concomitantly. The medication may interfere with the action of anticholinesterase agents in the management of myasthenia gravis.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not take double or extra doses to make up for a missed dose. If multiple doses are missed, consultation with a healthcare provider is recommended before resuming therapy.

Overdose

Symptoms of overdose may include severe nausea, vomiting, salivation, sweating, bradycardia, hypotension, respiratory depression, collapse, and convulsions. Muscular weakness and fasciculations may occur. Increasing muscle weakness may result in death if respiratory muscles are involved. Treatment should consist of general supportive measures. Tertiary anticholinergics such as atropine may be used as an antidote. Intravenous atropine sulfate titrated to effect is recommended, with initial doses of 1.0 to 2.0 mg IV, with subsequent dosing based on clinical response.

Storage

Store at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container tightly closed to protect from moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. The orally disintegrating tablets should be kept in the blister package until immediately before use.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Aricept is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual results may vary, and not all patients will experience the same benefits or side effects. Patients should consult with their healthcare provider for personalized medical advice and to discuss whether this medication is appropriate for their specific condition.

Reviews

Clinical studies involving thousands of patients have demonstrated that Aricept provides statistically significant improvements in cognitive function, activities of daily living, and global assessment scores compared to placebo. Many clinicians report observed stabilization of cognitive decline in their patients, with some showing meaningful improvement in memory and functional abilities. Caregivers often note improved engagement and communication in patients taking Aricept. The medication has maintained its position as a first-line treatment in Alzheimer’s management for over two decades, supported by extensive clinical experience and post-marketing surveillance data.