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Aricept Fact Sheet

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Medication Name (brand): 
Aricept
Medication Name (clinical): 
donepezil
Manufacturer: 

Esai and Pfizer; patent expires 2010.

Indications: 
  • Mild to moderate Alzheimer’s dementia.

  • Moderate to severe Alzheimer's dementia.
  • Off-label use for mild cognitive impairment.

Mechanism: 

Acetylcholinesterase inhibitor. Enhances brain cholinergic function.

Dosing: 
  • Supplied as:

  • 5 mg white and 10 mg yellow tablets
  • Orally disintegrating tablets: 5 mg white and 10 mg yellow.
  • Start at 5 mg QD, increase to 10 mg QD after four weeks. Morning dosing may minimize insomnia and vivid dreams.
  • No dose adjustment needed in renal impairment; only a minimal dose decrease required in hepatic impairment.

Side Effects: 
  • Most common: nausea, diarrhea, insomnia, fatigue.

  • Occasionally: agitation, vivid dreams.
  • May aggravate stomach ulcers (potential class effect of all cholinesterase inhibitors)
  • Pregnancy risk category C.

Drug-drug Interactions: 

Partly metabolized by P450 3A4, so theoretically levels could be increased by 3A4 inhibitors such as Luvox, and levels could be decreased by inducers such as Tegretol.

Pharmokinetics: 
  • Metabolized mostly by liver; about 20% is excreted unchanged in the urine.

  • Half-life 3 days.

Pearls: 

Aricept has the best evidence for effectiveness in mild cognitive impairment of all cholinesterase inhibitors.

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