Dosage Recommendations
The recommended starting dosage of Aricept (Donepezil) for mild to moderate Alzheimer’s disease is 5 mg administered once per day in the evening٫ just prior to retiring. The maximum recommended dosage is 10 mg per day. It is important not to administer a dose of 10 mg until patients have been on a daily dose of 5 mg for 4 to 6 weeks. The tablets are available in strengths of 5 mg٫ 10 mg٫ and 23 mg٫ and should be taken orally with or without food.
Dosage Forms and Strengths
Aricept (Donepezil) is available in tablet form with the following strengths⁚
– 5 mg
– 10 mg
– 23 mg
Administration Instructions
Aricept (Donepezil) should be administered orally once per day in the evening, just before bedtime. The tablets can be taken with or without food. It is crucial to follow the recommended dosages and not exceed the maximum dosage of 10 mg per day. For patients starting on a dosage of 5 mg٫ it is advised to wait 4 to 6 weeks before considering an increase to 10 mg per day.
Special Populations
Special care should be taken when prescribing Aricept (Donepezil) to patients with a history of certain conditions. Patients with a history of gastrointestinal bleeding, gastric ulcers, or those taking nonsteroidal anti-inflammatory drugs (NSAIDs) should be closely monitored due to an increased risk of GI bleed. Cholinesterase inhibitors, such as Donepezil, may impact muscle relaxation during anesthesia and have vagotonic effects on the heart, potentially causing bradycardia or heart block. Patients with certain conditions like asthma, obstructive pulmonary disease, seizure disorders, or cardiac conduction abnormalities should use Donepezil with caution.
Storage and Handling
Aricept (Donepezil) tablets should be stored at controlled room temperature between 20°C to 25°C (68°F to 77°F). It is important to keep the medication in its original container, tightly closed, and away from moisture and heat. Do not store in the bathroom. Keep Aricept out of reach of children and pets. If any tablets are outdated or no longer needed, they should be disposed of properly according to local regulations or guidelines.
Clinical Pharmacology
Donepezil, the active ingredient in Aricept, is a reversible inhibitor of the enzyme acetylcholinesterase. By inhibiting this enzyme, donepezil increases acetylcholine levels in the brain, enhancing cholinergic neurotransmission. The medication is metabolized by hepatic P-450 enzymes CYP2D6 and CYP3A4, with 4 major metabolites, 2 of which are active. Donepezil is primarily excreted through urine and feces. Its effects on neurotransmitters can improve memory, awareness, and cognitive function in patients with Alzheimer’s disease.
Side Effects and Precautions
Common side effects of Aricept (Donepezil) may include nausea, vomiting, diarrhea, loss of appetite, weight loss, dizziness, drowsiness, weakness, trouble sleeping, tremors, or muscle cramps. It is important to report any severe or persistent side effects to your healthcare provider. Precautions should be taken in patients with a history of seizures, urinary tract obstruction, peptic ulcer disease, cardiac conduction abnormalities, or respiratory conditions like COPD or asthma. Special care is necessary to monitor for potential adverse reactions and adjust treatment accordingly.