Donepezil

Administration

• Type: Acetylcholinesterase inhibitor
• Dosage Forms: Tab: 5 mg, 10 mg, 23 mg; ODT: 5 mg, 10 mg
• Routes of Administration: Oral
• Common Trade Names: Aricept

Adult Dosing

Alzheimer dementia, mild-moderate

• 5 mg PO qhs x4-6wk
  • Increase to 10 mg PO qhs

Alzheimer dementia, moderate-severe

• 5 mg PO qhs x4-6wk
  • Increase to 10mg PO qhs x3mo, then increase to 23mg PO qhs

Pediatric Dosing

Safety/efficacy not established in pediatric patients

Special Populations

• Pregnancy Rating: C
• Lactation risk: N/A

Renal Dosing

• Adult: Not defined
• Pediatric: Not defined

Hepatic Dosing

• Adult: Not defined
• Pediatric: Not defined

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• AV block, Bradycardia
• Syncope
• Seizures
• GI Bleeding
• Hemolytic anemia
• Urinary obstruction
• Stevens-Johnson syndrome, Toxic epidermal necrolysis

Common

• Nausea, Vomiting
• Diarrhea
• Headache, Dizziness
• Insomnia, abnormal dreams, fatigue
• Muscle Cramps
• Anorexia, weight loss
• Ecchymosis
• Depression
• Syncope
• Arthritis
• Urinary frequency

Pharmacology

• Half-life: 70h
• Metabolism: Liver; CYP450: 2D6, 3A4
• Excretion: Urine, Feces

Mechanism of Action

• Reversibly binds to and inactivates acetylcholinesterase