Donepezil

Donepezil is a medicine used in the treatment of a form of dementia called Alzheimer's disease. One of the features of Alzheimer's disease appears to be a lower than normal level of acetylcholine. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

Donepezil is used to treat the symptoms of Alzheimer's disease, a common type of dementia. This medicine works on nerve cells in the brain. Donepezil is not a cure for Alzheimer's disease, but aims to slow its progression and improve symptoms such as loss of the ability to concentrate and communicate. It is prescribed for mild to moderately severe Alzheimer's dementia. 

What is Donepezil? 

Donepezil is a medicine used in the treatment of a form of dementia called Alzheimer's disease. One of the features of Alzheimer's disease appears to be a lower than normal level of acetylcholine. Acetylcholine is a chemical in the brain that acts as a neurotransmitter, a chemical message released by nerve cells to send signals to other cells. Donepezil increases the level of acetylcholine in the brain. It does this by preventing the action of acetylcholinesterase, the compound that normally breaks it down. The result of this is increased activity of acetylcholine in the brain. 

When is Donepezil used? 

Donepezil is used to treat mild to moderately severe Alzheimer's dementia. The disease affects everyone differently, but over time the person's mental abilities progressively deteriorate. Symptoms of Alzheimer's disease include: 

  • Forgetfulness. 
  • Difficulty performing daily tasks, such as making coffee, getting dressed or doing the laundry. 
  • Misplacing things, putting things in unusual places. 
  • Changes in mood and personality. 
  • Confusion with time or place. 
  • Restlessness. 
  • Decreased vision. 

Alzheimer's disease leads to memory loss. This is because the disease, among other things, interferes with the ability of brain cells to communicate with each other. This seems in part to be due to the brain's reduced sensitivity to the neurotransmitter acetylcholine. Donepezil increases the level of acetylcholine in the brain. The result of this is increased activity of acetylcholine in the brain.  

Donepezil does not stop the progression of Alzheimer's disease. But it can improve symptoms such as loss of attention and ability to concentrate and communicate. However, it does not work equally well for everyone. 

How is Donepezil used? 

Always use this medication as directed by your doctor. The general guidelines for use are as follows: 

  • Treatment with Donepezil is usually started with one tablet taken once daily at bedtime. 
  • The tablet should be swallowed whole with a drink of water. 
  • If you forget to take a dose at bedtime, you should just leave out that dose and take your next dose as usual the following day. Never take a double dose to make up for the forgotten dose. If you forget to take your medicine for more than one week, contact your doctor before taking any more medicine. 
  • Does this medicine affect your driving? Donepezil may cause side effects such as dizziness or tiredness. Stay out of traffic if you do experience these side effects. 
  • Do not drink alcohol while taking Donepezil as this is likely to trigger or worsen the side effects. 

For more information on how to use this medicine, see the package leaflet. 

What doses are available? 

Donepezil is available in tablets of 5 mg and 10 mg. A doctor should determine what strength you should use. The recommended dose in adults and children is: 

  • Adults: one 5-mg tablet once a day. If necessary, the doctor may increase this dose after a few weeks to 10 mg, once daily. Do not take more than 10 mg in any 24-hour period. 

Donepezil is not suitable for use in children. Read the package leaflet before use. 

What are the side effects of Donepezil? 

Donepezil may cause side effects. The following are some of the side effects that are known to be associated with this medicine. 

  • Nausea and vomiting. 
  • Diarrhoea. 
  • Headache. 
  • Tiredness. 
  • Sleep problems. 
  • Muscle cramps. 
  • Dizziness. 
  • Slow heart rate. 

Most side effects are usually only temporary and will disappear once the body adjusts to the medicine.  

See the package leaflet for a list of all possible side effects. Consult a doctor if the side effects are severe or you think you have experienced a side effect that is not listed here. 

When not to use Donepezil? 

Donepezil is not suitable for everyone. Do not use this medicine if: 

  • You are allergic to the active ingredient donepezil or any other ingredient in this medicine. (See the package leaflet for a full list of ingredients.)  
  • You are hypersensitive to piperidine derivatives. 
  • You are pregnant or breastfeeding. 

Donepezil should be used with extreme caution in some patients. For example, in people with:  

  • A history of peptic ulcers or duodenal ulcers. 
  • Heart problems such as heart arrhythmia. 
  • Asthma or other chronic lung disorders. 
  • Epilepsy. 
  • Hepatitis or other liver diseases. 
  • Urinary problems. 
  • Mild kidney disease. 

For more information on the above, see the package leaflet. Always consult a doctor if you fall into one of the above-mentioned categories. Your doctor will be able to advise you if this medicine is appropriate for you and how to use it safely. 

Can Donepezil be used in combination with other medicines? 

Some medicines interact with each other. They may interfere with the effectiveness of other medicines or increase the risk of side effects. Donepezil is known to interact with the following medications: 

  • Other medicines for Alzheimer's disease (e.g. galantamine). 
  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac and ibuprofen. 
  • Certain antibiotics. 
  • Antifungal medications (e.g. ketoconazole). 
  • Antidepressants. 
  • Anticonvulsants. 
  • Muscle relaxants (e.g. diazepam).  
  • Anticholinergic medicines, such as certain medicines for urinary incontinence. 
  • Heart medication such as beta blockers. 

It is important to tell your doctor if you are taking any of these medicines, including medicines bought without a prescription and herbal medicines, before you start treatment with Donepezil to make sure that the combination is safe. For more information on possible drug interactions, see the package leaflet. 

Where can I buy Donepezil? 

Donepezil is only available at pharmacies or online pharmacies. 

Can I buy Donepezil without a prescription? 

Donepezil is only available on prescription. This means a doctor's prescription is required to obtain this medicine. 

Sources 

Alzheimer Nederland. (2016, 1 April). Wat is Donepezil? (What is Donepezil?) Dementie.nl. https://dementie.nl/informatie-over-donepezil 

Package leaflet Donepezilhydrochloride Ipca 5 mg, 10 mg. (2018, July). Geneesmiddeleninformatiebank. https://www.geneesmiddeleninformatiebank.nl/Bijsluiters/h111597.pdf 

KNMP (Royal Dutch Pharmaceutical Society). (2020, 25 March). Donepezil Apotheek.nl. https://www.apotheek.nl/medicijnen/donepezil#! 

Zorginstituut Nederland (Dutch National Health Care Institute). (n.d.). Donepezil. FK Online. Consulted on 01 July 2020 on https://www.farmacotherapeutischkompas.nl/bladeren/preparaatteksten/d/donepezil 

Assessed by:

Dr Arco Verhoog, Pharmacist
Registration number: BIG: 19065378617

Mr Arco Verhoog holds a degree in pharmacy from the University of Groningen (RUG). He served as a pharmacist in the Netherlands and St Maarten from 2005 to 2008. Since 2008, Arco Verhoog has worked as managing pharmacist on Curaçao.