Donepezil | Side Effects, Dosage, Uses & More
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Generic Name:

donepezil, Oral tablet

All Brands

  • Aricept
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Highlights for donepezil

Oral tablet
1

Donepezil is an oral drug that’s used to treat dementia due to mild, moderate, and severe Alzheimer's disease. This drug isn’t a cure for Alzheimer’s disease, but it may help slow down how quickly your symptoms progress.

2

Your dose depends on how severe you’re Alzheimer’s disease is and how you respond to this medication. Your doctor will decide a dose that’s right for you. You can take donepezil once per day, with or without food.

3

If you are on donepezil orally disintegrating tablets (ODT), you shouldn’t swallow the tablets whole. Let it dissolve on your tongue. Then drink water afterwards to make sure that you’ve taken the full dose of the medication.

4

Common side effects include nausea, diarrhea, not sleeping well, vomiting, bruising, muscle cramps, tiredness, and poor appetite.

5

Donepezil may cause side effects when taken with certain anesthesia drugs. Tell your doctor or dentist that you’re on this drug before having any medical or dental surgeries or procedures.

IMPORTANT INFORMATION

Slow heart rate

Donepezil may cause a slow heart rate and fainting. Call your doctor right away if this happens. Your risk may be higher if you have heart problems.

Stomach bleeding/ulcers

Donepezil can increase your stomach acid, which raises your risk of stomach bleeding or ulcers. The risk is higher for people with a history of ulcers and people on aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Tell your doctor if you have history of ulcers or stomach issues, or if you’re taking aspirin or NSAIDs.

Drug features

Donepezil is prescription drug. It’s available in these forms: oral tablets and oral disintegrating tablets (ODT).

Donepezil is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand.  Talk to your healthcare provider to see if the generic will work for you.

This drug may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

Donepezil is used to treat dementia due to mild, moderate, and severe Alzheimer's disease. This drug isn’t a cure for Alzheimer’s disease, but it may help slow down how quickly your symptoms progress. Symptoms of Alzheimer’s disease will get worse over time, even if you take medications like donepezil.

How it works

Donepezil belongs to a class of drugs called acetylcholinesterase inhibitors. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

More Details

How it works

Donepezil belongs to a class of drugs called acetylcholinesterase inhibitors. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

People with Alzheimer’s disease have low amounts of a chemical in the brain known as acetylcholine. Low levels of this chemical can cause problems with mental function or doing daily tasks (dementia). Donepezil works by preventing the breakdown of acetylcholine. This can help decrease the symptoms of dementia.

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donepezil Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with donepezil include:

  • nausea

  • diarrhea

  • not sleeping well

  • vomiting

  • muscle cramps

  • tiredness

  • not wanting to eat or having a poor appetite

  • bruising

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • slow heart rate and fainting

  • stomach ulcers and bleeding. Donepezil can increase stomach acid, which raises the chance of stomach ulcers and bleeding. Symptoms include:

    • heartburn
    • stomach pain that won’t go away
    • nausea or vomiting
    • blood in your vomit, or dark-colored vomit that looks like coffee grounds
    • bowel movements that look like black tar
  • worsening of lung problems in people with asthma or other lung disease

  • seizures

  • trouble urinating

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Donepezil doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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donepezil May Interact with Other Medications

Oral tablet

Donepezil can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications that might interact with this drug

Alzheimer’s disease medications

These medications work similarly to donepezil. Taking them together can increase your risk of side effects.

These drugs include:

  • galantamine
  • rivastigmine

Anesthesia drug

These medications work similarly to donepezil. Taking them together can increase your risk of side effects.

These drugs include:

  • succinylcholine

Antifungal medications

These drugs can increase the level of donepezil in your body. This can cause more side effects.

These drugs include:

  • ketoconazole

Antihistamines

These drugs and donepezil work in opposite ways. If you take them together, the drugs may be less effective. Or you may have a higher risk of side effects.

These drugs include:

  • dimenhydrinate
  • diphenhydramine
  • hydroxyzine

Anti-seizure medications

These drugs can decrease the level of donepezil in your body. This means that it may not work as well to treat your dementia.

  • phenytoin
  • carbamazepine
  • phenobarbital

Depression medicines

Donepezil and certain antidepressants work in opposite ways. If you take them together, the drugs may be less effective. Or you may have a higher risk of side effects.

These drugs include:

  • amitriptyline
  • desipramine
  • doxepin
  • nortriptyline

Heart medications

These drugs can increase the level of donepezil in your body. This can cause more side effects.

These drugs include:

  • quinidine

Overactive bladder (OAB) medications

These drugs and donepezil work in opposite ways. If you take them together, the drugs may be less effective. Or you may have a higher risk of side effects.

These drugs include:

  • darifenacin
  • oxybutynin
  • tolterodine
  • trospium

Steroids

These medicines can decrease the level of donepezil in your body. This means that it may not work as well to treat your dementia.

These drugs include:

  • dexamethasone

Stomach medications

These drugs and donepezil work in opposite ways. If you take them together, the drugs may be less effective. Or you may have a higher risk of side effects.

These drugs include:

  • dicyclomine
  • hyoscyamine
  • loperamide

Tuberculosis medications

These medicines can decrease the level of donepezil in your body. This means that it may not work as well to treat your dementia.

These drugs include:

  • rifampin

Urinary retention medications

These medications work similarly to donepezil. Taking them together can increase your risk of side effects.

These drugs include:

  • bethanechol

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Donepezil warnings
heart problems
People with heart problems

Tell your doctor if you have heart problems, especially issues with irregular, slow, or fast heart rate. You have a higher risk for experiencing a slow heart rate and fainting while taking donepezil.

stomach ulcers
People with stomach ulcers or bleeding

Talk to your doctor if you have a history of stomach problems, ulcers, or bleeding. Donepezil may increase the amount of acid in your stomach. This may put you at risk of having another stomach ulcer or bleed.

lung problems
People with lung problems

Talk to your doctor if you have asthma or other lung diseases. Donepezil may make these conditions worse, so it needs to be used with caution.

bladder problems
People with bladder problems

Donepezil may block your bladder, making it difficult to urinate. Talk to your doctor if you’ve had any bladder problems in the past.

seizure or epilepsy
People with seizures or epilepsy

Donepezil may cause seizures. Tell your doctor if you have a history of seizures. Alzheimer’s disease may also raise your risk for seizures.

liver problems
People with liver problems

Talk to your doctor if you have a history of liver problems. If your liver isn’t working well, more of this drug may stay in your body longer. This puts you at a greater risk for side effects.

pregnant women
Pregnant women

Donepezil is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Donepezil should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

It isn’t known if donepezil passes into breast milk. If it does, it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

As you age, your organs (such as your liver and kidneys) may not work as well as they did compared to when you were younger. More of this drug may stay in your body longer, putting you at risk for side effects.

for children
For children

The safety and effectiveness of donepezil in children under the age of 18 haven’t been established.

call doctor
When to call the doctor

Surgeries or procedures: Donepezil may cause side effects when taken with certain anesthesia drugs. Tell your doctor or dentist that you’re on this drug before having any medical or dental surgeries or procedures.

allergies
Allergies

Donepezil can cause a severe allergic reaction. Symptoms include:

  • trouble breathing or swallowing
  • swelling of your face, lips, throat, or tongue
  • hives

Don’t take this drug again if you’ve ever had an allergic reaction to it or other medications that contain piperidines. Taking it again could be fatal (cause death).

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How to Take donepezil (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Dementia caused by Alzheimer’s disease

Brand: Aricept

Form: Oral tablet
Strengths: 5 mg, 10 mg, and 23 mg
Form: Orally disintegrating tablet (ODT)
Strengths: 5 mg and 10 mg

Generic: donepezil

Form: Oral tablet
Strengths: 5 mg, 10 mg, and 23 mg
Form: Orally disintegrating tablet (ODT)
Strengths: 5 mg and 10 mg
Adult dosage (ages 18 years and older)
  • mild to moderate Alzheimer's disease: The starting dose is 5 mg taken by mouth in the evening just before going to bed. After 4–6 weeks, your doctor may increase your dose to 10 mg per day if needed.
  • moderate to severe Alzheimer's disease: The starting dose is 5 mg taken by mouth in the evening just before going to bed. After 4–6 weeks, your doctor may increase your dose to 10 mg per day if needed. After 3 months, your doctor may increase our dose to 23 mg per day.  
Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 18 years.

Special considerations

Liver problems: If your liver isn’t working well, more of this drug may stay in your body longer and put you at greater risk for side effects. You may need a lower dose or a different dosing schedule.

Warnings

Dose increases:

  • Your doctor will increase your dose slowly if needed. This gives the drug time to work and lowers your risk of side effects.
  • Your doctor may increase your dose to 10 mg taken once per day after you’ve been taking 5 mg per day for 4–6 weeks. Your doctor may increase your dose further to 23 mg taken once per day after you’ve been taking 10 mg per day for at least 3 months.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Donepezil comes with serious risks if you don’t take it as prescribed.

If you don't take it at all or stop taking it

If you don't take it regularly or stop taking it, donepezil won’t work to treat your dementia and your symptoms may not improve.

If you take too much

If you take too much donepezil, you may have these side effects:

  • severe nausea
  • vomiting
  • drooling (salivation)
  • sweating
  • slow heart rate
  • low blood pressure
  • trouble breathing
  • seizures
  • muscle weakness

If you think that you’ve taken too much donepezil, call your doctor or poison control center, or go to the emergency room right away. You may be given a medicine like atropine to reverse these effects of taking too much of this drug.

What to do if you miss a dose

If you miss a dose of donepezil, skip that dose. Wait and take your next scheduled dose at its usual time.

Don’t take two doses at the same time to make up for the missed dose. If you miss taking donepezil for 7 days or more, talk with your doctor before you start taking it again.

How to tell if the drug is working

You may be able to tell that this drug is working if your mental function and ability to do daily tasks improve.

Donepezil doesn’t cure Alzheimer's disease. Symptoms of Alzheimer's disease get worse over time, even if you take donepezil.

Donepezil is used for long-term treatment.

Don’t split, crush, or chew the 23 mg tablets

Donepezil oral disintegrating tablet (ODT) melts on your tongue. Drink water after the tablet melts to make sure that you’ve taken the full dose of the medication.

Store this drug at room temperature

Keep it from 59–86°F (15–30°C).

Keep this drug away from extremes in temperature, such as very cold or very hot.

Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Keep donepezil and all medicines out of the reach of children.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Before starting and during treatment with donepezil, your doctor may check the following:

  • stomach ulcer or bleed: This drug can increase stomach acid, which raises the chance of stomach ulcers and bleeding. You and your doctor should monitor for the following symptoms:
    • heartburn
    • stomach pain that won’t go away
    • nausea or vomiting
    • blood in your vomit or dark-colored vomit that looks like coffee grounds
    • bowel movements that look like black tar
  • weight. Some people lose their appetite and lose weight while taking this drug.

Not every pharmacy stocks donepezil 23-mg strength

When filling your prescription, be sure to call ahead.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for the 23-mg strength of donepezil.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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How Much Does donepezil Cost?

Oral tablet

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These prices represent the lowest priced national pharmacies for donepezil on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 31, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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