Donepezil Hydrochloride (Agents for Alzheimer's Dementia)

Question 1

What is the brand name of donepezil hydrochloride?

Answer 1

Aricept

Question 2

What are the available tablet strengths for donepezil hydrochloride?

Answer 2

5 mg, 10 mg, 23 mg

Question 3

What are the available ODT tablet strengths for donepezil hydrochloride?

Answer 3

5 mg and 10 mg (Aricept ODT)

Question 4

What is the FDA approved indication in dosage for donepezil hydrochloride?

Answer 4

The treatment of mild, moderate and severe dementia of the Alzheimer’s type

Began with a dose of 5 mg at bedtime. Dosage may be increased after an initial period of 4 to 6 weeks to a daily dose of 10 mg given at bedtime. A dose of 23 mg once daily can be given after patients have been on a dose of 10 mg once daily for at least three months. As may be expected, cholinergic side effects are greater with a higher dose.

Question 5

What is the mechanism of action for Aricept?

Answer 5

Donepezil hydrochloride is a reversible acetylcholinesterase inhibitor that works centrally to increase the amount of acetylcholine available at cholinergic synapses.

Question 6

What are the drug interactions for donepezil hydrochloride?

Answer 6

• Clinical effects of CYP2D6 and 3A4 or not known. In vitro there is minimal effects on the metabolism of terfenadine and cisapride.
• The metabolism Aricept may be increased by phenytoin, carbamazepine, phenobarbital, rifampicin or dexamethasone, or decreased by ketoconazole or quinidine.

Question 7

What are the contraindications for Aricept?

Answer 7

• Contraindicated in patients with known hypersensitivity to donepezil or piperidine derivatives. It may be beneficial to discontinue usage prior to known anesthesia.
• May cause vagotonic attacks on the heart, therefore use caution in patients with sick sinus syndrome.
• May increase gastric acid secretion therefore use caution in patients problem to ulcers or G.I. bleeding.
• Use with caution in patients with asthma or obstructive pulmonary disease.
• Pregnancy Category C

Question 8

What are the adverse effects for donepezil hydrochloride?

Answer 8

The most common adverse effects or nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue, and anorexia. Rare but potentially serious adverse effects include rhabdomyolysis, QTc prolongation, Stevens Johnson syndrome and toxic epidermal necrolysis.

Question 9

What should the RPh tell the patient when they are counseled for Aricept?

Answer 9

• May be taken with or without food
• Take in the evening, just prior to retiring.
• If a dose is missed, skip it and return to normal dosing schedule. Do not double doses.