Aricept

Aricept (donepezil) treats Alzheimer's symptoms. Acetylcholinesterase inhibitor boosts acetylcholine for memory/cognition. Effective slow decline mild-severe Alzheimer's.

Development/Approval History

Eisai/Pfizer developed, FDA 1996. Widely prescribed Alzheimer's efficacy trials; cornerstone dementia treatment.

Main Benefits/Properties

Benefits

Boosts cognition Alzheimer's.
Manages memory loss/confusion/daily activities difficulty.
Enhances quality patients/caregivers.

Unique

Long half-life once-daily compliance.
Forms: Tablets/disintegrating flexible.
Efficacy mild-severe versatile.

Efficacy

Vs. Similar

Vs rivastigmine/galantamine: Better effects/tolerated.
Significant cognition/daily improvements, often surpass.
Confirmed trials/real-world preferred.

Safety/Acceptance

Info

Tolerated; common GI nausea/diarrhea/vomit, insomnia/cramps.

Serious rare: Slow heart, faint, severe cramps. Monitor long-term.

Suitable long-term, follow-ups essential.

Uses

Treated

Alzheimer's mild/moderate/severe.
Dementia Alzheimer's associated.

Description

Alzheimer's: Progressive neurodegeneration memory/cognitive/behavior.
Dementia: Symptoms affect memory/think/social daily interfere.
Boosts acetylcholine, improves nerve communication, alleviates symptoms.

Symptoms/Indications

Memory loss first.
Confusion/think/reason difficulty, problem-solve/plan impact.
Daily activities challenges finances/cook/hygiene.
Behavior: Irritability/anxiety/depression up.

Help Symptoms

Inhibits acetylcholinesterase, boosts acetylcholine, enhances transmission.

Improves neurotransmitter, reduces decline memory/confusion, boosts function.

Patients: Better communicate/perform/reduce behavior, quality up.

Dosing/Usage

Dose/Intake

Adult

Start 5 mg daily bedtime; up 10 mg after 4-6 weeks response/tolerate. Some 23 mg severe.

Child

Not recommended kids; safety/efficacy not established.

Special Elderly/Comorbid

Elderly/liver: Monitor/adjust avoid adverse; start low, gradual.

Timing

Optimal

Once daily bedtime minimize nausea/dizzy.

Frequency

Once daily.

Food Effect

With/without; with reduce GI nausea/upset.

Tips

Instructions

Tablets full water.

Disintegrating: Dissolve tongue, swallow with/without water.

Action

Description

Main

Inhibits acetylcholinesterase, prevents acetylcholine breakdown.

Boosts levels, enhances transmission.

Targets

Acetylcholinesterase breaks acetylcholine synapses brain.

Biochem

Metabolic

Inhibits, boosts acetylcholine, enhances neurotransmission cognition.

Changes

Boosted acetylcholine improves neurons communicate, memory/learn.

Physio

Organ/System

Affects CNS cholinergic, enhances memory/cognition/brain function.

Therapeutic

Cognition improve.
Slow symptom progression.
Better daily management.

Ingredients

Active

Main

Donepezil hydrochloride.

Mechanism

Inhibits acetylcholinesterase, boosts acetylcholine, improves neurons communicate/cognition.

Role Treatment

Manages Alzheimer's symptoms, boosts memory/cognition neurotransmitter.

Excipients

List

Lactose monohydrate
Corn starch
Microcrystalline cellulose
Hydroxypropyl cellulose
Magnesium stearate
Talc
Polyethylene glycol

Function

Lactose: Filler
Starch: Disintegrant
Cellulose: Binder
Hydroxypropyl: Binder
Stearate: Lubricant
Talc: Anti-caking
Glycol: Solubilizer

Impact

Stability/efficacy/manufacture; enhance bioavailability, improve ingest experience.

Effects

Introduction

Understand effects safe/effective; tolerated, aware aids manage.

Potential

Common

Nausea
Diarrhea
Insomnia
Cramps
Fatigue

Less

Vomit
Appetite loss
Weight loss
Urinate frequent

Serious

Slow heart
Faint
GI bleed
Seizures

Frequency/Severity

Common

Mild-moderate, resolve adjust.

Less

May need attention persist/worsen.

Serious

Immediate intervention; stop/seek emergency.

Avoiding

Introduction

Prevent enhances compliance/effectiveness; measures/lifestyle mitigate.

Tips

Measures

Follow dose, no abrupt; report unusual immediately.

Tolerance

With food GI reduce; hydrate/balanced support; activity manage fatigue/cramps.

Restrictions

Introduction

Understand avoid harmful, ensure safe.

Conditions

List

Hypersensitivity donepezil/excipients
Severe liver
Pregnancy/lactation without supervise
GI bleed/ulcers history

Description

Hypersensitivity: Risk reactions.

Missed

Actions

Take remembered unless near next, skip/resume; no double.

Handling

Consistent routine minimize.

Tips Schedule

App/alarm; visible schedule; organizer track.

Interaction

Introduction

Understand prevent adverse/enhance efficacy; discuss meds provider.

Examples

List

NSAIDs
Anticholinergics
Antifungals (ketoconazole)
Antidepressants (SSRIs)

Effects

NSAIDs: GI bleed risk
Anticholinergics: Reduce effectiveness
Antifungals: Up levels toxicity
Antidepressants: Up effects dizzy/confusion

Avoid Negative

Safe Use

Inform all meds/OTC/supplements; no start/stop without; review regularly manage.

Overdose

Signs

Main

Severe nausea/vomit
Drool excessive
Sweat/bradycardia
Respiratory depression
Seizures

Mild/Serious

Mild: GI discomfort/headache

Serious: Weak/loss consciousness/respiratory

Actions Suspected

Measures

Emergency; charcoal if advised.

Seek Help

Immediate severe; detail dose/timing professionals.

Kinetics

Uptake

Rate/Extent

Well oral; peaks 3-4 hours.

Factors

Food no significant, flexible meals.

Spread

Body

Wide including brain; high plasma bind.

Breakdown

Pathways

Liver CYP450 mainly 3A4/2D6; active/inactive metabolites.

Impact

Affects duration/elimination.

Removal

Routes

Urine metabolites; small feces.

Half-Life/Factors

~70 hours daily; liver impact rate.

Forms

Available

List

Tablets: 5/10 mg
Disintegrating: 5/10 mg
Extended: 23 mg

Advantages

Tablets: Easy swallow/stable
Disintegrating: Convenient swallow difficulty, quick dissolve
Extended: Higher severe once-daily

Pregnancy/Breastfeeding

Safety

Risks Mother/Child

Category C: Risk not ruled, use if benefits justify fetal.

Limited pregnancy data weigh benefits/risks.

Unknown milk excrete, caution breastfeeding.

Research

Animal adverse high doses, no well-controlled women.

Potential adverse nursing, decide discontinue nursing/drug per importance.

Recommendations

Pregnancy

Only needed/prescribed; monitor/consult manage risks.

Breastfeeding

Consult before; alternatives if possible.

If necessary, monitor infant adverse/consult pediatrician.

Storage

Recommendations

General

Room 20-25°C, original closed.

Place

Dry away moisture/light; out child/pet.

Conditions

Temperature

Stable ensure efficacy/longevity; no fluctuations bathrooms/sinks.

Protection

Away direct sun/moisture degrade.

Shelf/Opening

No past expiry; follow pharmacist/provider instructions opening.

Trials/Efficacy

Overview

Description

Extensive trials efficacy/safety Alzheimer's; randomized double-blind placebo mild/moderate/severe.

Methods/Design

Assess cognition/daily/global scales; monitor effects/reactions extended.

Results/Conclusions

Efficacy

Improvements cognition vs placebo
Enhanced daily
Slower progression

Comparison

Superior placebo multiple; comparable/better rivastigmine/galantamine.

Conclusions

Confirm effective Alzheimer's, improve cognition/quality.

Ongoing support use stages, robust evidence.

Conclusion

Summary Key

Highlights

Effective treat Alzheimer's symptoms, improve cognition/quality patients/caregivers.
Tolerated favorable safety long-term.
Versatile mild/moderate/severe.

Optimizing

Tips Treatment/Efficacy

Adhere prescribed dose/timing max benefits.
Monitor/report effects promptly.
Open communication provider adjust plans.

Final

Valuable manage Alzheimer's, benefits cognition/daily.

Proper use/monitor enhance quality patients/caregivers, cornerstone management.