💊 Donepezil (Donepezil)
Donepezil is an oral medicine for treating dementia of the Alzheimer's type. Efficacy has been shown in mild, moderate, and severe Alzheimer's disease. Your doctor sets the dose, and the drug does not alter the course of the underlying disease.
In Arabic: دونيبيزيل (هيدروكلوريد الدونيبيزيل)
✅ What it is used for
- Treatment of dementia of the Alzheimer's type (mild, moderate, and severe)
🧪 Active ingredient
The active ingredient is donepezil hydrochloride, a reversible inhibitor of acetylcholinesterase. It increases acetylcholine concentration and enhances cholinergic function.
🌿 Benefits
- Helps treat symptoms of dementia in Alzheimer's disease across stages
- Taken once daily
- Absorption is not affected by food
📝 How to use
- Your doctor or pharmacist sets the right dose for you; do not change it on your own.
- The tablet is usually taken once daily in the evening, just before bedtime.
- It can be taken with or without food.
- The dose is increased only by your doctor, after a set period on the lower dose.
💊 Dosage forms
- Film-coated tablets 5 mg (white, round)
- Film-coated tablets 10 mg (yellow, round)
⚠️ Common side effects
- Nausea
- Diarrhea
- Insomnia
- Vomiting
- Muscle cramps
- Fatigue
- Loss of appetite
🚨 Serious — seek medical help
- Slow heart rate, fainting, or heart block
- Gastrointestinal bleeding or stomach ulcers
- Weight loss (with the 23 mg dose)
- Difficulty urinating
- Seizures
- Worsening in people with asthma or obstructive lung disease
⛔ Do not use if
- Known hypersensitivity to donepezil hydrochloride or to piperidine derivatives
❗ Warnings & precautions
- May exaggerate muscle relaxation from succinylcholine-type drugs during anesthesia; tell your doctor you take it before any procedure.
- May cause slow heart rate or heart block; fainting episodes have been reported.
- Can cause nausea and vomiting, more often at higher doses; close observation at start and after dose increases.
- Watch for signs of GI bleeding, especially if at higher risk of ulcers.
- The 23 mg daily dose is associated with weight loss.
- May cause bladder outflow obstruction and may cause seizures.
- Use with care in patients with a history of asthma or obstructive pulmonary disease.
🔄 Drug interactions
- Anticholinergic medicines: donepezil may interfere with their activity.
- Succinylcholine and similar neuromuscular blockers: a synergistic effect may be expected.
- Cholinergic agonists such as bethanechol, and other cholinesterase inhibitors: a synergistic effect may be expected.
🤰 Pregnancy
There are no adequate data on use in pregnant women. In animal studies, no developmental toxicity was seen during organogenesis, but giving it to rats in late pregnancy and during lactation increased stillbirths and decreased offspring survival. Consult your doctor before use.
🍼 Breastfeeding
There are no data on whether donepezil passes into human milk or on its effects on the infant or milk production. The benefits of breastfeeding should be weighed against the mother's need for the drug, with your doctor.
🧒 Children
Safety and effectiveness in pediatric patients have not been established.
👴 Older adults
Alzheimer's disease occurs mainly in people over 55; the mean age in the studies was 73 years. No clinically significant differences were seen in most adverse reactions between patients aged 65 and over and younger patients.
🌡️ Storage
Store at 20° to 25°C (68° to 77°F). Do not use if the blister is torn or broken.
⏰ Missed dose
The label gives no specific instructions for a missed dose; ask your doctor or pharmacist.
🆘 Overdose
Overdose can cause cholinergic crisis: severe nausea and vomiting, salivation, sweating, slow heart rate, low blood pressure, respiratory depression, collapse, and convulsions; increasing muscle weakness may occur. Contact a Poison Control Center or seek emergency care immediately.
💰 Price & brands in your area
🏛️ Official price in Palestine — Ministry of Health price list:
| Product | Company | Pack | Price |
|---|---|---|---|
| Donepezil Teva 10mg Donepezil | Teva | 30 TAB | 66 ₪ |
| Donepezil Teva 5mg Donepezil | Teva | 30 TAB | 66 ₪ |
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Mechanism of action
Reversible acetylcholinesterase inhibitor that raises acetylcholine by inhibiting its hydrolysis, enhancing cholinergic neurotransmission. No evidence it alters the underlying dementing process. Half-life about 70 hours; metabolized by CYP2D6 and CYP3A4 and glucuronidation; about 96% protein bound.
Labeled dosing
Mild to moderate AD: start 5 mg once daily in the evening before retiring; maximum 10 mg/day; 10 mg only after 4 to 6 weeks on 5 mg. Moderate to severe AD: maximum 23 mg/day; 23 mg only after at least 3 months on 10 mg. May be taken with or without food. The dose is set by the physician.
- GI effects are more frequent at 10 mg than 5 mg and at 23 mg than 10 mg; nausea 11.8% vs 3.4% when moving from 10 to 23 mg.
- Overdose management: supportive care; IV atropine 1.0 to 2.0 mg initially, then per clinical response.
- It is not known whether dialysis removes donepezil or its metabolites.
🎓 Key points for students
- Mechanism: reversible acetylcholinesterase inhibition raising acetylcholine.
- Efficacy shown in mild, moderate, and severe Alzheimer's disease.
- Half-life about 70 hours; steady state within 15 days.
- Metabolized by CYP2D6, CYP3A4, and glucuronidation.
- Common adverse effects are cholinomimetic: nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue, anorexia.
- Antidote for overdose: atropine.
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What is donepezil used for?
It treats dementia of the Alzheimer's type in mild, moderate, and severe stages.
When should I take it?
Usually once daily in the evening before bedtime, with or without food, as set by your doctor.
What are the common side effects?
Nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue, and loss of appetite.
Does it cure Alzheimer's disease?
There is no evidence it alters the course of the underlying disease; it enhances cholinergic function.
Can children use it?
Safety and effectiveness in children have not been established.
⚕️ For education only — not a substitute for advice from your doctor or pharmacist. Do not start or stop any medicine without advice. Source: official FDA drug label via openFDA (2025-09), simplified. Updated: 2026-11-11.