Pharm
Aricept
search
Aricept
, Donepezil
See Also
Acetylcholinesterase Inhibitor
Dementia
Dementia Management
Rivastigmine
(
Exelon
)
Galantamine
(
Reminyl
)
Mechanism
Acetylcholinesterase Inhibitor
Indications
Mild to Moderate
Dementia
(
Folstein MMSE
: 10-26)
Adverse Effects
See
Acetylcholinesterase Inhibitor
No hepatotoxicity
Syncope
and
Torsades de Pointes
(have been reported for Aricept, but not other
Acetylcholinesterase Inhibitor
s)
Dosing
Start at 5 mg orally at bedtime
Increase to 10 mg orally at bedtime after 4-6 weeks
Increase to 23 mg orally at bedtime after 3 weeks at 10 mg dose
Advantages
Gene
ric Aricept is the least expensive of the
Cholinesterase Inhibitor
s ($11 for 30 tablets in 2017)
Efficacy
See
Acetylcholinesterase Inhibitor
As effective as
Cognex
(without the hepatotoxicity risk)
Mini-Mental Status Exam
changes
Reduces decline by 3 points in 6 months
Patient reverts to prior decline with
Drug Withdrawal
May be preferred over
Galantamine
Appears more effective than
Galantamine
Better tolerated than
Galantamine
Lanctot (2003) CMAJ 169:557-64 [PubMed]
Long-term use of Donepezil has minimal to no effect
Does not prevent
Nursing Home
placement
Minimally improves cognition
Does not protect against longterm functional decline
Courtney (2004) Lancet 363:2105-15 [PubMed]
References
Epperly (2017) Am Fam Physician 95(12): 771-8 [PubMed]
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