Aricept

Donepezil alone
1. Donepezil Hydrochloride Tablet (or ODT): 5 mg, 10 mg
2. Donepezil Extended Release: 23 mg
Donepezil combination with Memantine (Namenda)
1. Donepezil Hydrochloride AND Memantine hydrochloride: 10 mg/7 mg, 10 mg/14 mg, 10 mg/21 mg, 10 mg/28 mg
2. Donepezil Hydrochloride AND Memantine Extended Release (Namzaric): 10 mg/14 mg, 10 mg/28 mg

Start at 5 mg orally at bedtime
Increase to 10 mg orally at bedtime after 4-6 weeks
May increase to the sustained release 23 mg orally at bedtime after 3 weeks at 10 mg dose
1. However, may be no more effective than 10 mg dose (and with greater adverse effects)

See Acetylcholinesterase Inhibitor
No hepatotoxicity
Cardiovascular
1. Syncope
2. QTc Prolongation (and Torsades de Pointes)
  1. Have been reported for Aricept (but not other Acetylcholinesterase Inhibitors)
3. Atrioventricular Block
4. Bradycardia
Gastrointestinal
1. Diarrhea
2. Nausea or Vomiting
3. Decreased appetite and Weight loss
Neuropsychiatric
1. Headache
2. Myalgias
3. Dizziness and Fall Risk
4. Somnolence
5. Vivid dreams

See Acetylcholinesterase Inhibitor
Generic Aricept is the least expensive of the Cholinesterase Inhibitors ($11 for 30 tablets in 2017)
1. Most commonly prescribed Acetylcholinesterase Inhibitor
2. As effective as Cognex (without the hepatotoxicity risk)
Mini-Mental Status Exam changes
1. Reduces decline by 3 points in 6 months
2. Patient reverts to prior decline with Drug Withdrawal
May be preferred over Galantamine
1. Appears more effective than Galantamine
2. Better tolerated than Galantamine
3. Lanctot (2003) CMAJ 169:557-64 [PubMed]
Long-term use of Donepezil has minimal to no effect
1. Does not prevent Nursing Home placement
2. Minimally improves cognition
3. Does not protect against longterm functional decline
4. Courtney (2004) Lancet 363:2105-15 [PubMed]