Aricept


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Related to Aricept: Namenda

donepezil hydrochloride

Aricept

Pharmacologic class: Acetylcholinesterase inhibitor

Therapeutic class: Anti-Alzheimer's agent

Pregnancy risk category C

Action

Reversibly inhibits acetylcholinesterase hydrolysis in CNS, leading to increased acetylcholine level and temporary cognitive improvement in patients with Alzheimer's disease

Availability

Tablets: 5 mg, 10 mg, 23 mg

Tablets (orally disintegrating): 5 mg, 10 mg

Indications and dosages

Mild to moderate Alzheimer's disease

Adults: Initially, 5 mg P.O. daily. After 4 to 6 weeks, may increase dosage to 10 mg at bedtime.

Moderate to severe Alzheimer's disease

Adults: Initially, 10 mg P.O. daily. After 3 months, may increase dosage to 23 mg.

Contraindications

• Hypersensitivity to drug or piperidine derivatives

Precautions

Use cautiously in:
• cardiovascular disease, chronic obstructive pulmonary disease (COPD), asthma, or sick sinus syndrome
• patients at risk for developing ulcers, such as those with history of ulcer disease or those concurrently receiving NSAIDs
• pregnant or breastfeeding patients
• children (safety and efficacy not established).

Administration

• Give with or without food.
• For best response, give at bedtime.

Adverse reactions

CNS: headache, dizziness, vertigo, fatigue, depression, aggression, irritability, restlessness, nervousness, paresthesia, insomnia, abnormal dreams, tremor, aphasia, seizures

CV: chest pain, bradycardia, hypertension, hypotension, vasodilation, atrial fibrillation, heart block

EENT: cataracts, blurred vision, eye irritation, sore throat

GI: nausea, vomiting, diarrhea, anorexia, bloating, epigastric pain, fecal incontinence, GI bleeding

GU: urinary frequency, increased libido, bladder outflow obstruction

Metabolic: dehydration

Musculoskeletal: muscle cramps, arthritis, bone fracture

Respiratory: dyspnea, bronchitis

Skin: pruritus, urticaria, bruising, diaphoresis, rash, flushing

Other: toothache, decreased appetite, weight loss, hot flashes, influenza

Interactions

Drug-drug.Anticholinergics: reduced donepezil effects

Anticholinesterases, cholinomimetics: synergistic effects

Carbamazepine, dexamethasone, phenobarbital, phenytoin, rifampin: accelerated donepezil elimination

NSAIDs: increased risk of GI bleeding

Patient monitoring

Watch closely for increased bronchoconstriction in patients with history of asthma or COPD.
• Assess cardiovascular status. Drug may cause bradycardia from increased vagal tone.
• Monitor closely for signs and symptoms of GI ulcers and bleeding, especially if patient takes NSAIDs concurrently.

Patient teaching

• Advise patient to take drug at bedtime with or without food.
• Instruct patient to allow orally disintegrating tablet to dissolve under tongue and then follow with a glass of water.
• Tell patient not to split, crush, or chew 23-mg tablet.
• Inform patient that drug may slow the heart rate, leading to fainting episodes.

Instruct patient to immediately report signs or symptoms of GI ulcers ("coffee-ground" vomitus, black tarry stools, and abdominal pain), or irregular heartbeat.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.

Aricept

(âr′ə-sĕpt′)
A trademark for the drug donepezil hydrochloride.

Aricept®

Donepezil Neurology An agent that transiently slows the mental decline in Alzheimer's disease. See Alzheimer's disease.

Aricept

A brand name for DONEPEZIL.
References in periodicals archive ?
As per the report, the sale of Aricept 23mg in US were approximately $78 million for the 12 months ended June 2014.
The trial was a multi-center, randomized, double-blind, placebo controlled, parallel-group study to evaluate the efficacy and safety of Aricept 10 mg tablets in 313 Chinese patients with severe AD.
I tried Exylon and it didn't work for me, I had no quality of life at all and felt sick all the time, but with Aricept I feel brilliant.
In the last year alone, Aricept earned Eisai about $3.
Aricept is at the centre of controversy over a decision which prevents patients with early symptoms having access to it on the NHS.
As previously announced, Eisai filed the infringement actions in December 2005 contesting Teva's submission of an abbreviated new drug application to the FDA for Aricept.
Last year Nice, backed by an appeal panel, decided that Aricept, Reminyl and Exelon should no longer be made available on the NHS in the early stages of Alzheimer's.
It has been a long journey, but a slower one thanks to Aricept - a revolutionary drug which has been proven to prolong the mental health of sufferers.
THE NHS watchdog has withdrawn the drug Aricept which families say helps Alzheimer's patients live a better life.
More than 500 patients with severe AD were studied; the data showed that those treated with Aricept performed better on cognitive functioning and overall functioning measures, compared with those taking placebo, according to the Food and Drug Administration.
Alan, a retired school caretaker, has been prescribed Aricept after being diagnosed with Alzheimer's four years ago.
Nice rejected an appeal last month over its guidance that states that sufferers with early or late stage Alzheimer's disease should not have access to Aricept (donepezil), Reminyl (galantamine) or Exelon (rivastigmine).