Donepezil is indicated for the treatment of dementia of the Alzheimer’s type.

Alzheimer's Disease

• Mild to Moderate Alzheimer’s Disease - 5 mg or 10 mg administered once daily 
• Moderate to Severe Alzheimer’s Disease - 10 mg or 23 mg administered once daily 
• A dose of 10 mg once daily can be administered once patients have been on a daily dose of 5 mg for 4 to 6 weeks. A dose of 23 mg once daily can be administered once patients have been on a dose of 10 mg once daily for at least 3 months.

The most common adverse reactions were-

• nausea
• vomiting
• diarrhea
• dizziness
• headache
• decreased appetite
• muscle cramps
• fatigue
• insomnia

Nausea

Headache

Anorexia

Diarrhea

• Cholinesterase inhibitors are likely to exaggerate succinylcholine type muscle relaxation during anesthesia
• Cholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes manifesting as bradycardia or heart block
• Donepezil can cause vomiting.  Patients should be observed closely at initiation of treatment and after dose increases 
• Patients should be monitored closely for symptoms of active or occult gastrointestinal (GI) bleeding, especially those at increased risk for developing ulcers
• The use of Donepezil in a dose of 23 mg once daily is associated with weight loss
• Cholinomimetics may cause bladder outflow obstructions
• Cholinomimetics are believed t o have some potential to cause generalized convulsions
• Cholinesterase inhibitors should be prescribed with care to patients with a history of asthma or obstructive pulmonary disease