Donepezil (available in the US as Aricept® and generic, Aricept ODT® and generic, and Namzaric® in combination with memantine) is a reversible inhibitor of the enzyme acetylcholinesterase. Here is basic information about this medication.
Donepezil (Aricept, Aricept ODT)
FDA-approved indications
Treatment of mild, moderate, and severe Alzheimer’s disease
Dosage
1. Mild to moderate disease
Starting: 5 mg once daily in the evening just before going to bed
Maximum: 10 mg once daily, to be started only after the patient has been on 5 mg dose for 4-6 weeks
2. Moderate to severe disease
Starting: 5 mg once daily in the evening just before going to bed
Titration: 10 mg once daily, to be started only after the patient has been on 5 mg dose for 4-6 weeks
Maximum: 23 mg once daily, to be started only after the patient has been on 10 mg dose for at least 3 months.
Potential side effects
The most common side effects (defined as those occurring 5% or more of patients receiving 10 mg/day and twice as often as on placebo) were (Prescribing Information):
– Nausea
– Diarrhea
– Insomnia
– Vomiting
– Muscle cramps
– Fatigue
– Anorexia.
These adverse events were often transient and resolved while donepezil was continued without the need for a dose
reduction (Prescribing Information).
Instructions
1. May be taken with or without food.
2. The 23 mg tablet should not be split, crushed, or chewed.
3. Allow orally disintegrating tablet (ODT) to dissolve on the tongue and follow with water.
Dosage forms and strengths
Tablets: 5 mg, 10 mg, and 23 mg
Orally disintegrating tablets: 5 mg and 10 mg
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Memantine and donepezil (Namzaric®) extended-release
Namzaric® is a combination of memantine hydrochloride, an NMDA receptor antagonist, and donepezil hydrochloride, an acetylcholinesterase inhibitor.
FDA-approved indications
Treatment of moderate to severe dementia of the Alzheimer’s type in patients stabilized on 10 mg of donepezil once daily
Dosage
1. For patients stabilized on donepezil 10 mg daily
Starting: 7 mg/10 mg (memantine/donepezil) taken once daily in the evening
Titration: Increase dosage in 7 mg increments with a minimum interval of at least one week between dose increases.
Maximum: 28 mg/10 mg
2. For patients stabilized on both memantine (10 mg twice daily or 28 mg extended-release once daily) and donepezil (10 mg once daily)
Switch to Namzaric® 28 mg/10 mg, taken once daily in the evening
3. In patients with severe renal impairment
Recommended maintenance dose is 14 mg/10 mg once daily in the evening
Instructions
May be taken with or without food, whole or sprinkled on applesauce
Capsule should not be divided, chewed, or crushed
Dosage forms and strengths
Extended-Release Capsules:
7 mg memantine hydrochloride and 10 mg donepezil hydrochloride
14 mg memantine hydrochloride and 10 mg donepezil hydrochloride
21 mg memantine hydrochloride and 10 mg donepezil hydrochloride
28 mg memantine hydrochloride and 10 mg donepezil hydrochloride
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Related Pages
Tips for interviewing patients with dementia
Neuroimaging in persons with dementia
Key points from the APA Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia
Neurocognitive disorders: Classification (Free)
References
Donepezil (Aricept®, Aricept ODT®) prescribing information
Memantine and donepezil (Namzaric®) extended-release capsules prescribing information
Copyright 2016, Rajnish Mago, MD. All rights reserved. May not be reproduced in any form without express written permission.
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