Donepezil

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Aricept, Donepezil; Belgium: Aricept; Bulgaria: Aricept; Cyprus: Aricept; Czech Republic: Adonep, Alzhedon, Alzil, Aricept, Calofra, Donepezil, Donpethon, Landex, Promemore, Tolerdilan, Yasnal; Denmark: Aricept, Memac; Estonia: Andepezil, Aricept, Donecleus, Donepezil, Donesyn, Yasnal, Zolpezil; Finland: Aricept, Donepezil, Doneprion, Doneratio, Dopezon, Mikzil, Yasnal; France: Aricept; Germany: Aricept, Donebacher, Donelb, Donemed, Donepedura, Donepegen, Donepezil, Donesyn, Donethon, Donetifi, Kibilis, Memac, Neuristor, Synpezil; Greece: Aricept, Aripezil, Dementis, Donelet, Donepezil, Donopez, Dozilax, Hania, Kibilis, Nepezil, Pezale, Razil, Tactrol; Hungary: Alzepil, Aricept, Cognezil, Donecept, Donectil, Donepezil, Donesyn, Palixid, Yasnal; Ireland: Aricept, Aripez, Aripil, Dentap, Donecept, Donelinn, Donepezil, Donesyn, Dozept; Italy: Aricept, Memac; Latvia: Alzepil, Aricept, Donepezil, Donesyn, Yasnal; Lithuania: Alzepil, Aricept, Donepezil, Donesyn, Memofit, Yasnal, Zopezil; Luxembourg: Aricept; Malta: Aricept, Donecept; Poland: Alzdone, Alzepezil, Aricept, Cogiton, Cognezil, Donecept, Donectil, Donemed, Donepex, Donepezil, DoneSan, Donesyn, Donethon, Memocept, Pezilgen, Redumas, Symepezil, Yasnal; Portugal: Alkimus, Alzibran, Aricept, Damzipil, Dilpeze, Dizil, Dolizi, Donepezilo; Romania: Aldemiz, Alzepil, Aricept, Cogiton, Cognezil, Davia, Denemar, Donecept, Donedim, Donepezil, Donesyn, Pridia, Tolerdilan, Tuadin, Yasnal, Zildon; Slovakia: Adonep, Aricept, Calofra, Cognezil, Donepezil, Donesyn, Landex, Napezacta, Yasnal; Slovenia: Alzepil, Aricept, Donepezilijev, Yasnal; Spain: Aricept, Donepezil, Donezepilo; Sweden: Aricept, Azepezil, Donepe, Donepegen, Donepezil, Doneprion, Doneratio, Donezil, Penzondil; UK: Aricept.

North America

Canada: Aricept; USA: Aricept, Donepezil.

Latin America

Argentina: Alzaimax, Cebrocal, Crialix, Cristaclar, Donepes, Donnox, Donzeimer, Endoclar, Eranz, Lirpan, Oldinot, Onefin, Valpex; Brazil: Eranz.

Asia

Japan: Aricept.

Drug combinations

Chemistry

Donepezil Hydrochloride: C~24~H~29~NO~3~ HCl. Mw: 415.95. (±)-2-[(1-Benzyl-4-piperidyl)methyl]-5,6-dimethoxy-1-indanone hydrochloride. CAS-142057-77-0; CAS-120014-06-4 (donepezil)(1997).

Pharmacologic Category

Parasympathomimetic (Cholinergic) Agents; Acetylcholinesterase Inhibitor (Central). Anti-Dementia Agents; Cholinesterase Inhibitors. (ATC-Code: N06DA02).

Mechanism of action

Donepezil, a piperidine derivative, is a centrally active, reversible acetylcholinesterase inhibitor. The precise mechanism(s) of action of donepezil in dementia of the Alzheimer’s type (Alzheimer’s disease) have not been fully elucidated. The drug reversibly and noncompetitively inhibits centrally-active acetylcholinesterase. This appears to result in increased concentrations of acetylcholine available for synaptic transmission in the CNS.

Therapeutic use

Used for the palliative treatment of mild to moderate dementia of the Alzheimer’s type (Alzheimer’s disease, presenile or senile dementia). Donepezil is not a cure for Alzheimer’s disease, but may slow the progression of symptoms.

Pregnancy and lactiation implications

Teratogenic effects not observed in animal studies. There are no adequate, well-controlled studies in pregnant women. Not indicated for use in nursing women.

Unlabeled use

ADHD. Behavioral syndromes in dementia. Mild-to-moderate dementia associated with Parkinson’s disease. Lewy body dementia.

Contraindications

Hypersensitivity to donepezil, piperidine derivatives, or any component of the formulation.

Warnings and precautions

May cause diarrhea, nausea, and/or vomiting, which may be dose-related. Potential for increased gastric acid secretion. Cholinesterase inhibitors may produce bradycardia and/or heart block with or without history of cardiac disease. Syncope reported. Use with caution in the following cases: sick-sinus syndrome, bradycardia, or conduction abnormalities, risk of ulcer disease (may increase gastric acid secretion), history of asthma or obstructive pulmonary disease, history of seizure disorder, bladder outlet obstruction, or prostatic hyperplasia. Potential for exaggerated succinylcholine-type muscle relaxation during anesthesia. Cholinomimetic agents may have the potential to cause generalized seizures (seizures also may be a manifestation of Alzheimer’s disease).

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