What is Aricept used for?
- Mild to moderately severe Alzheimer's dementia.
Aricept only slows the worsening of Alzheimer's disease, rather than being a cure. As a result, your doctor will want to re-assess the patient after they have been taking the medicine for two to four months at the maintenance dose. If there has been no improvement in their symptoms, or they continue to deteriorate, your doctor may decide it is not worth continuing the medicine. For patients who continue treatment, the benefit of the medicine should be reassessed on a regular basis. The medicine should be stopped when it is considered that it is no longer providing a beneficial effect.
The benefit of this medicine in treating dementia or memory loss that are due to causes other than Alzheimer's disease has not been demonstrated. It should only be used to treat dementia that has been confirmed as Alzheimer's disease by a doctor experienced in treating Alzheimer's.
How does Aricept work?
Aricept tablets and Aricept Evess tablets both contain the active ingredient donepezil hydrochloride, which is a type of medicine called an acetylcholinesterase inhibitor. Donepezil tablets are also available without a brand name, ie as the generic medicine. Donepezil works by slowing the breakdown of a compound in the brain called acetylcholine.
Acetylcholine is a natural compound known as a neurotransmitter. Neurotransmitters are stored in nerve cells in the brain and nervous system, and are involved in transmitting messages between the nerve cells. They are necessary for the normal functioning of the brain and nervous system. Acetylcholine in the brain is continually being released by nerve cells and then broken down by another natural chemical called acetylcholinesterase.
One of the features of Alzheimer's disease appears to be a lower than normal level of acetylcholine in the brain. This is due in part to degeneration of brain cells, in particular those that normally release acetylcholine.
Donepezil increases the level of acetylcholine in the brain. It does this by preventing the action of acetylcholinesterase, the compound that normally breaks it down. This slows the breakdown of acetylcholine that is released from remaining undamaged nerve cells in the brain.
The result of this is increased activity of acetylcholine in the brain. This improves the cognitive processes of thinking, learning and memory, and improves the symptoms of dementia and daily functioning in Alzheimer's disease.
How do I take Aricept?
- Treatment with Aricept is usually started with one 5mg tablet taken once daily at bedtime. After four weeks your doctor may decide to increase the dose to one 10mg tablet daily at bedtime.
- Aricept can be taken either with or without food.
- Aricept film-coated tablets should be swallowed whole with a drink of water.
- Aricept Evess tablets (orodispersible) should be placed on the tongue, where they disintegrate in the saliva and can then be swallowed either with or without a drink of water.
- If you forget to take a dose a bedtime you should just leave out that dose and take your next dose as usual the following bedtime. Do not take a double dose to make up for a missed dose.
- If you forget to take your medicine for more than one week, contact your doctor before taking any more medicine.
Important information about Aricept
- A doctor will only prescribe this medicine if the patient has a caregiver available who will regularly make sure that the patient is taking the medicine.
- This medicine may cause fatigue, dizziness and muscle cramps, particularly when starting treatment or increasing the dose. As a result it may reduce the patient's ability to perform potentially hazardous tasks safely.
- Stop using this medicine and consult your doctor immediately if the patient experiences the following symptoms, as they may be caused by a rare but serious side effect of this type of medicine, called the neuroleptic malignant syndrome: high temperature (fever), pale complexion, sweating, muscle stiffness, fast heartbeat and decreased consciousness.
Aricept should be used with caution in
- People with decreased liver function.
- People with poor control of the working of the heart (sick sinus syndrome).
- People with disturbances in the heart's electrical message pathways (heart conduction defects, eg heart block).
- People with a history of peptic ulcer.
- People taking long-term non-steroidal anti-inflammatory drugs (NSAIDs) eg diclofenac, ibuprofen, naproxen.
- People who have difficulty passing urine.
- People with parkinson's disease.
- People taking antipsychotic medicines.
- People with epilepsy.
- People with asthma.
- People with chronic obstructive pulmonary disease (COPD).
Aricept should not be used in
- Women who are breastfeeding.
- Aricept film-coated tablets contain lactose and are not suitable for people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Aricept Evess tablets do not contain lactose.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. It should not be used during pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
- It is not known if this medicine passes into breast milk. It should not be used by women who are breastfeeding. Seek medical advice from your doctor.
Possible side effects of Aricept
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Very common (affect more than 1 in 10 people)
Common (affect between 1 in 10 and 1 in 100 people)
- Loss of appetite.
- Aggressive behaviour.
- Abnormal dreams and nightmares.
- Difficulty sleeping (insomnia).
- Rash or itching.
- Muscle cramps.
- Urinary incontinence.
Uncommon (affect between 1 in 100 and 1 in 1000 people)
- Slow heart rate (bradycardia).
- Ulceration or bleeding in the stomach or intestines.
Rare (affect between 1 in 1000 and 1 in 10,000 people)
- Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects).
- Liver disorders, eg hepatitis.
- Slowed conduction of electrical messages between the chambers of the heart (atrioventricular block).
Very rare (affect fewer than 1 in 10,000 people)
- High temperature combined with falling levels of consciousness, paleness, sweating and a fast heart beat (neuroleptic malignant syndrome). This requires stopping the medicine and immediate medical treatment - see important information section above.
It is important to tell your doctor or pharmacist what medicines the patient is already taking, including those bought without a prescription and herbal medicines, before they start treatment with this medicine. Similarly, check with your doctor or pharmacist before any new medicines are taken with this one, to make sure that the combination is safe.
There may be an increased risk of a very rare side effect called the neuroleptic malignant syndrome if donepezil is taken in combination with antipsychotic medicines such as risperidone or olanzapine.
The following medicines may possibly increase the amount of donepezil in the blood, which could increase the risk of its side effects:
The following medicines may possibly decrease the amount of donepezil in the blood, which could make it less effective:
Other medicines containing donepezil as the active ingredient
Donepezil tablets and orodispersible tablets are also available without a brand name, ie as the generic medicine.