From the Guidelines
Aricept (donepezil) is associated with gastrointestinal side effects, including nausea, vomiting, diarrhea, and loss of appetite, which are the most common side effects, as reported in a study published in the Annals of Internal Medicine 1. These symptoms often improve after a few weeks as the body adjusts. Other frequent side effects include:
- Headaches
- Dizziness
- Insomnia
- Fatigue
- Muscle cramps
- Increased urination More serious but less common side effects can include:
- Slow heart rate (bradycardia)
- Fainting
- Seizures
- Difficulty urinating
- Gastrointestinal bleeding Some patients may experience vivid dreams or nightmares. Side effects are typically dose-dependent, with higher doses (such as 10mg versus 5mg) causing more pronounced effects, as shown in a study published in the Annals of Internal Medicine 2. These side effects occur because Aricept increases acetylcholine levels in the brain and body by inhibiting the enzyme acetylcholinesterase. While this helps improve cognitive function in Alzheimer's disease, it also affects acetylcholine receptors throughout the body, leading to these various side effects. If side effects are severe or persistent, patients should consult their healthcare provider, as dosage adjustments or medication changes may be necessary rather than discontinuing the medication abruptly, as suggested in a study published in the American Family Physician 3. The most recent and highest quality study, published in the Annals of Internal Medicine 1, reported that diarrhea and nausea were the most frequent side effects, with relative risks of 2.57 and 2.54, respectively. Overall, the side effects of Aricept should be carefully monitored and managed to minimize their impact on the patient's quality of life.
From the FDA Drug Label
Donepezil hydrochloride tablets may cause the following serious side effects: slow heartbeat and fainting. This happens more often in people with heart problems. more stomach acid. This raises the chance of ulcers and bleeding, especially when taking donepezil hydrochloride tablets 23 mg The risk is higher for people who have had ulcers, or take aspirin or other NSAIDs. worsening of lung problems in people with asthma or other lung disease. seizures. difficulty passing urine. The most common side effects of donepezil hydrochloride tablets are: nausea diarrhea not sleeping well vomiting muscle cramps feeling tired not wanting to eat
The possible side effects of Aricept (donepezil hydrochloride tablets) include:
- Serious side effects: + Slow heartbeat and fainting + Increased stomach acid, which can lead to ulcers and bleeding + Worsening of lung problems in people with asthma or other lung disease + Seizures + Difficulty passing urine
- Common side effects: + Nausea + Diarrhea + Not sleeping well + Vomiting + Muscle cramps + Feeling tired + Not wanting to eat 4
From the Research
Aricept Side Effects
- Initial side effects of Aricept (donepezil) include: + Nausea + Vomiting + Diarrhoea + Insomnia + Muscle cramps + Fatigue + Anorexia + Syncope 5
- Caution is advised in patients with bradycardia when taking Aricept 5
- Aricept is generally safe and well tolerated, with fewer patients withdrawing due to adverse events compared to other cholinesterase inhibitors such as rivastigmine and galantamine 6
- The incidence of gastrointestinal adverse events is lower with Aricept compared to rivastigmine and galantamine 6
- Non-gastrointestinal adverse events, such as CNS and cardiovascular events, occur at a low frequency and have a similar incidence across different cholinesterase inhibitors 6
Long-term Safety and Tolerability
- Long-term use of Aricept has been found to be safe and well tolerated, with improvements in cognitive performance and stabilization of functional abilities in patients with mild-to-moderate Alzheimer's disease 7, 8
- Aricept may also lessen caregiver burden and have a positive impact on patients' quality of life, although more data are needed to confirm these effects 8, 9