What is patient education on Aricept (donepezil)?

Patient Education on Donepezil (Aricept)

Patients taking donepezil (Aricept) should be instructed to take the medication once daily, preferably in the morning to minimize sleep disturbances, with or without food, and should be informed about common side effects including gastrointestinal symptoms, muscle cramps, and potential sleep disturbances. 1, 2

Administration Instructions

• Take donepezil only once per day as prescribed, either with or without food 2
• Morning administration is recommended rather than bedtime dosing to minimize sleep disturbances 1, 3
• Standard dosing starts at 5 mg daily, potentially increasing to 10 mg after 4-6 weeks if tolerated 1, 4
• Donepezil 23 mg tablets (for moderate to severe Alzheimer's) should be swallowed whole without splitting, crushing, or chewing 2

Common Side Effects to Monitor

• Gastrointestinal symptoms are the most common adverse effects:
  • Nausea and vomiting (relative risk 2.54) 4
  • Diarrhea (relative risk 2.57) 4, 2
  • Anorexia/decreased appetite (relative risk 3.21) 4, 2
• Other common side effects include:
  • Insomnia and sleep disturbances, especially with bedtime dosing 2, 5
  • Muscle cramps, particularly leg cramps 1, 4
  • Fatigue 2, 5
  • Dizziness (relative risk 1.47) 4

Managing Side Effects

• Most gastrointestinal side effects are dose-dependent, with higher incidence at 10 mg compared to 5 mg 1, 4
• Side effects are typically mild to moderate and often transient, improving after the first few weeks of therapy 4, 6
• Taking the medication in the morning rather than at bedtime can help minimize sleep disturbances 1
• If side effects are problematic, discuss with healthcare provider before stopping the medication 1, 4

Important Monitoring Points

• Unlike some older medications for Alzheimer's disease, donepezil does not cause liver toxicity and does not require liver function monitoring 4, 6
• Patients should report any significant weight loss, as this can be associated with higher doses 1
• Patients with a history of cardiac conditions should be monitored for potential bradycardia (slow heart rate) 5

Medication Adherence Tips

• Take at the same time each day to maintain consistent blood levels 1
• Use pill organizers or reminder systems to help maintain the once-daily regimen 1
• Do not stop taking donepezil suddenly without consulting your healthcare provider 1, 4
• Inform healthcare providers about all other medications being taken to avoid potential drug interactions 4

When to Contact Healthcare Provider

• If experiencing severe or persistent gastrointestinal symptoms 4, 2
• If new or worsening sleep problems occur 1, 2
• Before any surgical procedures, as donepezil may interact with certain anesthesia medications 2
• If pregnant or planning to become pregnant 2