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1 NSAIDs; History of seizures; History of asthma or obstructive pulmonary disease; OB,

Lactation, Pedi: Safety not established; assumed to be secreted in breast milk. Dis-
PDF Page #1
donepezil (doe-nep-i-zill) continue drug or bottle-feed.
Aricept, Aricept ODT Adverse Reactions/Side Effects
Classification CNS: headache, abnormal dreams, depression, dizziness, drowsiness, fatigue, in-
Therapeutic: anti-Alzheimer’s agents somnia, syncope, sedation (unusual). CV: atrial fibrillation, hypertension, hypoten-
Pharmacologic: cholinergics (cholinesterase inhibitors) sion, vasodilation. GI: diarrhea, nausea, anorexia, vomiting, weight gain (unusual).
Pregnancy Category C GU: frequent urination. Derm: ecchymoses. Metab: hot flashes, weight loss. MS:
arthritis, muscle cramps.
Indications Interactions
Mild, moderate, or severe dementia/neurocognitive disorder associated with Alzhei- Drug-Drug: Exaggerates muscle relaxation from succinylcholine. Interferes with
mer’s disease. the action of anticholinergics.qcholinergic effects of bethanechol. Mayqrisk of
GI bleeding from NSAIDs. Quinidine and ketoconazolepmetabolism of donepe-
Action zil. Rifampin, carbamazepine, dexamethasone, phenobarbital, and phenyt-
Inhibits acetylcholinesterase thus improving cholinergic function by making more
oin induce the enzymes that metabolize donepezil and maypits effects.
acetylcholine available. Therapeutic Effects: May temporarily lessen some of the
dementia associated with Alzheimer’s disease. Enhances cognition. Does not cure the Drug-Natural Products: Jimson weed and scopolia may antagonize choliner-
disease. gic effects.

Pharmacokinetics Route/Dosage
Absorption: Well absorbed after oral administration. Mild to Moderate Alzheimer’s Disease
Distribution: Unknown. PO (Adults): 5 mg once daily; after 4– 6 wk mayqto 10 mg once daily (dose should
Protein Binding: 96%. not exceed 5 mg/day in frail, elderly females).
Metabolism and Excretion: Partially metabolized by the liver (CYP2D6 and Severe Alzheimer’s Disease
CYP3A4 enyzmes) and partially excreted by kidneys (17% unchanged). Two metabo- PO (Adults): 5 mg once daily; mayqto 10 mg once daily after 4– 6 wk; after 3 mo,
lites are pharmacologically active. may thenqto 23 mg once daily.
Half-life: 70 hr.
TIME/ACTION PROFILE (improvement in symptoms)
NURSING IMPLICATIONS
ROUTE ONSET PEAK DURATION
Assessment
● Assess cognitive function (memory, attention, reasoning, language, ability to per-
PO unknown several wk 6 wk† form simple tasks) periodically during therapy.
†Return to baseline after discontinuation ● Monitor heart rate periodically during therapy. May cause bradycardia.
Contraindications/Precautions Potential Nursing Diagnoses
Contraindicated in: Hypersensitivity to donepezil or piperidine derivatives. Disturbed thought process (Indications)
Use Cautiously in: Underlying cardiac disease, especially sick sinus syndrome or Impaired environmental interpretation syndrome (Indications)
supraventricular conduction defects; History of ulcer disease or currently taking Risk for injury (Indications)
⫽ Canadian drug name. ⫽ Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued.
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Implementation PDF Page #2
● Do not confuse Aricept with Aciphex or Azilect.
● PO: Administer in the evening just before going to bed. May be taken without re-
gard to food.
● Oral disintegrating tablets should be allowed to dissolve on tongue; follow with
water.
● Swallow 23 mg tablet whole. Do not split, crush or chew; may increase rate of ab-
sorption.
Patient/Family Teaching
● Emphasize the importance of taking donepezil daily, as directed. Missed doses
should be skipped and regular schedule returned to the following day. Do not take
more than prescribed; higher doses do not increase effects but may increase side
effects.
● Inform patient/family that it may take weeks before improvement in baseline be-
havior is observed.
● Caution patient and caregiver that donepezil may cause dizziness.
● Advise patient and caregiver to notify health care professional if nausea, vomiting,
diarrhea, or changes in color of stool occur or if new symptoms occur or previ-
ously noted symptoms increase in severity.
● Instruct patient to notify health care professional of all Rx or OTC medications, vi-
tamins, or herbal products being taken and to consult health care professional be-
fore taking other Rx, OTC, or herbal products.
● Advise patient and caregiver to notify health care professional of medication regi-
men before treatment or surgery.
● Emphasize the importance of follow-up exams to monitor progress.
Evaluation/Desired Outcomes
● Improvement in cognitive function (memory, attention, reasoning, language, abil-
ity to perform simple tasks) in patients with Alzheimer’s disease.
Why was this drug prescribed for your patient?

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