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Generic Name: Donepezil
Brand Name(s):
Information updated: April 1, 2000
Overview
Aricept was recently been approved for the treatment of Alzheimer's disease.
This medication is not a cure, and not all patients respond well.
Like
Cognex, it presumably works by increasing the activity of an important brain
chemical, acetylcholine.
Aricept appears to slow the mental
deterioration associated with this dread disease and may help some families
delay institutionalization of the patient.
Within six weeks of
discontinuing Aricept, the benefits are no longer measurable.
Side Effects and Interactions
Aricept can cause a number of side effects,
including nausea, diarrhea, vomiting, and loss of appetite.
Its effect
on acetylcholine is expected to increase the secretion of stomach acid. This may
place patients at risk of an ulcer.
People who also take arthritis pain
relievers (NSAIDs) should be followed closely for signs of ulcer.
Other
possible reactions include headache, muscle cramps, pain, insomnia, dizziness,
fatigue, and depression.
Slower heart rate, increased stomach acid,
breathing difficulties, and convulsions could cause special problems in people
with pre-existing conditions such as heart disease, ulcers, asthma or epilepsy.
Report any symptoms to the physician promptly.
Any
gastrointestinal side effects should be treated cautiously, as some common
stomach medicines, such as Pro-Banthine, are likely to interact with Aricept.
Nizoral and quinidine slow Aricept elimination and increase the amount
of the drug circulating in the body.
Grapefruit may be expected to
affect the same enzyme (CYP 3A4), so it would be prudent to avoid grapefruit and
grapefruit juice while on Aricept until studies show whether there is an
interaction.
Because Aricept is still a fairly new drug, there may be
other interactions that have not yet been identified.
Ask your doctor
and pharmacist to check whether any other drug that must be taken is safe in
combination with Aricept.
Special Precautions
Aricept may interact with some drugs given during anesthesia. If surgery is planned, the regimen should be discussed in detail with the anesthesiologist.
Patients with asthma should be monitored extremely carefully while on Aricept.
Fainting episodes have occurred in patients on Aricept. The heart condition "sick sinus syndrome" increases this risk.
Taking the Medicine
Aricept is to be taken at bedtime. It may be taken with or without food.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio.
© 2000