The People's Perspective on Medicine

Donepezil

Overview

Aricept was recently 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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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Here is my real comment.

My husband was on Aricept for 5 weeks in which time he became very constipated, more confused, bad dreams, strength in legs was weakened and he lost 14 pounds in that time. He had weighed the same for 2 yrs…!!! sudden loss of appetite. Needless to say we took him off and within 24 hrs. his appetite increase and other symptoms went away !! What an eye opener that was. Never again will he go on it.

I’ve already posted regarding Cozaar. Aricept is another drug I would like to find in generic form for my mother. She is taking both these drugs and I know they are expensive. It seems that neither is available in the U.S. in generic, but they can be obtained through Canada. There is a warning against the generic for Aricept and I don’t know if that is a fair warning or just a way of keeping people from buying from Canada?

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