Buy Aricept Online

Aricept (donepezil hydrochloride)

THERAPEUTIC CLASS

Acetylcholinesterase (AChE) inhibitor

DEA CLASS

RX

INDICATIONS

Treatment of dementia of the Alzheimer's type.

ADULT DOSAGE

Alzheimer's Disease

Dementia of the Alzheimer's type

Mild to Moderate:
Initial: 5mg qd
Titrate: May increase to 10mg qd after 4-6 weeks
Usual: 5-10mg qd

Moderate to Severe:
Initial: 5mg qd
Titrate: May increase to 10mg qd after 4-6 weeks, then to 23mg qd after at least 3 months
Usual: 10-23mg qd

ADMINISTRATION

Oral route

Take qhs
Take w/ or w/o food

23mg Tab
Do not split, crush, or chew

ODT
Dissolve on the tongue and follow w/ water

HOW SUPPLIED

Tab: 5mg, 10mg, 23mg; Tab, Disintegrating: (ODT) 5mg, 10mg

WARNINGS/PRECAUTIONS

May exaggerate succinylcholine-type muscle relaxation during anesthesia. May have vagotonic effects on sinoatrial (SA) and atrioventricular (AV) nodes, manifesting as bradycardia or heart block. Syncopal episodes reported. May produce diarrhea, N/V; observe closely at initiation of treatment and after dose increases. May increase gastric acid secretion; monitor for active or occult GI bleeding. Caution patients with increased risk for developing ulcers (eg, history of ulcer disease). May cause weight loss, generalized convulsions, and bladder outflow obstruction. Caution with history of asthma or obstructive pulmonary disease.

ADVERSE REACTIONS

N/V, diarrhea, insomnia, muscle cramps, fatigue, anorexia, headache, dizziness, weight decrease, infection, HTN, back pain, abnormal dreams, ecchymosis.

DRUG INTERACTIONS

Monitor closely for GI bleeding with concurrent NSAID use. Ketoconazole and quinidine, inhibitors of CYP3A4 and CYP2D6, respectively, inhibit metabolism in vitro. Increased concentrations with ketoconazole. CYP3A4 inducers (eg, phenytoin, dexamethasone, rifampin) may increase elimination rate. May interfere with activity of anticholinergic medications. Synergistic effect with neuromuscular blocking agents (eg, succinylcholine) or cholinergic agonists (eg, bethanechol).

PREGNANCY AND LACTATION

Category C, caution in nursing.

MECHANISM OF ACTION

Acetylcholinesterase inhibitor; may exert effect by increasing acetylcholine concentrations through reversible inhibition of its hydrolysis by acetylcholinesterase.

PHARMACOKINETICS

Absorption: Tmax=3 hrs (10mg), 8 hrs (23mg). Distribution: Vd=12-16L/kg; plasma protein binding (96%). Metabolism: Hepatic via CYP2D6 and CYP3A4; glucuronidation. Elimination: Urine (57%, 17% unchanged), feces (15%); T1/2=70 hrs.

ASSESSMENT

Assess for hypersensitivity to the drug or piperidine derivatives, underlying cardiac conduction abnormalities, risks for developing ulcers, history of asthma or obstructive pulmonary disease, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for vagotonic effects on SA and AV nodes, syncopal episodes, diarrhea, N/V, active/occult GI bleeding, weight loss, bladder outflow obstruction, generalized convulsions, and other possible adverse reactions.

PATIENT COUNSELING

Instruct to take as prescribed. Advise that N/V, diarrhea, insomnia, muscle cramps, fatigue, and decreased appetite may occur.

STORAGE

15-30°C (59-86°F).

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