Experiences with

Donepezil

Donepezil is a medicine that helps with some types of dementia.

It does not cure dementia. However, it treats some of the symptoms of Alzheimer's disease, Parkinson's disease and dementia with Lewy bodies.

It can also help with mixed dementia. This is when you have more than one type of dementia.

Donepezil is available on prescription only.

It comes as tablets, including tablets that melt in your mouth, and as a liquid that you swallow.

Who can take donepezil

Most adults aged 18 years old and over can take donepezil.

Who may not be able to take donepezil

Donepezil is not suitable for some people. To make sure this medicine is safe to take, tell your doctor if you or the person you're caring for have:

• ever had an allergic reaction to donepezil or any other medicine
• liver problems
• ever had an ulcer in your gut or intestines, or a stomach ulcer
• heart problems, such as an irregular or slow heartbeat
• asthma or other lung disease such as chronic obstructive pulmonary disease (COPD)
• ever had a seizure or fit
• a condition that makes it difficult to pee

Dosage

Donepezil comes as 5mg or 10mg tablets.

If you're taking liquid donepezil, a 5ml spoonful contains 5mg of medicine (1mg/1ml).

The usual starting dose of donepezil is 5mg (one tablet or one 5ml spoonful of liquid), taken once a day.

After a month, the doctor may increase your dose to 10mg (one 10mg tablet or two, 5ml spoonfuls of liquid), taken once a day.

How to take it

It's best to take your donepezil at bedtime. This is because you may feel dizzy after you take it.

If donepezil gives you bad dreams or makes it hard to sleep, you can take it in the morning instead.

Standard tablets

Swallow your donepezil tablet with a drink of water.

Dissolvable tablets

Donepezil also comes as a tablet that melts in your mouth (orodispersible tablet).

Put the tablet on your tongue and let it dissolve until it's gone. You can then swallow it without a drink. You can have a drink of water afterwards if you need to.

Donepezil liquid

Use the plastic spoon that comes with your medicine to measure out your dose. If you do not have a measuring spoon, ask a pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

Swallow the liquid donepezil. You can have a drink of water afterwards if you need to.

How long to take it for

You, or the person you're caring for, will have regular check-ups with a doctor to see whether donepezil is still helping.

The effects may wear off a bit around 6 to 12 months after you start taking it. Your symptoms may start to gradually get worse again, even if you're still taking donepezil.

Talk to your doctor if you're worried that donepezil is no longer working.

The medicine is probably still helping and if you stop taking it your symptoms could become even worse.

If you forget to take it

If you forget a dose of donepezil, skip the missed dose and take the next one at the normal time the next day.

Do not take 2 doses to make up for a forgotten dose.

If you've forgotten to take your donepezil for more than a week, talk to your doctor before you take any more.

If you forget doses often, it may help to set an alarm to remind you. You could also ask a doctor, pharmacist or dementia support group for advice on other ways to help you remember to take your medicine.

If you take too much

The amount of donepezil that can cause an overdose varies from person to person.

• you take more than your usual dose of donepezil

Go to 111.nhs.uk or call 111

you take more than your usual dose of donepezil and you:

• feel dizzy or sick, or you're being sick
• start drooling or sweating a lot
• have a slow heart rate
• start having breathing problems
• faint or have a seizure or fit

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the donepezil packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of donepezil happen to more than 1 in 100 people. There are things you can do to help cope with them:

Side effects are less likely to happen if your doctor starts you on the lower 5mg dose for at least a month.

As your body gets used to donepezil, these side effects should wear off. If the advice on how to cope does not help and you're bothered by them, speak to a doctor. They may want to adjust your dose or recommend a different medicine.

Serious side effects

Less than 1 in 100 people have serious side effects with donepezil.

Call a doctor or call 111 now if you, or the person you're caring for, have:

• yellowing skin (this may be less obvious on black or brown skin) or the whites of your eyes turn yellow, or if you have pale poo and dark pee – these can be signs of liver problems
• severe indigestion, heartburn or stomach pain, severe or continued vomiting – these can be signs of an ulcer in your stomach or gut
• black poo, or blood or something that looks like coffee grounds in your vomit – these can be signs of internal bleeding
• muscle weakness or cramps and pains in your muscles (that you did not have before) – these can sometimes be signs of muscle and kidney problems
• a high temperature together with stiff muscles, sweating, confusion and seeing or hearing things that are not there – these can be signs of a rare side effect called neuroleptic malignant syndrome

• you, or the person you're caring for, have had a seizure or fit

In rare cases, donepezil may cause a serious allergic reaction (anaphylaxis).

These are not all the side effects of donepezil. For a full list see the leaflet inside your medicines packet.

Donepezil and pregnancy

There is little information available about donepezil and the effect it can have on unborn babies, so it is not recommended during pregnancy.

If you're taking donepezil and are trying to get pregnant, or are already pregnant, talk to your doctor about whether it's right for you. Do not stop your medicine without speaking to your doctor first.

Donepezil and breastfeeding

Donepezil is not usually recommended if you're breastfeeding. This is because there is no information about how donepezil may affect your baby.

Donepezil and fertility

There's no evidence to suggest that taking donepezil affects fertility in either men or women.

Cautions with other medicines

Some medicines do not mix well with donepezil. They can increase the risk of side effects or stop donepezil working as well as it should.

Tell your doctor if you or the person you're caring for:

• take medicines used for heart problems like amiodarone, atenolol, bisoprolol, digoxin or verapamil
• take medicines for epilepsy, such as phenytoin or carbamazepine
• take non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin (including low-dose aspirin) or ibuprofen
• take risperidone, olanzapine or fluoxetine, or any other medicines for mental health issues
• take antibiotics, such as erythromycin or rifampicin
• are due to have general or local anaesthetic (for an operation or a minor procedure)

These are not all the medicines that affect the way donepezil works.

For a full list, see the leaflet inside your medicines packet.

Taking donepezil with painkillers

It's usually OK to take paracetamol with donepezil.

Do not take non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, without checking with a doctor first.

Mixing donepezil with herbal remedies and supplements

St John's wort, a herbal remedy used for depression, can lower the levels of donepezil in your blood. This can stop your medicine from working as well as it should.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with donepezil. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Related links

HealthUnlocked contains information from NHS Digital, licensed under the current version of the Open Government Licence