Aricept Evess Overdosage

The estimated median lethal dose of donepezil HCl following administration of a single oral dose in mice and rats is 45 and 32 mg/kg, respectively, or approximately 225 and 160 times the maximum recommended human dose of 10 mg/day.
Symptoms: Dose-related signs of cholinergic stimulation were observed in animals and included reduced spontaneous movement, prone position, staggering gait, lacrimation, clonic convulsions, depressed respiration, salivation, miosis, fasciculation and lower body surface temperature.
Overdosage with cholinesterase inhibitors can result in cholinergic crisis characterised by severe nausea, vomiting, salivation, sweating, bradycardia, hypotension, respiratory depression, collapse and convulsions. Increasing muscle weakness is a possibility and may result in death if respiratory muscles are involved.
Treatment: As in any case of overdose, general supportive measures should be utilized. Tertiary anticholinergics eg, atropine may be used as an antidote for Aricept Evess overdosage. Intravenous atropine sulfate titrated to effect is recommended. An initial dose of 1-2 mg IV with subsequent doses based upon clinical response. Atypical responses in blood pressure and heart rate have been reported with other cholinomimetics when co-administered with quaternary anticholinergics eg, glycopyrrolate. It is not known whether donepezil HCl and/or its metabolites can be removed by dialysis (haemodialysis, peritoneal dialysis or haemofiltration).