Aricept Evess Dosage/Direction for Use

Adults/Elderly: Mild to Moderate Alzheimer's Disease: Treatment is initiated at 5mg/day (once-a-day dosing). Aricept Evess should be taken orally, in the evening, just prior to retiring. The tablet should be placed on the tongue and allowed to disintegrate before swallowing with or without water, according to patient preference. The 5mg/day dose should be maintained for at least one month in order to allow the earliest clinical responses to treatment to be assessed and to allow steady-state concentrations of donepezil hydrochloride to be achieved. Following a one-month clinical assessment of treatment at 5mg/day, the dose of Aricept Evess can be increased to 10mg/day (once-a-day dosing). The maximum recommended daily dose is 10mg. Doses greater than 10mg/day have not been studied in clinical trials.
Upon discontinuation of treatment, a gradual abatement of the beneficial effects of Aricept is seen.
Severe Alzheimer's Disease: Aricept has been shown to be effective in controlled clinical trials at a dose of 10mg administered once daily.
Evidence from the controlled trials in mild to moderate Alzheimer's Disease indicates that the 10mg dose, with one week titration, is likely to be associated with a higher incidence of cholinergic adverse events than the 5mg dose. In open label trials using a 6 week titration, the frequency of these same adverse events was similar between the 5mg and 10mg dose groups. Therefore, because steady state is not achieved for 15 days and because the incidence of untoward effects may be influenced by the rate of dose escalation, a dose of 10mg should not be escalated until patients have been on a daily dose of 5mg for 4 to 6 weeks. Upon discontinuation of treatment, a gradual abatement of the beneficial effects of Aricept is seen. There is no evidence of a rebound effect after abrupt discontinuation of therapy.
Treatment should be initiated and supervised by a physician experienced in the diagnosis and treatment of Alzheimer's dementia. Diagnosis should be made according to accepted guidelines (e.g. DSM IV, ICD 10). Therapy with donepezil should only be started if a caregiver is available who will regularly monitor drug intake for the patient. Maintenance treatment can be continued for as long as a therapeutic benefit for the patient exists. Therefore, the clinical benefit of donepezil should be reassessed on a regular basis. Discontinuation should be considered when evidence of a therapeutic effect is no longer present. Individual response to donepezil cannot be predicted.
Renal and hepatic impairment: A similar dose schedule can be followed for patients with renal impairment as clearance of donepezil hydrochloride is not affected by this condition. Due to possible increased exposure in mild to moderate hepatic impairment (see Pharmacology: Pharmacokinetics under Actions), dose escalation should be performed according to individual tolerability. There are no data for patients with severe hepatic impairment.
Children: ARICEPT is not recommended for use in children.