Aricept 23 mg/Aricept Evess

Donepezil HCl

Symptomatic treatment of mild to moderate & severe Alzheimer's dementia. Aricept 23 mg Patient whose condition is not adequately controlled by donepezil HCl 10 mg.

Aricept 23 mg Adult/elderly 23 mg once daily at bedtime. Aricept Evess Adult/elderly Initially 5 mg once daily at bedtime, maintain for at least 1 mth. May be increased to 10 mg once daily following 4-6 wk clinical assessment. If not adequately controlled, may be increased to 23 mg (one Aricept 23 mg FC tab).

May be taken with or without food. Take at bedtime. FC tab: Swallow whole, do not split/crush. Orodispersible tab: Place tab on the tongue & allow to dissolve; it can then be swallowed w/ water.

Hypersensitivity to donepezil HCl or piperidine derivatives. Pregnancy.

Regularly reassess clinical benefit of donepezil HCl; consider discontinuation when evidence of therapeutic effect is no longer present. Patients w/ other types of dementia or memory impairment (eg, age-related cognitive decline). Likely to exaggerate succinylcholine-type muscle relaxation during anaesth. Vagotonic effects on SA & AV nodes. Patients w/ pre-existing or family history of QTc prolongation, treated w/ drugs affecting QTc interval or w/ revelant pre-existing cardiac disease (eg, uncompensated heart failure, recent MI, bradyarrhythmias) or electrolytes disturbances (eg, hypokalaemia, hypomagnesaemia). May cause diarrhea, nausea, vomiting; wt loss. Closely monitor patients for symptoms of active or occult GI bleeding especially those at increased risk for developing ulcers (eg, history of ulcer disease & those receiving concurrent NSAIDs). May cause bladder outflow obstruction. May exacerbate or induce extrapyramidal symptoms. Patients w/ history of asthma or obstructive pulmonary disease. Discontinue therapy if signs & symptoms of NMS or unexplained high fever develop; markedly elevated CPK levels &/or signs & symptoms of rhabdomyolysis develop. Patients w/ predisposing/risk factors (eg, prior history of muscular disorders, uncontrolled hypothyroidism, hepatic or renal impairment). Avoid concomitant use w/ other acetylcholinesterase inhibitors, cholinergic system agonists or antagonists. Concomitant use w/ rhabdomyolysis-causing medications (eg, statins, antipsychotics, SSRIs/SNRIs). Dementia may cause impairment of driving performance or compromise the ability to use machinery. Severe hepatic impairment. Lactation; women on donepezil HCl should not breast feed. Not recommended for childn. Aricept 23 mg Possible syncopal episodes. Patients weighing <55 kg are more prone to nausea, vomiting & decreased wt than those weighing ≥55 kg.

Diarrhoea, nausea; headache. Common cold; anorexia; hallucinations, agitation, aggressive behavior, abnormal dreams & nightmares; syncope, dizziness, insomnia; vomiting, abdominal disturbance; rash, pruritus; muscle cramps; urinary incontinence; fatigue, pain; accidents including falls.

Metabolism may be inhibited w/ ketoconazole & quinidine, CYP450, 3A4 & 2D6 inhibitors. Reduced clearance w/ CYP2D6 inhibitor. Increased rate of elimination w/ CYP2D6 & CYP3A4 inducers (eg, phenytoin, carbamazepine, dexamethasone, rifampin & phenobarb). May interfere w/ the activity of anticholinergics. Synergistic effect w/ succinylcholine, similar neuromuscular blocking agents or cholinergic agonists (eg, bethanechol). In combination w/ other medicinal products known to prolong QTc interval [eg, class IA antiarrhythmics (eg, quinidine), class III antiarrhythmics (eg, amiodarone, sotalol), antidepressants (eg, citalopram, escitalopram, amitriptyline), antipsychotics (eg, phenothiazine derivatives, sertindole, pimozide, ziprasidone), antibiotics (eg, clarithromycin, erythromycin, levofloxacin, moxifloxacin)].

Neurodegenerative Disease Drugs

N06DA02 - donepezil ; Belongs to the class of anticholinesterases. Used in the management of dementia.

POM