Donepezil (brand name Aricept) is a common pill doctors use to help with memory and thinking in Alzheimer’s disease. It doesn’t cure dementia, but it can slow symptom decline for months in many people. People also sometimes use it for other types of memory problems, like Lewy body dementia, when a clinician thinks the benefits outweigh risks.
Most people start at 5 mg once daily, often taken at bedtime to reduce nausea. After several weeks a doctor may raise the dose to 10 mg daily if it’s tolerated and helpful. For advanced cases there’s a 23 mg once-daily option, but that’s only for patients already on 10 mg and doing okay. Donepezil comes as tablets and as a dissolving tablet for people who have trouble swallowing.
If you miss a dose, take it when you remember unless it’s close to the next dose—don’t double up. Don’t stop suddenly without talking to the prescriber; some people notice worse confusion or behavior after abrupt stopping.
Common side effects are stomach upset, nausea, diarrhea, trouble sleeping, vivid dreams, muscle cramps, and weight loss. Some people develop a slow heart rate, dizziness, or fainting. If you feel faint, have fainting spells, or notice a very slow heartbeat, call your provider right away.
Donepezil works by boosting acetylcholine in the brain. That means medicines that block acetylcholine (so-called anticholinergics like some bladder or allergy drugs) can reduce its effect. Also watch for interactions: strong CYP3A4 or CYP2D6 inhibitors (certain antifungals, antibiotics, or antidepressants) can raise donepezil levels; enzyme inducers can lower them. Combining donepezil with beta-blockers or some calcium-channel blockers can increase the chance of a slow heart rate. Using NSAIDs may increase GI bleeding risk—ask your doctor before combining.
Routine checks are simple: monitor weight, appetite, bowel changes, sleep, and any falls or fainting. Your doctor may check heart rate and blood pressure and ask about stomach symptoms. Cognitive tests every few months help decide if the drug is still helping.
Caregiver tips: use a pill box or set a phone alarm. If swallowing is hard, ask about the dissolving tablet. If nausea is bad, try taking it with a light snack or switch to morning dosing after checking with the doctor. Keep a short symptom log—when memory seemed better or when side effects started—that makes clinic visits faster and more useful.
Only use prescription pharmacies you trust. Donepezil is prescription-only; avoid unverified online sellers. If a price looks too good or a site asks for no prescription, stop and call your pharmacist or doctor. When in doubt, ask a clinician—small changes early can avoid bigger problems later.
If you have questions about dosing, side effects, or interactions with other medicines, bring a list of current meds to your next visit. Quick action on fainting, slow pulse, or new severe stomach issues keeps treatment safer for everyone involved.
In 2025, there are several viable alternatives to Aducanumab for treating Alzheimer's. This article discusses six options, including Donepezil, which increases acetylcholine levels, and Lecanemab, known for its antibody targeting Alzheimer's plaque. The pros and cons of each alternative are considered, offering a comprehensive comparison for those exploring treatment choices.
