Donepezil Hydrochloride
Pronunciation: doe-NEP-e-zil.
- Generic name
- donepezil hydrochloride
- Brand names
- Donecept, Donamem, Aricept RDT, Donepezil Teva, Donepezil Accord, Aricept
- Drug class
- Acetylcholinesterase inhibitor
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What donepezil hydrochloride is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how donepezil hydrochloride works
Donepezil is a reversible acetylcholinesterase inhibitor. It increases the concentration of acetylcholine in the brain by inhibiting its breakdown, thereby enhancing cholinergic neurotransmission. This action is believed to improve or stabilize symptoms of Alzheimer's disease, particularly cognition and memory. (1)
What donepezil hydrochloride is used for
Alzheimer's disease
Approved to treat the symptoms of mild, moderate, and severe dementia of the Alzheimer's type; it helps some patients with memory, awareness, and daily function but does not cure the disease or stop its underlying progression. (2)
Dementia due to Alzheimer's disease
Used specifically for dementia caused by Alzheimer's disease; use in other types of dementia (e.g., vascular dementia, Lewy body dementia) is off-label and should be guided by a specialist. (2)
Before taking donepezil hydrochloride
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to donepezil or piperidine derivatives. (Contraindication) (2)
Tell your clinician about
(2)How to take donepezil hydrochloride
- General Instructions: Take donepezil exactly as prescribed, usually once daily at bedtime. Do not increase your dose or take more often than directed.. Adult Dosing: Start with 5 mg once daily at bedtime. After 4-6 weeks, the dose may be increased to 10 mg once daily if tolerated. For severe Alzheimer's, some may be increased to 23 mg once daily after at least 3 months on 10 mg.. Pediatric Dosing: Donepezil is not approved for use in children or adolescents.. Administration: Swallow tablets whole with water. Orally disintegrating tablets should be allowed to dissolve on the tongue and then swallowed.. When To Stop: Do not stop taking donepezil without consulting your healthcare provider. Stopping suddenly may worsen symptoms.. Storage: Store at room temperature (20–25°C/68–77°F), away from moisture and heat. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double the dose to catch up.
Overdose
Symptoms of overdose may include severe nausea, vomiting, drooling, sweating, slow heartbeat, muscle weakness, breathing difficulties, or seizures. Seek emergency medical help immediately if overdose is suspected. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Most frequent reported reaction; incidence rises with dose (about 3.4% at 10 mg vs 11.8% at 23 mg, per FDA label)
Diarrhea
Incidence: Common (per FDA label most-frequent list)
Insomnia
Incidence: Common (per FDA label most-frequent list)
Vomiting
Incidence: Common (per FDA label most-frequent list)
Muscle cramps
Incidence: Common (per FDA label most-frequent list)
Fatigue
Incidence: Common (per FDA label most-frequent list)
Loss of appetite (anorexia)
Incidence: Common (per FDA label most-frequent list)
Signs of gastrointestinal bleeding (black or bloody stools, vomiting blood), especially if also taking NSAIDs or with a history of ulcers
Incidence: Uncommon but serious
Fainting, very slow heartbeat, or seizure
Incidence: Uncommon but serious
Serious warnings
May cause bradycardia (slow heart rate) and fainting — serious
Symptoms: May cause bradycardia (slow heart rate) and fainting. Use caution in patients with asthma or COPD. May increase risk of gastrointestinal bleeding, especially in those with a history of ulcers. Can cause seizures in susceptible individuals. Dose adjustments may be needed in liver impairment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
The only formal FDA contraindication is known hypersensitivity to donepezil or to piperidine derivatives — serious
Symptoms: The only formal FDA contraindication is known hypersensitivity to donepezil or to piperidine derivatives. Beyond that, donepezil should be used with caution and clinician monitoring in patients with cardiac conduction abnormalities (e.g., sick sinus syndrome, bradycardia), a history of peptic ulcer disease, asthma, COPD, or seizure disorders, and in anyone also taking NSAIDs (watch for gastrointestinal bleeding).
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Because donepezil is a cholinesterase inhibitor, tell any anesthesia provider or surgeon that you are taking it before surgery — serious
Symptoms: Because donepezil is a cholinesterase inhibitor, tell any anesthesia provider or surgeon that you are taking it before surgery: it is likely to exaggerate succinylcholine-type muscle relaxation during anesthesia.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Donepezil may interact with anticholinergic drugs (which can reduce its effectiveness), certain antifungals (like ketoconazole), antibiotics (such as erythromycin), and medications that affect heart rhythm (such as beta-blockers). Always inform your healthcare provider about all medicines and supplements you are taking. | (1) |
| Succinylcholine and other agents used during anesthesia | As a cholinesterase inhibitor, donepezil is likely to exaggerate succinylcholine-type muscle relaxation during anesthesia. Tell any surgeon or anesthesia provider that you are taking donepezil before any surgery or procedure requiring anesthesia. | (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Based on animal data, donepezil may cause fetal harm — animal studies showed increased stillbirths at clinically relevant doses during late pregnancy, and adequate human data are not available. Use during pregnancy requires an individualized discussion with the prescribing clinician about risks and benefits. (2)
Breastfeeding
There is no data on whether donepezil passes into human breast milk. The prescribing clinician and the patient should weigh the developmental and health benefits of breastfeeding against the mother's clinical need for donepezil and any potential risk to the infant. (2)
Children
Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Safety not established in children (2)
Renal_impairment
Hepatic impairment: clearance is reduced by about 20% in patients with cirrhosis; a dose adjustment should be considered by the prescriber. Renal impairment: no dosage adjustment is needed for moderate-to-severe renal impairment. (2)
Hepatic_impairment
Hepatic impairment: clearance is reduced by about 20% in patients with cirrhosis; a dose adjustment should be considered by the prescriber. Renal impairment: no dosage adjustment is needed for moderate-to-severe renal impairment. (2)
Monitoring
(2)Storage
Store at controlled room temperature, 15°C to 30°C (59°F to 86°F), away from moisture and heat. Keep out of reach of children.
Study the drug class: Dementia agents
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Alzheimer's disease
Dose summary: Initial dose of 5 mg orally once daily, may be increased to 10 mg once daily after 4-6 weeks based on clinical response.
Renal context: No dosage adjustment is needed for moderate-to-severe renal impairment. (1) (2)
Frequently asked questions
How long does it take for donepezil to start working?
It may take several weeks (typically 4–6 weeks) to notice improvement in symptoms. Some patients may require up to 3 months to see the full benefit.
Can donepezil cure Alzheimer's disease?
No, donepezil does not cure Alzheimer's disease. It may help improve symptoms or slow their progression, but it does not stop the underlying disease process.
What should I do if I experience severe side effects?
If you experience severe side effects such as chest pain, severe dizziness, fainting, or signs of an allergic reaction, seek emergency medical attention immediately.
Can I stop taking donepezil suddenly?
Do not stop taking donepezil without consulting your doctor. Stopping suddenly may worsen symptoms or cause withdrawal effects.
Is donepezil safe for people with liver or kidney problems?
Donepezil is primarily metabolized by the liver. Caution is advised in patients with liver impairment, and dose adjustments may be necessary. It is generally safe in mild to moderate kidney impairment.
Can donepezil be used in other types of dementia?
Donepezil is approved for Alzheimer's disease. Its use in other dementias (such as vascular dementia or Lewy body dementia) is off-label and should be guided by a specialist.
What happens if I miss several doses?
If you miss more than 7 days of donepezil, contact your doctor before restarting. You may need to restart at a lower dose to minimize side effects.
What happens if I take too much Donepezil?
Taking too much Donepezil can lead to a cholinergic crisis, characterized by severe nausea, vomiting, salivation, sweating, bradycardia, and muscle weakness. In extreme cases, seizures and respiratory depression may occur. If you suspect an overdose, seek immediate emergency medical attention. Do not attempt to self-treat.
Can I drink alcohol while taking Donepezil?
It is generally advisable to avoid or limit alcohol consumption while taking Donepezil. Alcohol can exacerbate some of the common side effects of Donepezil, such as dizziness and drowsiness, potentially increasing the risk of falls or impaired judgment. Additionally, alcohol may interfere with the drug's effectiveness in managing cognitive symptoms.
Is Donepezil safe during pregnancy?
Donepezil is classified under a pregnancy category that indicates potential risks. Therefore, its use during pregnancy is generally not recommended unless the potential benefits outweigh the risks to the fetus. It is crucial to consult with your healthcare provider to discuss the risks and benefits if you are pregnant or planning to become pregnant while taking Donepezil.
What is the mechanism of action of donepezil hydrochloride?
Donepezil is a reversible acetylcholinesterase inhibitor. It increases the concentration of acetylcholine in the brain by inhibiting its breakdown, thereby enhancing cholinergic neurotransmission. This action is believed to improve or stabilize symptoms of Alzheimer's disease, particularly cognition and memory. (1)
What is the generic name of Donepezil Hydrochloride?
The generic name is donepezil hydrochloride. It is sold under brand names including Donecept, Donamem, Aricept RDT, Donepezil Teva, Donepezil Accord, Aricept.
What class of drug is donepezil hydrochloride?
Donepezil Hydrochloride is classed as: Acetylcholinesterase inhibitor.
References
- Donepezil — clinician-authored medicine recordMedGuideGlobal · null · accessed 2026-08-06 · source 1
- ARICEPT (donepezil hydrochloride) tablets — prescribing informationU.S. Food and Drug Administration · United States · accessed 2026-08-06 · source 2
- Donepezil — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
- DONEPEZIL HYDROCHLORIDE — FDA approval record (Drugs@FDA ANDA202782)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- donepezil — RxNorm normalized drug concept (RXCUI 135447)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient donepezil hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Aricept10 mg, 23 mg, 5 mg · eisai inc.
Canada
- ARICEPT
- ARICEPT RDT
- SANDOZ DONEPEZIL ODT
- ACT DONEPEZIL ODT