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Donepezil hydrochloride is a prescription acetylcholinesterase inhibitor used for dementia of the Alzheimer's type. Clinical studies include mild, moderate, and severe Alzheimer's disease. Oral dosing is once daily, and current labeling includes 5 mg, 10 mg, and 23 mg treatment levels depending on disease severity and prior therapy.
read more about donepezil ...Donepezil reversibly inhibits acetylcholinesterase, the enzyme that breaks down acetylcholine. This increases acetylcholine concentrations and strengthens cholinergic signaling in the brain. Current labeling states that donepezil treats symptoms of Alzheimer dementia but has not been shown to alter the underlying disease process.
Donepezil is indicated for dementia of the Alzheimer's type, with efficacy demonstrated across mild, moderate, and severe disease. It is not approved for pediatric patients. Treatment decisions account for cognitive status, tolerability, heart conduction problems, gastrointestinal history, body weight, and other medicines.
Treatment starts at 5 mg once daily in the evening. For mild to moderate disease, the dose can increase to 10 mg after four to six weeks at 5 mg. For moderate to severe disease, 23 mg once daily is an option only after at least three months at 10 mg daily. Tablets can be taken with or without food.
Donepezil can cause slow heart rate, heart block, fainting, nausea, vomiting, diarrhea, weight loss, and gastrointestinal bleeding. Cholinesterase inhibition can intensify succinylcholine-type muscle relaxation during anesthesia. Seizures and pulmonary concerns are also addressed in current labeling. The 23 mg tablet is swallowed whole without splitting, crushing, or chewing.
Donepezil treats dementia of the Alzheimer's type across mild, moderate, and severe disease.
The recommended starting dose is 5 mg once daily in the evening.
The dose can increase to 10 mg after four to six weeks of treatment at 5 mg daily.
No. Current labeling states that donepezil has not been shown to change the underlying dementing process.
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Donepezil. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Donepezil. Date Accessed September 25, 2026.
Donepezil. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK513257/. Date Accessed September 25, 2026.