Aricept 23mg

Forms and dosages

Aricept is supplied as film-coated tablets (5mg white, 10mg yellow, 23mg reddish) and as orally disintegrating tablets (5mg and 10mg) for patients who have difficulty swallowing. Treatment starts at 5mg once daily, usually in the evening before bedtime, and may be increased to 10mg after at least 4 to 6 weeks, once early side effects have settled. The 23mg tablet, approved only in the United States for moderate to severe disease, may be considered after a patient has been stable on 10mg for at least 3 months; it must be swallowed whole, not crushed. Patients who develop insomnia or vivid dreams can switch to morning dosing after discussing it with their doctor.

Indications

Aricept is approved in the United States for the treatment of dementia of the Alzheimer's type across the mild, moderate and severe stages. In the European Union and the United Kingdom the licence covers mild to moderately severe Alzheimer's dementia, while Japan has additionally approved donepezil for dementia with Lewy bodies. Off-label, clinicians sometimes use it in vascular or mixed dementia, where the evidence is weaker. According to clinical guidelines, the diagnosis should be confirmed by a physician experienced in dementia care before treatment begins, with reassessment of benefit every 6 to 12 months and a review of cardiac history because of the risk of bradycardia and fainting.