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Drug Treatments

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Aricept (also known as donepezil or E2020)

The purpose of this medication

Aricept is one of a group of drugs called “cholinesterase inhibitors” which is used to treat symptoms in
people with mild to moderate and advanced Alzheimer’s disease.

In the brains of people with Alzheimer’s disease there is a progressive degeneration of nerve cells,
particularly of the cells that make acetylcholine, a chemical thought to be important for learning and
memory. Because of this, people with Alzheimer’s disease have lower brain levels of acetylcholine. It is
believed that Aricept works by reducing the breakdown of acetylcholine and thus increasing the amount
of the chemical in the brain.

It has also been suggested, based on data from animal experiments, that the medication enhances
the action of acetylcholine by making the receptors it interacts with in the brain more responsive. In
the region of the brain first affected by Alzheimer’s disease, that dealing with cognition and memory,
too little acetylcholine is available at the junctions between nerve cells to get messages across to the
next nerve cell. The situation is helped, therefore, not only by preserving the acetylcholine from being
destroyed by cholinesterase, but by making the receptors more responsive to the lower amounts of
acetylcholine. Whether this effect is also true for humans is unknown.

The potential beneficial effect of Aricept could lessen as the disease progresses and when fewer cells
are available to make acetylcholine.

Ongoing research is finding that combining cholinesterase inhibitors (such as Aricept, Reminyl ER or
Exelon) together with memantine (a drug used to relieve the symptoms of people with moderate to
severe Alzheimer’s disease) seems to greatly improve outcomes, sometimes more than predicted from
the sum of the effects of either drug alone. However, more and larger drug trials are needed to confirm
these promising early results.

How does it help?

Aricept is intended to treat symptoms in people with mild to moderate and advanced Alzheimer’s
disease. In clinical trials, some individuals who took the drug, compared to individuals who took a
placebo (a substance which looks like the drug but has no effect), showed some improvement or no
decline in cognition (including memory, orientation and language) and global functioning (for example,
the performance of daily activities such as bathing, dressing and eating).

The medication may take as long as 12 weeks to begin working, and the type and length of response as
well as the time it takes for patients to respond to this medication will vary from person to person.

Will this medication cure Alzheimer's disease?

Aricept is not a cure for Alzheimer's disease as it does not affect the underlying degenerative process of the disease.

Who should take this medication?

The medication is approved for people who have been diagnosed with mild to moderate and advanced
Alzheimer’s disease. The use of Aricept is not advised by Health Canada outside of its approved

How do you obtain this medication?

Aricept can only be obtained with a prescription from a doctor after a diagnosis of Alzheimer's disease has been made.

A reminder: This medication has been prescribed only for you or for the person you are caring for. Never give it to anyone else.

Important! Things to know before taking this medication

Aricept tablets contain donepezil hydrochloride. The 5 mg tablets are white and the 10 mg tablets are

You should tell the doctor if you are allergic to donepezil hydrochloride or piperidine derivatives such as
Mycobutin (rifabutin), Ritalin (methylphenidate), Akineton (biperiden HCI), Artane (trihexyphenidyl HCI),
Bupivacaine HCI, and Paxil (paroxetine HCI). You should also tell your doctor if you have a condition
affecting your heart or your lungs; if you have had seizures; if you have had fainting spells; and if you
have a history of peptic ulcers or have an increased risk of developing ulcers (for example, if you
are taking non-steroidal anti-inflammatory drugs [NSAIDs] or high doses of acetylsalicylic acid [ASA/
Aspirin]). Aricept should not be used if you are pregnant or breastfeeding.

How do you take this medication?

  • Take only as prescribed by your doctor. Never change the dose yourself.
  • Take in the evening, just before going to bed. If you experience insomnia (difficulty sleeping), the medication may be taken in the morning.
  • This medication may be taken with or without food.
  • If you miss taking a dose do not worry. Take the next dose when it is due.
  • Do NOT take 2 doses at once.
  • If you have problems remembering to take medications, it may be necessary to have someone manage this for you.
  • The medication is available in a blisterpack to help remind you to take your medication every day. Ask your physician or pharmacist for more details.

What are the possible side effects?

Along with its beneficial effect, Aricept may cause some undesirable reactions. The most common side
effects include nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue and loss of appetite. In
clinical studies these effects were often mild, and generally went away with continued treatment. In
clinical studies some people treated with the drug experienced fainting. If you feel unwell in any other
way or have any symptoms that you do not understand, or find distressing, you should contact your
doctor immediately.

What to do if an overdose is taken

If more medication has been taken than what has been prescribed, contact your doctor, hospital emergency department, or the nearest poison control centre immediately.

How do you store this medication?

Aricept tablets contain donepezil hydrochloride. The 5 mg tablets are white and the 10 mg tablets are yellow.

  • Keep this medication in a safe place, out of reach of children.
  • Keep this medication in a cool dry place (15° to 30°C) and avoid exposure to moisture.
  • If the doctor decides to stop the treatment, return any leftover medication to your pharmacist.
  • Keep it only if the doctor tells you to do so.

How much does it cost and who pays for this medication?

The medication costs approximately $5.00 a day. It is covered under provincial drug plans in the
following provinces: Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick, Prince
Edward Island and Newfoundland and Labrador. In Nova Scotia, the medication is approved under the
Nova Scotia Seniors Pharmacare Program. The Alzheimer Society of British Columbia continues to
work to put the medication on its provincial drug plan. In provinces where Alzheimer medications are
covered, individuals must meet specific clinical criteria for entitlement. The medication is also covered
by most private insurance plans.

Who produces this medication?

Pfizer Canada Inc., 17300 Trans-Canada Highway, Kirkland, PQ H9J 2M5.

For further information

This information sheet is a brief description and summary of information about this medication. If you have any questions about Aricept, ask your doctor or pharmacist.


[The contents of this document are provided for information purposes only, and do not represent advice, an endorsement or a recommendation, with respect to any product, service or enterprise, and/or the claims and properties thereof, by the Alzheimer Society of Canada.]


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