donepezil (Rx)

Brand and Other Names:Aricept, Aricept ODT

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 5mg
  • 10mg
  • 23mg

tablet, oral disintegrating

  • 5mg
  • 10mg

Alzheimer Disease

Indicated for dementia of the Alzheimer type

Mild to moderate

  • 5 mg PO qHS initially, may increase to 10 mg/day after 4-6 weeks if warranted

Moderate to severe

  • 5 mg PO qHS initially, may increase to 10 mg qDay after 4-6 weeks; may further increase to 23 mg/day after 3 months if warranted

Administration

Take at bedtime before retiring

Take with or without food

ODT: Dissolve on tongue and follow with water

Dose Modification

Renal Impairment

  • Not studied

Hepatic Impairment

  • Not studied

Not recommended

Next:

Interactions

Interaction Checker

and donepezil

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (2)

            • dronedarone

              donepezil and dronedarone both increase QTc interval. Contraindicated.

            • thioridazine

              donepezil and thioridazine both increase QTc interval. Contraindicated.

            Serious - Use Alternative (85)

            • amiodarone

              donepezil and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

            • amisulpride

              donepezil and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

            • amoxapine

              donepezil and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • anagrelide

              donepezil and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.

            • arsenic trioxide

              donepezil and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether

              donepezil and artemether both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether/lumefantrine

              donepezil and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • asenapine

              donepezil and asenapine both increase QTc interval. Avoid or Use Alternate Drug.

            • asenapine transdermal

              asenapine transdermal and donepezil both increase QTc interval. Avoid or Use Alternate Drug.

            • azithromycin

              donepezil and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.

            • bedaquiline

              donepezil and bedaquiline both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine

              donepezil and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine buccal

              buprenorphine buccal and donepezil both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine subdermal implant

              buprenorphine subdermal implant and donepezil both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine transdermal

              buprenorphine transdermal and donepezil both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine, long-acting injection

              buprenorphine, long-acting injection and donepezil both increase QTc interval. Avoid or Use Alternate Drug.

            • ceritinib

              donepezil and ceritinib both increase QTc interval. Avoid or Use Alternate Drug.

            • chloroquine

              donepezil and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.

            • chlorpromazine

              donepezil and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.

            • citalopram

              donepezil and citalopram both increase QTc interval. Avoid or Use Alternate Drug.

            • clarithromycin

              donepezil and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

            • crizotinib

              donepezil and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.

            • disopyramide

              donepezil and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.

            • dofetilide

              donepezil and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

            • droperidol

              donepezil and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • encorafenib

              donepezil and encorafenib both increase QTc interval. Avoid or Use Alternate Drug.

            • entrectinib

              donepezil and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

            • eribulin

              donepezil and eribulin both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin base

              donepezil and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              donepezil and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              donepezil and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              donepezil and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

            • fexinidazole

              fexinidazole and donepezil both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

            • flecainide

              donepezil and flecainide both increase QTc interval. Avoid or Use Alternate Drug.

            • foscarnet

              donepezil and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.

            • glasdegib

              donepezil and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.

            • histrelin

              donepezil and histrelin both increase QTc interval. Avoid or Use Alternate Drug.

            • hydroxychloroquine sulfate

              donepezil and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.

            • ibutilide

              donepezil and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • iloperidone

              donepezil and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.

            • inotuzumab

              donepezil and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.

            • isoflurane

              donepezil and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.

            • ivosidenib

              donepezil and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug.

            • lefamulin

              lefamulin and donepezil both increase QTc interval. Avoid or Use Alternate Drug.

            • lenvatinib

              donepezil and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.

            • lithium

              donepezil and lithium both increase QTc interval. Avoid or Use Alternate Drug.

            • lofexidine

              donepezil and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.

            • lopinavir

              donepezil and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.

            • macimorelin

              donepezil and macimorelin both increase QTc interval. Avoid or Use Alternate Drug.

            • methadone

              donepezil and methadone both increase QTc interval. Avoid or Use Alternate Drug.

            • midostaurin

              donepezil and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.

            • mobocertinib

              donepezil and mobocertinib both increase QTc interval. Avoid or Use Alternate Drug.

            • moxifloxacin

              donepezil and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • nilotinib

              donepezil and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

            • ondansetron

              donepezil and ondansetron both increase QTc interval. Avoid or Use Alternate Drug.

            • osimertinib

              donepezil and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.

            • oxaliplatin

              donepezil and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.

            • ozanimod

              donepezil and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.

            • paliperidone

              donepezil and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.

            • pazopanib

              donepezil and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

            • pentamidine

              donepezil and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

            • pimavanserin

              donepezil and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.

            • pimozide

              donepezil and pimozide both increase QTc interval. Contraindicated.

            • pitolisant

              donepezil and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

            • ponesimod

              ponesimod, donepezil. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.

              donepezil and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.

            • procainamide

              donepezil and procainamide both increase QTc interval. Avoid or Use Alternate Drug.

            • propafenone

              donepezil and propafenone both increase QTc interval. Avoid or Use Alternate Drug.

            • quetiapine

              donepezil and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.

            • quinidine

              donepezil and quinidine both increase QTc interval. Contraindicated.

            • quinine

              donepezil and quinine both increase QTc interval. Avoid or Use Alternate Drug.

            • ribociclib

              ribociclib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              donepezil and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.

            • selpercatinib

              donepezil and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.

            • sevoflurane

              donepezil and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.

            • siponimod

              donepezil and siponimod both increase QTc interval. Avoid or Use Alternate Drug.

            • solifenacin

              donepezil and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.

            • sorafenib

              donepezil and sorafenib both increase QTc interval. Avoid or Use Alternate Drug.

            • sotalol

              donepezil and sotalol both increase QTc interval. Avoid or Use Alternate Drug.

            • tetrabenazine

              donepezil and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.

            • toremifene

              donepezil and toremifene both increase QTc interval. Avoid or Use Alternate Drug.

            • trazodone

              donepezil and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

            • triamcinolone acetonide injectable suspension

              triamcinolone acetonide injectable suspension, donepezil. unspecified interaction mechanism. Avoid or Use Alternate Drug. Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, withdraw anticholinesterase agents at least 24 hours before initiating corticosteroid therapy.

            • trimipramine

              donepezil and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.

            • vandetanib

              donepezil and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.

            • vemurafenib

              donepezil and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.

            • ziprasidone

              donepezil and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (159)

            • aclidinium

              donepezil increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • albuterol

              donepezil and albuterol both increase QTc interval. Use Caution/Monitor.

            • alfuzosin

              donepezil and alfuzosin both increase QTc interval. Use Caution/Monitor.

            • amifampridine

              amifampridine and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.

            • amitriptyline

              donepezil increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              donepezil and amitriptyline both increase QTc interval. Use Caution/Monitor.

            • amoxapine

              donepezil increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • anticholinergic/sedative combos

              donepezil increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • apomorphine

              donepezil and apomorphine both increase QTc interval. Use Caution/Monitor.

            • arformoterol

              donepezil and arformoterol both increase QTc interval. Use Caution/Monitor.

            • aripiprazole

              donepezil and aripiprazole both increase QTc interval. Use Caution/Monitor.

            • artemether/lumefantrine

              artemether/lumefantrine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • atomoxetine

              donepezil and atomoxetine both increase QTc interval. Use Caution/Monitor.

            • atracurium

              donepezil increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • atropine

              donepezil increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • atropine IV/IM

              donepezil increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • belladonna alkaloids

              donepezil increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • belladonna and opium

              donepezil increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benztropine

              donepezil decreases effects of benztropine by pharmacodynamic antagonism. Use Caution/Monitor.

            • bethanechol

              bethanechol and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.

            • carbachol

              carbachol and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.

            • carbamazepine

              carbamazepine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cevimeline

              cevimeline and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.

            • cimetidine

              cimetidine will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ciprofloxacin

              donepezil and ciprofloxacin both increase QTc interval. Use Caution/Monitor.

            • cisapride

              donepezil and cisapride both increase QTc interval. Use Caution/Monitor.

            • cisatracurium

              donepezil increases and cisatracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clarithromycin

              clarithromycin will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • clomipramine

              donepezil increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              donepezil and clomipramine both increase QTc interval. Use Caution/Monitor.

            • clozapine

              donepezil and clozapine both increase QTc interval. Use Caution/Monitor.

            • cyclizine

              donepezil increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyclobenzaprine

              donepezil increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • darifenacin

              donepezil increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dasatinib

              donepezil and dasatinib both increase QTc interval. Use Caution/Monitor.

            • degarelix

              donepezil and degarelix both increase QTc interval. Use Caution/Monitor.

            • desipramine

              donepezil and desipramine both increase QTc interval. Use Caution/Monitor.

            • desvenlafaxine

              desvenlafaxine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg

            • deutetrabenazine

              donepezil and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

            • dichlorphenamide

              dichlorphenamide and donepezil both decrease serum potassium. Use Caution/Monitor.

            • dicyclomine

              donepezil increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diltiazem

              diltiazem will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • diphenhydramine

              donepezil increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dolasetron

              donepezil and dolasetron both increase QTc interval. Use Caution/Monitor.

            • dosulepin

              donepezil increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • doxepin

              donepezil increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              donepezil and doxepin both increase QTc interval. Use Caution/Monitor.

            • echothiophate iodide

              donepezil and echothiophate iodide both increase cholinergic effects/transmission. Use Caution/Monitor.

            • efavirenz

              efavirenz will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • eliglustat

              donepezil and eliglustat both increase QTc interval. Use Caution/Monitor.

            • erythromycin base

              erythromycin base will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • erythromycin ethylsuccinate

              erythromycin ethylsuccinate will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • erythromycin lactobionate

              erythromycin lactobionate will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • erythromycin stearate

              erythromycin stearate will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • escitalopram

              donepezil and escitalopram both increase QTc interval. Use Caution/Monitor.

            • fesoterodine

              donepezil increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fingolimod

              fingolimod and donepezil both increase QTc interval. Use Caution/Monitor.

            • flavoxate

              donepezil increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fluconazole

              donepezil and fluconazole both increase QTc interval. Use Caution/Monitor.

            • fluoxetine

              fluoxetine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              donepezil and fluoxetine both increase QTc interval. Use Caution/Monitor.

            • fluphenazine

              donepezil and fluphenazine both increase QTc interval. Use Caution/Monitor.

            • fluvoxamine

              donepezil and fluvoxamine both increase QTc interval. Use Caution/Monitor.

            • formoterol

              donepezil and formoterol both increase QTc interval. Use Caution/Monitor.

            • fostemsavir

              donepezil and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

            • galantamine

              donepezil and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.

            • gemifloxacin

              donepezil and gemifloxacin both increase QTc interval. Use Caution/Monitor.

            • gemtuzumab

              donepezil and gemtuzumab both increase QTc interval. Use Caution/Monitor.

            • gilteritinib

              donepezil and gilteritinib both increase QTc interval. Use Caution/Monitor.

            • glycopyrrolate

              donepezil increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • glycopyrrolate inhaled

              donepezil increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • goserelin

              donepezil and goserelin both increase QTc interval. Use Caution/Monitor.

            • granisetron

              donepezil and granisetron both increase QTc interval. Use Caution/Monitor.

            • haloperidol

              donepezil and haloperidol both increase QTc interval. Use Caution/Monitor.

            • henbane

              donepezil increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • homatropine

              donepezil increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • huperzine A

              donepezil and huperzine A both increase cholinergic effects/transmission. Use Caution/Monitor.

            • hydroxyzine

              donepezil and hydroxyzine both increase QTc interval. Use Caution/Monitor.

            • hyoscyamine

              donepezil increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hyoscyamine spray

              donepezil increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • imipramine

              donepezil increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              donepezil and imipramine both increase QTc interval. Use Caution/Monitor.

            • indacaterol, inhaled

              donepezil and indacaterol, inhaled both increase QTc interval. Use Caution/Monitor.

            • ipratropium

              donepezil increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • itraconazole

              donepezil and itraconazole both increase QTc interval. Use Caution/Monitor.

            • ketoconazole

              ketoconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lapatinib

              donepezil and lapatinib both increase QTc interval. Use Caution/Monitor.

            • letermovir

              letermovir increases levels of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • leuprolide

              donepezil and leuprolide both increase QTc interval. Use Caution/Monitor.

            • levalbuterol

              donepezil and levalbuterol both increase QTc interval. Use Caution/Monitor.

            • levofloxacin

              donepezil and levofloxacin both increase QTc interval. Use Caution/Monitor.

            • levoketoconazole

              levoketoconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lofepramine

              donepezil increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loperamide

              donepezil and loperamide both increase QTc interval. Use Caution/Monitor.

            • lumefantrine

              lumefantrine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • maprotiline

              donepezil increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              donepezil and maprotiline both increase QTc interval. Use Caution/Monitor.

            • meclizine

              donepezil increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mefloquine

              donepezil and mefloquine both increase QTc interval. Use Caution/Monitor.

            • methscopolamine

              donepezil increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mifepristone

              donepezil and mifepristone both increase QTc interval. Use Caution/Monitor.

            • mirtazapine

              donepezil and mirtazapine both increase QTc interval. Use Caution/Monitor.

            • neostigmine

              donepezil and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

            • nortriptyline

              donepezil increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              donepezil and nortriptyline both increase QTc interval. Use Caution/Monitor.

            • octreotide

              donepezil and octreotide both increase QTc interval. Use Caution/Monitor.

            • ofloxacin

              donepezil and ofloxacin both increase QTc interval. Use Caution/Monitor.

            • olanzapine

              donepezil and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances

            • olodaterol inhaled

              donepezil and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.

            • onabotulinumtoxinA

              donepezil increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • orphenadrine

              donepezil increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • osilodrostat

              osilodrostat and donepezil both increase QTc interval. Use Caution/Monitor.

            • oxybutynin

              donepezil increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxybutynin topical

              donepezil increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxybutynin transdermal

              donepezil increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pancuronium

              donepezil increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • paroxetine

              paroxetine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              donepezil and paroxetine both increase QTc interval. Use Caution/Monitor.

            • pasireotide

              donepezil and pasireotide both increase QTc interval. Use Caution/Monitor.

            • perphenazine

              donepezil and perphenazine both increase QTc interval. Use Caution/Monitor.

            • physostigmine

              donepezil and physostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

            • pilocarpine

              donepezil and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

            • posaconazole

              donepezil and posaconazole both increase QTc interval. Use Caution/Monitor.

            • pralidoxime

              donepezil increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • primaquine

              donepezil and primaquine both increase QTc interval. Use Caution/Monitor.

            • prochlorperazine

              donepezil and prochlorperazine both decrease QTc interval. Use Caution/Monitor.

            • promethazine

              donepezil and promethazine both decrease QTc interval. Use Caution/Monitor.

            • propantheline

              donepezil increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • protriptyline

              donepezil increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              donepezil and protriptyline both increase QTc interval. Use Caution/Monitor.

            • pyridostigmine

              donepezil and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

            • quinidine

              quinidine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • ramelteon

              donepezil will increase the level or effect of ramelteon by unspecified interaction mechanism. Use Caution/Monitor. AUC and Cmax increased by 100% and 87% respectively.

            • ranolazine

              donepezil and ranolazine both increase QTc interval. Use Caution/Monitor.

            • rapacuronium

              donepezil increases and rapacuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • rifabutin

              rifabutin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifampin

              rifampin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rilpivirine

              donepezil and rilpivirine both increase QTc interval. Use Caution/Monitor.

            • risperidone

              donepezil and risperidone both increase QTc interval. Use Caution/Monitor.

            • rivastigmine

              donepezil and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

            • rocuronium

              donepezil increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • romidepsin

              donepezil and romidepsin both increase QTc interval. Use Caution/Monitor.

            • salmeterol

              donepezil and salmeterol both increase QTc interval. Use Caution/Monitor.

            • scopolamine

              donepezil increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sertraline

              donepezil and sertraline both increase QTc interval. Use Caution/Monitor.

            • solifenacin

              donepezil increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • St John's Wort

              St John's Wort will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • succinylcholine

              donepezil and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.

            • sunitinib

              donepezil and sunitinib both increase QTc interval. Use Caution/Monitor.

            • tacrolimus

              donepezil and tacrolimus both increase QTc interval. Use Caution/Monitor.

            • telavancin

              donepezil and telavancin both increase QTc interval. Use Caution/Monitor.

            • tiotropium

              donepezil increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tolterodine

              donepezil increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triclabendazole

              donepezil and triclabendazole both increase QTc interval. Use Caution/Monitor.

            • trifluoperazine

              donepezil and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • trihexyphenidyl

              donepezil decreases effects of trihexyphenidyl by pharmacodynamic antagonism. Use Caution/Monitor.

            • trimipramine

              donepezil increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triptorelin

              donepezil and triptorelin both increase QTc interval. Use Caution/Monitor.

            • trospium chloride

              donepezil increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • umeclidinium bromide/vilanterol inhaled

              donepezil and umeclidinium bromide/vilanterol inhaled both decrease QTc interval. Use Caution/Monitor.

            • valbenazine

              valbenazine and donepezil both increase QTc interval. Use Caution/Monitor.

            • vardenafil

              donepezil and vardenafil both increase QTc interval. Use Caution/Monitor.

            • vecuronium

              donepezil increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • venlafaxine

              donepezil and venlafaxine both decrease QTc interval. Use Caution/Monitor.

            • vilanterol/fluticasone furoate inhaled

              donepezil and vilanterol/fluticasone furoate inhaled both increase QTc interval. Use Caution/Monitor.

            • voclosporin

              donepezil and voclosporin both increase QTc interval. Use Caution/Monitor.

            • voriconazole

              donepezil and voriconazole both increase QTc interval. Use Caution/Monitor.

            • vorinostat

              donepezil and vorinostat both increase QTc interval. Use Caution/Monitor.

            Minor (130)

            • aclidinium

              donepezil decreases effects of aclidinium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • amiodarone

              amiodarone will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • amobarbital

              amobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • anticholinergic/sedative combos

              donepezil decreases effects of anticholinergic/sedative combos by pharmacodynamic antagonism. Minor/Significance Unknown.

            • aprepitant

              aprepitant will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • armodafinil

              armodafinil will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • artemether/lumefantrine

              artemether/lumefantrine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • asenapine

              asenapine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • atazanavir

              atazanavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • atracurium

              donepezil decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • atropine

              donepezil decreases effects of atropine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • atropine IV/IM

              donepezil decreases effects of atropine IV/IM by pharmacodynamic antagonism. Minor/Significance Unknown.

            • belladonna alkaloids

              donepezil decreases effects of belladonna alkaloids by pharmacodynamic antagonism. Minor/Significance Unknown.

            • belladonna and opium

              donepezil decreases effects of belladonna and opium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • bethanechol

              donepezil increases effects of bethanechol by pharmacodynamic synergism. Minor/Significance Unknown.

            • bosentan

              bosentan will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • budesonide

              budesonide will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • bupropion

              bupropion will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • butabarbital

              butabarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • butalbital

              butalbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • carbachol

              donepezil increases effects of carbachol by pharmacodynamic synergism. Minor/Significance Unknown.

            • celecoxib

              celecoxib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • cevimeline

              donepezil increases effects of cevimeline by pharmacodynamic synergism. Minor/Significance Unknown.

            • chloroquine

              chloroquine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • cimetidine

              cimetidine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • cisatracurium

              donepezil decreases effects of cisatracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • conivaptan

              conivaptan will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • cortisone

              cortisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • cyclizine

              donepezil decreases effects of cyclizine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • cyclobenzaprine

              donepezil decreases effects of cyclobenzaprine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • cyclosporine

              cyclosporine will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • darifenacin

              darifenacin will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              darifenacin will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              donepezil decreases effects of darifenacin by pharmacodynamic antagonism. Minor/Significance Unknown.

            • darunavir

              darunavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • dasatinib

              dasatinib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • deferasirox

              deferasirox will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • desipramine

              donepezil increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • dexamethasone

              dexamethasone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • DHEA, herbal

              DHEA, herbal will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • dicyclomine

              donepezil decreases effects of dicyclomine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • diphenhydramine

              diphenhydramine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              donepezil decreases effects of diphenhydramine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • dronedarone

              dronedarone will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              dronedarone will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • duloxetine

              duloxetine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • echothiophate iodide

              donepezil increases effects of echothiophate iodide by pharmacodynamic synergism. Minor/Significance Unknown.

            • eslicarbazepine acetate

              eslicarbazepine acetate will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • etravirine

              etravirine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • fesoterodine

              donepezil decreases effects of fesoterodine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • flavoxate

              donepezil decreases effects of flavoxate by pharmacodynamic antagonism. Minor/Significance Unknown.

            • fluconazole

              fluconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • fludrocortisone

              fludrocortisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • fosamprenavir

              fosamprenavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • fosaprepitant

              fosaprepitant will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • fosphenytoin

              fosphenytoin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • galantamine

              donepezil increases effects of galantamine by pharmacodynamic synergism. Minor/Significance Unknown.

            • glycopyrrolate

              donepezil decreases effects of glycopyrrolate by pharmacodynamic antagonism. Minor/Significance Unknown.

            • glycopyrrolate inhaled

              donepezil decreases effects of glycopyrrolate inhaled by pharmacodynamic antagonism. Minor/Significance Unknown.

            • grapefruit

              grapefruit will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • griseofulvin

              griseofulvin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • haloperidol

              haloperidol will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • henbane

              donepezil decreases effects of henbane by pharmacodynamic antagonism. Minor/Significance Unknown.

            • homatropine

              donepezil decreases effects of homatropine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • huperzine A

              donepezil increases effects of huperzine A by pharmacodynamic synergism. Minor/Significance Unknown.

            • hydrocortisone

              hydrocortisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • hyoscyamine

              donepezil decreases effects of hyoscyamine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • hyoscyamine spray

              donepezil decreases effects of hyoscyamine spray by pharmacodynamic antagonism. Minor/Significance Unknown.

            • imatinib

              imatinib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • indinavir

              indinavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ipratropium

              donepezil decreases effects of ipratropium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • isoniazid

              isoniazid will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • lapatinib

              lapatinib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • lumefantrine

              lumefantrine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • maraviroc

              maraviroc will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • marijuana

              marijuana will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              marijuana will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • meclizine

              donepezil decreases effects of meclizine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • methscopolamine

              donepezil decreases effects of methscopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • methylprednisolone

              methylprednisolone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • metronidazole

              metronidazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • miconazole vaginal

              miconazole vaginal will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nefazodone

              nefazodone will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nelfinavir

              nelfinavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • neostigmine

              donepezil increases effects of neostigmine by pharmacodynamic synergism. Minor/Significance Unknown.

            • nevirapine

              nevirapine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nifedipine

              nifedipine will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nilotinib

              nilotinib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              nilotinib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • onabotulinumtoxinA

              donepezil decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.

            • oxcarbazepine

              oxcarbazepine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • oxybutynin

              donepezil decreases effects of oxybutynin by pharmacodynamic antagonism. Minor/Significance Unknown.

            • oxybutynin topical

              donepezil decreases effects of oxybutynin topical by pharmacodynamic antagonism. Minor/Significance Unknown.

            • oxybutynin transdermal

              donepezil decreases effects of oxybutynin transdermal by pharmacodynamic antagonism. Minor/Significance Unknown.

            • pancuronium

              donepezil decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • pantothenic acid

              pantothenic acid, donepezil. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.

            • parecoxib

              parecoxib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • pentobarbital

              pentobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • perphenazine

              perphenazine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • phenobarbital

              phenobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • phenytoin

              phenytoin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • physostigmine

              donepezil increases effects of physostigmine by pharmacodynamic synergism. Minor/Significance Unknown.

            • pilocarpine

              donepezil increases effects of pilocarpine by pharmacodynamic synergism. Minor/Significance Unknown.

            • posaconazole

              posaconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • pralidoxime

              donepezil decreases effects of pralidoxime by pharmacodynamic antagonism. Minor/Significance Unknown.

            • prednisone

              prednisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • primidone

              primidone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • procainamide

              procainamide decreases effects of donepezil by pharmacodynamic antagonism. Minor/Significance Unknown.

            • propafenone

              propafenone will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • propantheline

              donepezil decreases effects of propantheline by pharmacodynamic antagonism. Minor/Significance Unknown.

            • pyridostigmine

              donepezil increases effects of pyridostigmine by pharmacodynamic synergism. Minor/Significance Unknown.

            • quinacrine

              quinacrine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • quinupristin/dalfopristin

              quinupristin/dalfopristin will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ranolazine

              ranolazine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • rapacuronium

              donepezil decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • rifapentine

              rifapentine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ritonavir

              ritonavir will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              ritonavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • rocuronium

              donepezil decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • rufinamide

              rufinamide will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • scopolamine

              donepezil decreases effects of scopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • secobarbital

              secobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • sertraline

              sertraline will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • solifenacin

              donepezil decreases effects of solifenacin by pharmacodynamic antagonism. Minor/Significance Unknown.

            • succinylcholine

              donepezil increases effects of succinylcholine by pharmacodynamic synergism. Minor/Significance Unknown.

            • thioridazine

              thioridazine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • tiotropium

              donepezil decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • tipranavir

              tipranavir will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • tolterodine

              donepezil decreases effects of tolterodine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • topiramate

              topiramate will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • trazodone

              donepezil increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • trospium chloride

              donepezil decreases effects of trospium chloride by pharmacodynamic antagonism. Minor/Significance Unknown.

            • vecuronium

              donepezil decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • venlafaxine

              venlafaxine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • verapamil

              verapamil will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • voriconazole

              voriconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • zafirlukast

              zafirlukast will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

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            Adverse Effects

            >10%

            Nausea (3-19%)

            Diarrhea (5-15%)

            Insomnia (2-14%)

            Accident (7-13%)

            Infection (11%)

            1-10%

            Headache (3-10%)

            Vomiting (3-8%)

            Cramping (3-8%)

            Fatigue (3-8%)

            Anorexia (2-8%)

            Hypertension (3% )

            Abnormal dreams (3%)

            Hallucinations (3%)

            Confusion (2%)

            Syncope (2%)

            Postmarketing reports

            Abdominal pain, agitation, aggression, cholecystitis, convulsions, heart block (all types), hemolytic anemia, hepatitis, hyponatremia, neuroleptic malignant syndrome, pancreatitis, rash, rhabdomyolysis, QTc prolongation, Stevens Johnson syndrome toxic epidermal necrolysis and torsade de pointes

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            Warnings

            Contraindications

            Hypersensitivity to donepezil or to piperidine derivatives

            Cautions

            Risk of GI bleed, especially in patients with history of gastric ulcer or those on NSAIDs

            Cholinesterase inhibitors are likely to exaggerate succinylcholine-type muscle relaxation during anesthesia

            Cholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes manifesting as bradycardia or heart block

            Can cause vomiting (higher risk with dose of 23 mg/day)

            May cause anorexia and/or weight loss (dose dependent)

            Cholinomimetics may cause bladder outflow obstructions

            Cholinomimetics are believed to have some potential to cause generalized convulsions

            Cholinesterase inhibitors should be prescribed with care with history of asthma or obstructive pulmonary disease

            Use with caution in patients with history of seizure disorders, urinary tract obstruction, peptic ulcer disease, cardiac conduction abnormalities, or respiratory disease including COPD or asthma

            May be associated with QT prolongation and torsades de pointes; use caution in patients at risk of cardiac repolarization

            Rare cases of neuroleptic malignant syndrome reported; may consider discontinuing therapy if symptoms occur

            Rare cases of rhabdomyolysis reported following few months of therapy or following therapy initiation; use caution in patients with risk factors rhabdomyolysis, including medications associated with rhabdomyolysis; consider discontinuing therapy if marked elevation of CPK levels or symptoms suggesting rhabdomyolysis occur

            Low weight patients <55 kg may experience more weight loss, nausea, and vomiting than patients >55 kg

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            Pregnancy & Lactation

            Pregnancy category: C

            Pregnancy

            There are no adequate data on developmental risks associated with use in pregnant women

            Animal data

            • In animal studies, developmental toxicity was not observed when donepezil was administered to pregnant rats and rabbits during organogenesis, but administration to rats during latter part of pregnancy and throughout lactation resulted in increased stillbirths and decreased offspring survival at clinically relevant doses; in the U.S. general population, estimated background risks of major birth defects and miscarriage in clinically recognized pregnancies are 2% to 4% and 15% to 20%, respectively; background risks of major birth defects and miscarriage for indicated population are unknown

            Lactation

            There are no data on presence of donepezil or metabolites in human milk, effects on breastfed infant, or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Reversible acetylcholinesterase inhibitor; increases acetylcholine concentrations, which in turn enhances cholinergic neurotransmission

            Absorption

            Bioavailability: 100%

            Peak plasma time: 3-4 hr

            Distribution

            Protein bound: 96%

            Vd: 12-16 L/kg

            Metabolism

            Hepatic P-450 enzymes CYP2D6, CYP3A4

            Metabolites: 4 major metabolites, 2 active

            Elimination

            Half-life: 70 hr

            Total body clearance: 0.13 L/hr/kg

            Excretion: Urine (57%), feces (17%)

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Aricept oral
            -
            10 mg tablet
            Aricept oral
            -
            23 mg tablet
            Aricept oral
            -
            5 mg tablet
            donepezil oral
            -
            10 mg tablet
            donepezil oral
            -
            10 mg tablet
            donepezil oral
            -
            5 mg tablet
            donepezil oral
            -
            23 mg tablet
            donepezil oral
            -
            10 mg tablet
            donepezil oral
            -
            23 mg tablet
            donepezil oral
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            23 mg tablet
            donepezil oral
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            donepezil oral
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            23 mg tablet
            donepezil oral
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            10 mg tablet
            donepezil oral
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            23 mg tablet
            donepezil oral
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            10 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            10 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            10 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            10 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            10 mg tablet
            donepezil oral
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            10 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            5 mg tablet
            donepezil oral
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            5 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            donepezil oral

            DONEPEZIL - ORAL

            (doh-NEP-eh-zil)

            COMMON BRAND NAME(S): Aricept

            USES: Donepezil is used to treat confusion (dementia) related to Alzheimer's disease. It does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to function. This medication is an enzyme blocker that works by restoring the balance of natural substances (neurotransmitters) in the brain.

            HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking donepezil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily just before bedtime. If you experience sleep problems (insomnia), talk to your doctor about switching to a morning dose.If you are taking the 23-milligram strength tablets, swallow them whole. Do not split, crush, or chew these tablets. Doing so can increase the risk of side effects.Dosage is based on your medical condition and response to treatment. To reduce your risk of side effects (such as nausea and diarrhea), your doctor will start this medication at a low dose and gradually increase your dose over weeks to months. Follow your doctor's instructions carefully. Do not increase your dose or use this drug more often than prescribed.If you do not take donepezil for 7 or more days in row, talk with your doctor before starting again. You may need to start at a lower dose to decrease the risk of side effects.Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day. Do not stop taking it unless your doctor instructs you to do so. It may take a several weeks before you get the full benefit of this drug.Tell your doctor if your condition worsens.

            SIDE EFFECTS: Nausea, vomiting, diarrhea, loss of appetite/weight loss, dizziness, drowsiness, weakness, trouble sleeping, shakiness (tremor), or muscle cramps may occur as your body adjusts to the drug. These effects usually last 1-3 weeks and then lessen. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: trouble urinating, severe stomach/abdominal pain, black stools, vomit that looks like coffee grounds, seizures.Get medical help right away if you have any very serious side effects, including: slow/fast/irregular heartbeat, severe dizziness, fainting.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking donepezil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as asthma, chronic obstructive pulmonary disease), fainting, seizures, stomach/intestinal disease (such as ulcers, bleeding), trouble urinating (such as enlarged prostate).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Donepezil may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using donepezil, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using donepezil safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aspirin/non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen, naproxen).Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, or naproxen) that if taken together with donepezil may increase your risk for stomach/intestinal bleeding. Low-dose aspirin, as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually 81-162 milligrams a day), should be continued. Consult your doctor or pharmacist for more details.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include nausea/vomiting that is severe or doesn't stop, excessive sweating, very slow heartbeat, slow or shallow breathing, seizures.

            NOTES: Do not share this medication with others.Your doctor should check your weight periodically to monitor for side effects.

            MISSED DOSE: If you miss a dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised March 2023. Copyright(c) 2023 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.