Jeffrey Panko NP Psychiatry · Patient education
Donepezil
Aricept / Adlarity patch / Generic oral formulations
A guide for adults taking donepezil.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Oral tablets and dissolving tablets are generally taken daily. Adlarity is a once-weekly patch with separate application and switching instructions.
What it is used for
Donepezil treats symptoms of Alzheimer dementia. It may help cognition or daily functioning for a time, but it does not cure Alzheimer disease or stop its progression.
How it works
It slows the breakdown of acetylcholine, a messenger involved in memory and attention. Increased acetylcholine also affects the digestive tract and heart rate.
What to expect over time
The dose is adjusted gradually. Benefit is assessed over weeks to months through memory, daily tasks, and caregiver observations. Stabilization can be meaningful even without an obvious improvement.
Taking your medication
- Take the exact formulation and schedule prescribed, with or without food for oral treatment.
- Do not split or crush the 23-mg tablet. Follow the dissolving-tablet instructions if prescribed.
- Do not double a missed oral dose. After one week or longer off oral treatment, call before restarting.
- For a patch, remove the old patch before applying one new patch and follow site rotation and heat precautions.
When to get help
Emergency symptoms. Get emergency care for fainting with a slow pulse, black or bloody stools, vomiting blood, a seizure, or severe breathing difficulty.
Prompt medical advice. Report persistent vomiting or diarrhea, weight loss, new falls, or a severe skin reaction to a patch.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Nausea, diarrhea, or vomiting
- Reduced appetite or weight loss
- Muscle cramps, fatigue, or dizziness
- Insomnia or vivid dreams; patch-site irritation
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Track weight, appetite, gastrointestinal symptoms, falls, and pulse-related symptoms. Report fainting, black stools, or persistent vomiting.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss a slow pulse, heart block, fainting, ulcers or bleeding, asthma or COPD, seizures, and urinary obstruction.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Beta-blockers and other medicines that slow the heart can add fainting risk. Anticholinergic medicines may work against donepezil and worsen cognition.
NSAIDs can add gastrointestinal bleeding risk. Tell the anesthesia team before surgery.
Everyday tips
Use a caregiver-supported dose routine when needed.
Keep a record of patch placement and replacement dates if using Adlarity.
Your questions answered
How will we know whether it helps?
Review familiar tasks, communication, and care needs over time. A caregiver’s observations can help distinguish a useful effect from day-to-day fluctuation.
Can I stop if memory still worsens?
Consult with your provider. The decision should consider benefit, side effects, disease stage, and your goals.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.