Patient/caregiver was educated on how to take Donepezil as follows:
- Take/administer the medication at the same time, every day, to avoid forgetting the medication. Taking/administering the medication at regularly spaced intervals helps to maintain appropriate blood levels of donepezil needed to derive the desired beneficial effects and also prevent toxicity with the medication.
- Maintain strict compliance with intake of the medication as ordered, with regards to dosage and frequency, to derive the benefit of the medication.
- Do not change the dose on this medication without consulting your doctor.
- This medication can induce some nausea and vomiting, when taken on empty stomach. Taking the medication with a glass of water and some food or snack can help avoid these unpleasant gastrointestinal symptoms.
- Donepezil can induce some dizziness and confusion. Do not take donepezil with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the confusion caused by donepezil. A number of OTC cough medications, antihistamines, and antianxiety medications, can potentiate the confusion caused by donepezil and so, must be avoided taking along with donepezil. Starting the medication at a low dose and gradually increasing the dose, to help optimum control of your symptoms, can contribute to reducing the risk for drowsiness and dizziness due to the medication.
- Take the donepezil regular tablet as a whole. If you encounter difficulty swallowing the whole tablet, you may cut the tablet and swallow it in pieces with a glass of water. You may also crush the tablet and sprinkle the powder on a spoonful of soft jelly or applesauce and swallow the jelly or sauce along with the medication.
- Donepezil is also available as an orally disintegrating tablet, which absorbs moisture from the atmosphere around rapidly and can start to dissolve. So, remove only one dose from the package at a time, just when it is time for intake of the dose. Make sure the hands are dry before getting the tablet out of the package. This orally disintegrating tablet must be placed on the tongue, allowed to dissolve in the mouth for one minute, before swallowing the remnants in the mouth with saliva. Do not chew on this tablet and do not swallow it as a whole, which can compromise the therapeutic benefit of the medication.
- Donepezil takes some time to fairly balance the chemicals in the brain, before any improvement in memory and behavior are noted. It could take about 3 – 4 weeks to note these changes and so, do not discontinue taking the medication without your physician’s consult, as you failed to see the improvement with Alzheimer’s symptoms immediately after taking the medication.
- Donepezil only helps with managing the Alzheimer’s symptoms, prevent further deterioration of memory, improve the ability to think, and restore functionality and awareness, by affecting the fine balance of chemicals neurotransmitters in the brain and is not a permanent cure. So, continue taking donepezil, even if the symptoms improve and you start feeling better. Discontinuing the medication abruptly can result in disruption of this chemical balance in the brain, resulting in further progression of Alzheimer’s and worsening of memory and cognitive skills. Discontinuation on donepezil use must only be on your physician’s recommendation.
- Donepezil intake closer to the sleep time can result in insomnia, with patients presenting with restlessness and irritability during the day time. If the insomnia is being severe, avoid taking the medication at bedtime. Report the insomnia to your physician and plan to have the medication sometime during the day, to avoid the induction of insomnia, with donepezil taken at sleep time. Also, avoid taking any caffeinated drinks closer to bedtime, which can help to have a restful sleep.
- As the chemical balance in the brain has to be finely regulated to help prevent worsening of memory, avoid having unpleasant side-effects and toxicity with donepezil, and experience feelings of well-being, the dose of donepezil needs to be finely regulated, in order to accomplish this goal.
- Your physician could change the dose of donepezil, based on the response and side-effects developed. Maintain compliance with follow-up physician appointments and be accommodative to the plan of dose changes, until you show an optimum response.
- Notify your doctor of any unresolved and worsening side-effects of donepezil use, such as, excessive salivation, vomiting, diarrhea, extremely slow heart rate with hypotension and dizziness symptoms, or any difficulty breathing. Also, notify your doctor of any progressively diminishing cognitive skills and memory, despite compliance with the medication, so that, your dosage on the medication could be revised or an alternative plan of treatment be considered.
- If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.
