Donepezil

Donepezil
Clinical data
Trade namesAricept, others
Other namesDonepezil hydrochloride (USAN US)
AHFS/Drugs.comMonograph
MedlinePlusa697032
License data
Pregnancy
category
  • AU: B3
Routes of
administration		By mouth, transdermal
Drug classAcetylcholinesterase inhibitor
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability100%[7][8]
Protein binding96%, albumin (about 75%) and alpha1-acid glycoprotein (21%).[8][7]
MetabolismCYP2D6, CYP3A4, and glucuronidation.[7] Four major metabolites, two of which are active.[8][7]
Onset of actionPeak plasma levels in 3–4 h.[8][7]
Elimination half-life70 hours[9] Around 100 hours in elderly patients.[7]
Duration of actionWith daily dosing, steady-state concentration is reached in 15–21 days.[8][7]
Excretion0.11–0.13 (L/h/kg); excreted mostly by the kidneys. Around 17% is excreted unchanged in the urine. About 15% to 20% is excreted in feces.[7][8] Steady-state clearance is similar at all ages.[7]
Identifiers
IUPAC name
  • (RS)-2-[(1-Benzyl-4-piperidyl)methyl]-5,6-dimethoxy-2,3-dihydroinden-1-one
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.125.198
Chemical and physical data
FormulaC24H29NO3
Molar mass379.500 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
SMILES
  • O=C2c1cc(OC)c(OC)cc1CC2CC4CCN(Cc3ccccc3)CC4
InChI
  • InChI=1S/C24H29NO3/c1-27-22-14-19-13-20(24(26)21(19)15-23(22)28-2)12-17-8-10-25(11-9-17)16-18-6-4-3-5-7-18/h3-7,14-15,17,20H,8-13,16H2,1-2H3 Y
  • Key:ADEBPBSSDYVVLD-UHFFFAOYSA-N Y
  (verify)

Donepezil, sold under the brand name Aricept among others, is a medication used to treat dementia of the Alzheimer's type.[5][6][10] It appears to result in a small benefit in mental function and ability to function.[11] Use, however, has not been shown to change the progression of the disease.[12] Treatment should be stopped if no benefit is seen.[13][14] It is taken by mouth or via a transdermal patch.[5][6][10]

Donepezil is a centrally acting reversible acetylcholinesterase inhibitor and structurally unrelated to other anticholinesterase agents.[10][7] Common side effects include nausea, trouble sleeping, aggression, diarrhea, feeling tired, and muscle cramps.[10][13] Serious side effects may include abnormal heart rhythms, urinary incontinence, and seizures.[10]

Donepezil was approved for medical use in the United States in 1996.[10] It is available as a generic medication.[13] In 2022, it was the 146th most commonly prescribed medication in the United States, with more than 3 million prescriptions.[15][16]

  1. ^ Anvisa (31 March 2023). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 4 April 2023). Archived from the original on 3 August 2023. Retrieved 16 August 2023.
  2. ^ "Aricept RDT Product information". Health Canada. 28 October 2022. Retrieved 16 February 2025.
  3. ^ "Aricept Product information". Health Canada. 20 August 1997. Retrieved 16 February 2025.
  4. ^ "Donepezil Hydrochloride 10 mg Film-coated tablets". Electronic Medicines Compendium. Archived from the original on 8 September 2022. Retrieved 8 September 2022.
  5. ^ a b c "Aricept- donepezil hydrochloride tablet, film coated Aricept ODT- donepezil hydrochloride tablet, orally disintegrating". DailyMed. 23 December 2021. Retrieved 15 March 2022.
  6. ^ a b c "Adlarity- donepezil hydrochloride patch". DailyMed. 11 March 2022. Retrieved 19 June 2022.
  7. ^ a b c d e f g h i j Cite error: The named reference Kum2020 was invoked but never defined (see the help page).
  8. ^ a b c d e f Seltzer B (October 2005). "Donepezil: a review". Expert Opinion on Drug Metabolism & Toxicology. 1 (3). Informa Healthcare: 527–536. doi:10.1517/17425255.1.3.527. PMID 16863459. S2CID 32689288. there is a linear relationship between dose and pharmacodynamic effects, measured as red blood cell acetylcholinesterase inhibition and clinical efficacy. Despite being 96% bound to plasma proteins, it has few interactions with other drugs, and the 5-mg dose can be given safely to patients with mild-to-moderate hepatic and renal-disease.
  9. ^ Asiri YA, Mostafa GA (2010). "Donepezil". Profiles of Drug Substances, Excipients and Related Methodology. Vol. 35. Elsevier. pp. 117–50. doi:10.1016/s1871-5125(10)35003-5. ISBN 978-0-12-380884-4. ISSN 1871-5125. PMID 22469221. S2CID 206178636. Plasma donepezil concentrations decline with a half-life of approximately 70 h. Sex, race, and smoking history have no clinically significant influence on plasma concentrations of donepezil [46–51].
  10. ^ a b c d e f "Donepezil Hydrochloride Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 4 February 2019.
  11. ^ Birks JS, Harvey RJ (June 2018). "Donepezil for dementia due to Alzheimer's disease". The Cochrane Database of Systematic Reviews. 2018 (6): CD001190. doi:10.1002/14651858.CD001190.pub3. PMC 6513124. PMID 29923184.
  12. ^ Swedish Council on Health Technology Assessment (June 2008). "Dementia – Caring, Ethics, Ethnical and Economical Aspects: A Systematic Review". SBU Systematic Reviews. PMID 28876770.
  13. ^ a b c British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 300. ISBN 978-0-85711-338-2.
  14. ^ "Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease: Evidence and interpretation § 4.3.44". National Institute for Health and Care Excellence. 20 June 2018. Archived from the original on 9 September 2024. Retrieved 20 January 2025.
  15. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  16. ^ "Donepezil Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
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