Anti Depressants

Aricept (Donepezil)

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Aricept (Donepezil) is a centrally acting reversible acetyl cholinesterase inhibitor. Its main therapeutic use is in the treatment of Alzheimer's disease where it is used to increase cortical acetylcholine. Donepezil is postulated to exert its therapeutic effect by enhancing cholinergic function. This is accomplished by increasing the concentration of acetylcholine through reversible inhibition of its hydrolysis by acetylcholinesterase. If this proposed mechanism of action is correct donepezil's effect may lessen as the disease process advances and fewer cholinergic neurons remain functionally intact.

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About Aricept (Donepezil):

Product Type: Other

Brand name: Aricept Generic name: Donepezil What is Aricept (Donepezil)? Aricept improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical which is important for the processes of memory thinking and reasoning. Aricept is used to treat mild to moderate dementia caused by Alzheimer's disease. Aricept may also be used for other purposes not listed in this medication guide. What is the most important information I should know about donepezil? Before taking donepezil tell your doctor if you have a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats) an enlarged prostate urination problems asthma obstructive pulmonary disease or a seizure disorder such as epilepsy. If you need to have any type of surgery tell the surgeon ahead of time that you are taking donepezil. Aricept can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. What should I discuss with my healthcare provider before taking donepezil? Do not take this medication if you are allergic to donepezil. Before taking donepezil tell your doctor if you are allergic to any drugs or if you have: • a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats); • a history of stomach ulcers; • an enlarged prostate or urination problems; • epilepsy or other seizure disorder; or • asthma or chronic obstructive pulmonary disease (COPD). If you have any of these conditions you may need a dose adjustment or special tests to safely take donepezil. FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether donepezil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I take donepezil? Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts or take it for longer than recommended by your doctor. Follow the directions on your prescription label. If you need to have any type of surgery tell the surgeon ahead of time that you are taking donepezil. You may need to stop using the medicine for a short time. Aricept can be taken with or without food or milk. Take the donepezil regular tablets with a full glass of water. To take donepezil orally disintegrating tablet (Aricept ODT): • Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel or cut the backing from the tablet blister. Do not push a tablet through the backing or you may damage the tablet. • Using dry hands remove the tablet and place it in your mouth. It will begin to dissolve right away. • Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. • Swallow several times as the tablet dissolves. After the tablet dissolves completely drink a glass of water. Aricept is usually taken at bedtime. Follow your doctor's instructions. Store donepezil at room temperature away from moisture and heat. What happens if I miss a dose? Take the missed dose as soon as you remember. If it is almost time for your next dose skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include severe nausea vomiting drooling sweating blurred vision feeling light-headed slow heartbeat shallow breathing muscle weakness fainting or seizure (convulsions). What should I avoid while taking donepezil? Aricept can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Aricept side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face lips tongue or throat. Stop using donepezil and call your doctor at once if you have any of these serious side effects: • black bloody or tarry stools; • coughing up blood or vomit that looks like blood or coffee grounds; • painful or difficult urination; • seizure (black-out or convulsions); Less serious side effects may include: • nausea vomiting diarrhea; • loss of appetite; • muscle cramps; • tired feeling; or • sleep problems (insomnia). This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. What other drugs will affect donepezil? Before taking donepezil tell your doctor if you are taking any of the following medicines: • atropine (Donnatal and others); • belladonna; • carbamazepine (Tegretol); • clidinium (Quarzan); • dexamethasone (Decadron); • dicyclomine (Bentyl); • glycopyrrolate (Robinul); • hyoscyamine (Anaspaz Cystospaz Levsin and others); • mepenzolate (Cantil); • methantheline (Provocholine); • methscopolamine (Pamine) scopolamine (Transderm-Scop); • phenobarbital (Luminal Solfoton); • phenytoin (Dilantin); • propantheline (Pro-Banthine); • quinidine (Cardioquin Quinidex Quinaglute others); • rifampin (Rifadin Rifamate Rifater); • a fungal antibiotic such as ketoconazole (Nizoral) fluconazole (Diflucan) or itraconazole (Sporanox); or • aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin Advil) naproxen (Aleve Naprosyn) diclofenac (Voltaren) diflunisal (Dolobid) etodolac (Lodine) flurbiprofen (Ansaid) indomethacin (Indocin) ketoprofen (Orudis) ketorolac (Toradol) mefenamic acid (Ponstel) meloxicam (Mobic) nabumetone (Relafen) piroxicam (Feldene) and others. This list is not complete and there may be other drugs that can interact with donepezil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins minerals herbal products and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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What should I discuss with my healthcare provider before taking Anafranil? • Do not take Anafranil if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan) phenelzine (Nardil) or tranylcypromine (Parnate) within the last 14 days. • Before taking Anafranil tell your doctor if you have liver disease kidney disease asthma thyroid disease diabetes stomach or intestinal problems high blood pressure or heart disease had a heart attack in the last 6 weeks an enlarged prostate or difficulty urinating glaucoma or seizures. • You may not be able to take Anafranil or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above. • While you are taking Anafranil you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Anafranil. In patients younger than 18 years the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety panic attacks difficulty sleeping irritability hostility impulsivity severe restlessness and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Anafranil. Do not stop taking Anafranil. • Anafranil is in the FDA pregnancy category C. This means that it is not known whether Anafranil will harm an unborn baby. 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If you experience drowsiness or dizziness avoid these activities. • Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Anafranil. • Grapefruit and grapefruit juice may interact with Anafranil. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. • Do not stop taking Anafranil suddenly. This could cause symptoms such as nausea headache and malaise. 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