Description:

Buy Donepezil

Donepezil is a selective and reversible inhibitor of acetylcholinesterase, which is the predominant type of cholinesterase in the brain. Donepezil inhibits this enzyme by more than 1000 times stronger than butyrylcholinesterase, contained mainly outside the central nervous system. Donepezil can be started only if there is a person caring for the patient who will constantly monitor the taking of the pills by the patient. Supportive therapy can be continued as long as the therapeutic effect of the drug persists. In this regard, the effect of donepezil should be regularly evaluated. The expediency of cessation of treatment should be discussed with the disappearance of its effect. Individual response to donepezil is impossible to predict. The effectiveness of the drug in patients with severe dementia of Alzheimer, other types of dementia, and other types of memory impairment (eg, age-related deterioration of cognitive function) has not been studied.

Donepezil can intensify the neuromuscular blockade caused by depolarizing muscle relaxants during general anesthesia.It is an anticholinesterase agent. Specific and reversible inhibitor of cholinesterase. Inhibiting cholinesterase in the brain, blocks the disintegration of acetylcholine, which transfers excitation to the central nervous system. A single dose of 5 mg or 10 mg in Css is accompanied by inhibition of cholinesterase activity (estimated in erythrocyte envelopes) by 63.6 and 77.3%, respectively. Slows down the progression of Alzheimer’s disease, reduces the severity of cognitive symptoms, in some cases restores the daytime activity of patients and facilitates the care of them. Corrects behavioral disorders, reduces apathy, hallucinations and unreasonable repetitive motions.

Precautionary Measures

Treatment should be started and continue under the supervision of a specialist doctor and with appropriate care for the patient (control of drug intake, etc.). Caution is advised if one has a history of arrhythmias, asthma, obstructive lung disease and peptic ulcer. Care is also needed in pregnancy and lactating women should stop breast feeding at the time of admission. The individual effects specially on performance in motor vehicles and other machinery need to be evaluated by a doctor.

Donepezil Dosage

Treatment should be started at a dose of 5 mg daily (single dose). Aricept drug should be given orally in the evening before bedtime. The dosage of 5 mg daily, should be continued for a minimum of 1 month, the time required to evaluate the clinical effect to treatment and achievement of steady state plasma concentrations. Based on the clinical results observed after 1 month of treatment at a dose of 5 mg daily, Aricept dosage may be doubled to 10 mg daily. As dosages above 10mg per day have not been studied in trials it is recommended that the daily Aricept doses are not increased from 10mg. Only physicians having experience in diagnosis and treatment of Alzheimer’s disease should be allowed to start a new patient on therapy based on Aricept packs. Donepezil treatment should be initiated in the presence of a family member who can regularly check that the patient is taking the medicine. Till the therapeutic advantage remains for the patient, Aricept drugs treatment can be continues. As a result, the clinical efficacy must be re evaluated on a regular schedule. The patient to patient response to treatment is not predictable. When donepezil therapy is stopped a steady decline in the useful effects of Aricept pill is seen.

Contraindications

Hypersensitivity to donepezil, other components of the drug, as well as to piperidine derivatives – the effectiveness and safety of donepezil in patients under the age of 18 years is not established – lactase deficiency, lactose intolerance, glucose-galactose malabsorption. With caution: Cholinesterase inhibitors should be administered with caution to patients with obstructive pulmonary disease in the anamnesis (including with bronchial asthma), with irregular heart rhythm possibly a vagotonic effect on heart rate (eg, bradycardia), anesthesia, as well as patients with an increased risk of developing peptic ulcer (for example, patients with a history of peptic ulcer disease or receiving concomitant therapy with nonsteroidal anti-inflammatory drugs), although Aricept did not show an increase in the incidence of peptic ulcers or gastrointestinal bleeding. It is necessary to avoid simultaneous use of donepezil with other acetylcholinesterase inhibitors, agonists or antagonists of the hall. The use of the drug in pregnancy is possible only if the intended benefit of therapy for the mother exceeds the potential risk to the fetus. Since the data on the excretion of donepezil with breast milk of lactating women there is no need to avoid the use of Aricept pills when breastfeeding.

Side Effects

The most commonly observed side effects were diarrhea, muscle cramps, fatigue, nausea, vomiting and insomnia. Poor metabolism and nutrition Anorexia. Also be very careful if you notice the following possible side effects:

• Psychiatry: hallucinations, agitation, aggressiveness, abnormal dreams and nightmares.
• The nervous system: syncope, dizziness, insomnia, seizures, extra-pyramidal symptoms, neuroleptic malignant syndrome.
• Cardiac: bradycardia, sino-auricular block, atrioventricular block.
• Gastrointestinal: diarrhea, nausea, vomiting, abdominal disorders, gastrointestinal bleeding, gastric and duodenal ulcer.
• Hepatobiliary: hepatic involvement including hepatitis.
• Skin: pruritus.
• Musculoskeletal: muscle cramps.
• Urogenital: urinary incontinence. general headache, tired, pain.
• Biological examination: slight increase in serum creatinine muscle kinase levels.
• When examining patients who have experienced syncope or convulsion, the possibility of heart block or prolonged sinus pause should be considered.

Donepezil  Interactions

Clinical experience with Aricept tablet is limited, so the doctor prescribing the drug must take into account the risk of unknown interactions to other means until now or the products of its metabolism do not inhibit the metabolism of theophylline, warfarin, cimetidine, digoxin, thioridazine, risperidone and sertraline. Simultaneous reception of digoxin, cimetidine, thioridazine, risperidone and sertraline does not affect the metabolism of donepezil. In patients with Parkinson’s disease who were treated with a combination of levodopa + [carbidopa], the use of donepezil for 21 days did not affect the concentration of these drugs in the blood.

There is no evidence of any effect of Aricept tablets on motor activity. Inducers of microsomal liver enzymes, such as rifampicin, phenytoin, carbamazepine and alcohol, can cause a decrease in donepezil concentration. Donepezil may interfere with the action of drugs that have anticholinergic activity. In addition, with the simultaneous use of donepezil can increase the action of suxamethonium, other muscle relaxants or agonists of cholinergic receptors and beta-adrenoblockers that affect cardiac conduction.