Donepezil is a leading medication for treating all stages of Alzheimer’s disease, but did you know it can cause significant dental side effects and interact with common drugs like steroids, NSAIDs, and antibiotics? Dive into this article to uncover the surprising impacts and what you need to watch out for!
Generic Name: Donepezil
Brand Name(s): Aricept
Pronunciation: doe NEP e zil
About this drug:
Donepezil is used to improve the mental function and daily tasks in people with Alzheimer's type of dementia.
It is not a cure for Alzheimer's disease.
Dentistry-related tidbits:
Donepezil may cause a toothache, periodontal abscess, or gingivitis.
This medication may cause xerostomia. Consider prescribing a fluoride supplement if the patient has a high rate of caries and increasing the frequency of dental exams.
Monitor heart rate when administering Articaine, Bupivacaine, Lidocaine, Ropivacaine, or Mepivacaine to a patient taking Donepezil, as the combination may increase the risk of bradycardia.
Combining the anticonvulsant Carbamazepine with Donepezil may reduce Donepezil's efficacy, lower the seizure threshold, and elevate the risk of bradycardia, AV block, and altered PR interval.
The risk of QT prolongation and cardiac arrhythmia may increase when Donepezil is combined with macrolide antibiotics (e.g Azithromycin), quinolone antibiotics (e.g. Levofloxacin), the antifungal Fluconazole, and the narcotics Hydrocodone (especially if extended release doses > 160 mg/day) and Tramadol.
Exercise caution if prescribing Aspirin, Aspirin-containing products, NSAIDs, or steroids to avoid an increased risk of GI bleeding.
The seizure threshold may decrease when Donepezil is combined with benzodiazepines or anticonvulsants. Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.
Fun facts:
Alzheimer's disease is a type of dementia with an unknown cause but researchers believe an accumulation of amyloid plaques disrupt communication between brain cells.
Donepezil inhibits the enzyme that degrades acetylcholine, a neurotransmitter important for brain cell communication.
Grapefruit juice should be limited to < 1 liter to decrease the risk of QT prolongation and cardiac arrhythmias when combined with Donepezil.
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