What is Donepezil: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Donepezil is a generic prescription drug that improves the symptoms of Alzheimer’s disease. It belongs to a family of drugs called cholinesterase inhibitors. These drugs work by increasing the activity of a neurotransmitter called acetylcholine. Many of the symptoms of Alzheimer’s are believed to be due to decreased acetylcholine activity in the brain. Although donepezil improves dementia symptoms, it is not a cure for Alzheimer’s. Doses are administered in several ways including tablets, orally disintegrating tablets, and an extended-release skin patch.

Donepezil overview

BRAND NAMES:

  • Aricept, Adlarity

Generic Names:

  • Donepezil HCl

Uses:

  • Treats Alzheimer’s disease.

Therapeutic Classes:

  • Anti-Alzheimer’s agent, cholinesterase inhibitor, central nervous system agent

Forms:

  • Tablet, orally disintegrating tablet, transdermal patch

How it’s taken:

  • By mouth, through the skin

What is Donepezil used for?

Donepezil treats mild, moderate, or severe Alzheimer’s disease. Healthcare providers may use it off-label for other types of dementia.

What form(s) does Donepezil come in

  • Tablet

    • 5 mg

    • 10 mg

    • 23 mg

  • Orally disintegrating tablet

    • 5 mg

    • 10 mg

  • Transdermal patch

    • 5 mg/day

    • 10 mg/day

What are common Donepezil doses?

  • For mild to moderate Alzheimer’s disease: 5–10 mg daily

  • For mild to moderate Alzheimer’s disease: 10–23 mg daily

Common Donepezil prescriptions

  • Donepezil HCl
    10mg tablet

  • Donepezil HCl
    23mg tablet

  • Donepezil HCl
    5mg tablet

  • Donepezil HCl
    10mg tablet disintegrating

  • Donepezil HCl
    5mg tablet disintegrating

How to take Donepezil

  • Take or administer this medicine as directed.

  • Please read the Patient Package Insert or the Instructions for Use that is included with the medicine.

  • Take or administer donepezil tablets or orally disintegrating tablets in the evening.

  • Donepezil tablets or orally disintegrating tablets can be taken with or without food.

  • How to take or administer donepezil tablets:

    • Swallow the tablet with a glass of water.

    • Swallow the 23 mg tablet whole. Do not crush, break, or chew it.

    • Store donepezil tablets at room temperature. 

  • How to take or administer donepezil orally disintegrating tablets:

    • Do not swallow the tablet.

    • Place the tablet in the mouth and allow it to completely dissolve.

    • Drink a glass of water after the tablet has dissolved.

    • Store donepezil orally disintegrating tablets at room temperature. 

  • How to use a donepezil transdermal system (Adlarity):

    • Read and follow the Instructions for Use that come with the medicine.

    • Patches are good for seven days. After that, they must be replaced by a new patch.

    • Remove the old patch before applying a new one.

    • To dispose of the old patch, fold it in half so the drug portion of the patch is completely covered. Throw it away so that it’s out of the reach of children and pets. Do not flush the patch down the toilet.

    • Take the new patch from the refrigerator and allow it to warm to room temperature before applying it to the skin. Do not try to heat it.

    • The patch must be used within 24 hours of its removal from the refrigerator.

    • Choose a spot on the body to place the patch. The recommended location is on the back. The healthcare provider will provide advice about where best to place the patch. 

    • Do not choose a spot that can be rubbed by tight clothing.

    • Do not place the patch on the same skin area that was covered by a previous patch in the last 14 days.

    • The skin should be clean, dry, intact, and with minimal hair.

    • Do not apply to any skin that is irritated, red, cut, or shaved.

    • Remove the patch from the pouch. Do not cut the pouch to open it.

    • Apply the patch and press down firmly on the patch for 30 seconds.

    • Wash your hands. Do not touch your eyes until washing your hands.

    • If a patch comes off, throw it away and replace it with a new patch.

    • Store Adlarity patches in their sealed pouches in the refrigerator. Do not freeze.

What to do if you miss a dose of Donepezil

  • If taking donepezil tablets, do not take a missed dose. Take the next dose at the regular time.

  • If seven consecutive doses are missed, call the doctor before taking the next dose.

  • If a donepezil patch hasn’t been removed and replaced, do so as soon as possible. Replace the new patch seven days later.

  • Do not apply two donepezil patches to make up for a missed patch.

Donepezil contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have had an allergic reaction to donepezil or to medications derived from piperidine.

  • Do not use a donepezil skin patch if previous use has caused an intense skin reaction (contact dermatitis).

Donepezil warnings

  • Tell any doctor, dentist, or other healthcare professional about donepezil, particularly before any procedures. Donepezil may need to be stopped before surgery or other medical procedures that involve anesthesia.

  • Tell the prescriber if you are pregnant, breastfeeding, or if you have:

    • Heart problems

    • Irregular heart rhythms including a slow or fast heart rate

    • Liver problems

    • Kidney problems

    • Stomach ulcers or bleeding

    • Trouble urinating.

    • Asthma or other breathing problems

  • Donepezil can cause serious problems including:

    • Slow heart rate

    • Heart block

    • Gastrointestinal bleeding

    • Weight loss

    • Urinary obstruction

    • Seizures

    • Vomiting

  • Tell the prescriber about any intense skin reactions to the donepezil patch.

  • Do not expose the donepezil patch to external heat sources such as excessive sunlight, heating pads, saunas, or solariums.

Donepezil interactions

  • To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements being taken or administered, particularly:

  • Make sure the prescriber knows about all drug allergies, particularly allergies to antipsychotics or opioids. 

  • Tell any other doctor about donepezil before any new medications are prescribed.

Find more information about donepezil interactions to avoid here.

Donepezil side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:

  • Chest pain, slow or uneven heartbeat, trouble breathing, fainting

  • Vomiting of blood or material that looks like coffee grounds

  • Bloody or black, tarry stools

  • Severe stomach pain

  • Seizures

  • Change in how much or how often you urinate

  • Worsening of asthma or other breathing problems

  • Skin reactions to the patch: increased redness, peeling, blistering, skin reactions that spread beyond the boundaries of the patch

  • Allergic reaction: Itching, hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

Less serious side effects

  • Nausea

  • Diarrhea

  • Trouble sleeping

  • Vomiting

  • Muscle cramps

  • Fatigue

  • Loss of appetite

  • Application site reactions (donepezil patch)

Find more information about donepezil side effects here.

Sources:

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