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What is donepezil? Donepezil is used to help improve mental function in people with Alzheimer's disease. Donepezil does not work the same in all people. Some people taking donepezil have improved mental function, while others may have unchanged or even worsening mental function. Donepezil is not a cure for Alzheimer's disease. This condition will progress over time, even in people who take donepezil. Donepezil may also be used for other purposes not listed in this medication guide. Warnings Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Before taking this medicine You should not use donepezil if you are allergic to donepezil or certain other drugs. Tell your doctor if you are allergic to any medicines. Tell your doctor if you have ever had: a heart rhythm disorder; a stomach ulcer; urination problems; asthma or other breathing disorder; liver or kidney disease; a seizure; or trouble swallowing tablets. Tell your doctor if you are pregnant or breast-feeding. How should I take donepezil? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. You may take donepezil with or without food. Swallow the regular tablet whole and do not crush, chew, or break it. Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Place the tablet in your mouth and allow it to dissolve, without chewing. Swallow several times as the tablet dissolves. After the tablet dissolves completely, drink a glass of water. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using donepezil. You may need to stop using the medicine for a short time. You should not stop using donepezil without your doctor's advice. Store at room temperature away from moisture and heat. What happens if I miss a dose? Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time. If you miss your doses for more than 7 days in a row, call your doctor before taking the medicine again. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. 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? Avoid driving or hazardous activity until you know how donepezil will affect you. Your reactions could be impaired. Donepezil side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: slow heartbeats; a light-headed feeling, like you might pass out; new or worsening stomach pain, heartburn, nausea, or vomiting; a seizure; painful or difficult urination; new or worsening breathing problems; or signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds. Common side effects may include: nausea, vomiting, diarrhea; loss of appetite; muscle pain; sleep problems (insomnia); or feeling tired. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Donepezil dosing information Usual Adult Dose for Alzheimer's Disease: Initial dose: 5 mg orally once a day, in the evening prior to retiring Mild to moderate Alzheimer's disease: -Maintenance dose: 10 mg orally once a day, after the patient has been on an initial dose of 5 mg once a day for 4 to 6 weeks Moderate to severe Alzheimer's disease: -Maintenance dose: 23 mg orally once a day, after the patient has been on a dose of 10 mg once a day for at least 3 months Comments: A higher dose of 10 mg may or may not provide a statistically significantly greater clinical benefit than a 5 mg dose. Prescriber and patient's preference should be considered. Uses: For mild, moderate, and severe Alzheimer's type dementia What other drugs will affect donepezil? Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with donepezil may increase your risk of stomach ulcer. Other drugs may affect donepezil, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
What is memantine? Memantine reduces the actions of chemicals in the brain that may contribute to the symptoms of Alzheimer's disease. Memantine is used to treat moderate to severe dementia of the Alzheimer's type. Memantine may also be used for purposes not listed in this medication guide. Warnings Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Before taking this medicine You should not use memantine if you are allergic to it. To make sure memantine is safe for you, tell your doctor if you have: epilepsy or other seizure disorder; liver disease; kidney disease; urination problems; or a bladder or kidney infection. memantine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether memantine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby. How should I take memantine? Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended. Memantine can be taken with or without food. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. To make swallowing easier, you may open the extended-release capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use. Measure liquid medicine (oral solution) with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Do not mix the oral solution with any other liquids. Rinse the empty oral syringe with clean water and allow it to air dry after every use. Use memantine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Your doctor will need to check your progress while you are using memantine. Store memantine at room temperature away from moisture and heat. Keep the liquid medicine bottle tightly closed with the cap provided. Do not store the bottle with the oral syringe in it. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions. What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. If you miss doses or forget to take your medicine for several days, call your doctor before starting the medicine again. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking memantine? Memantine 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. Memantine side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: severe headache, blurred vision, pounding in your neck or ears; seizure (convulsions); or unusual changes in mood or behavior. Common side effects may include: diarrhea; dizziness; or headache. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Memantine dosing information Usual Adult Dose for Alzheimer's Disease: IMMEDIATE-RELEASE: Week 1: 5 mg orally once a day. Week 2: 10 mg orally/day (Administer 5 mg twice a day.) Week 3: 15 mg orally/day (Administer 5 mg and 10 mg as separate doses.) Week 4/Maintenance Dose: 20 mg orally/day (Administer 10 mg twice a day.) EXTENDED-RELEASE: -Initial Dose: 7 mg orally once a day. -Maintenance and Maximum Dose: 28 mg orally once a day; increase the initial dose in 7 mg increments to the recommended maintenance dose. Comments: The minimum recommended interval between dose increases is one week; only increase dosage if the previous dose has been well tolerated. Use: Treatment of moderate to severe dementia of the Alzheimer's type.