Drug Interactions between donepezil and Fiorinal

Consumer information for this interaction is not currently available.

MONITOR: The concomitant use of acetylcholinesterase inhibitors (ACHEIs) (e.g., donepezil, galantamine, benzgalantamine physostigmine, rivastigmine, tacrine) with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of gastrointestinal (GI) bleeding. ACHEIs can increase gastric acid secretion due to their cholinergic effects and NSAIDS may increase the risk of GI bleeding and ulceration. In a Swedish retrospective case study of 70,060 patients aged 65 years and older with new prescriptions for both ACHEIs and NSAIDs, 1500 persons were diagnosed with incident peptic ulcer. The results suggested that the risk of peptic ulcer was significantly increased for the combination of ACHEIs and NSAIDs compared to NSAIDs alone. No increased risks were found for the use of ACHEIs alone.


MANAGEMENT: Caution and clinical monitoring are recommended if concomitant use of ACHEIs and NSAIDs is required, especially in patients with a prior history of peptic ulcer disease, the elderly, or debilitated patients. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence gastrointestinal bleeding such as black or tarry stools, bright red blood in vomit, coffee ground like vomit, abdominal pain or cramping, diarrhea, dizziness or lightheadedness, weakness or fatigue and pale skin.

Butalbital may reduce the blood levels and effects of donepezil. Using butalbital with donepezil may also increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You should seek immediate medical attention if you experience sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Information for this minor interaction is available on the professional version.