Key Points

• Aricept (donepezil) is a once-daily oral medication that may be used to treat dementia related to Alzheimer’s disease. It isn’t a cure, but it may help improve symptoms.
• Common side effects of Aricept include nausea, diarrhea, trouble sleeping, muscle cramps, and low appetite. For most people, these side effects last a few weeks and get better with continued use of Aricept.
• A more serious side effect that is rare from taking Aricept is gastrointestinal bleeding. The risk is higher in people who have a history of ulcer disease or who are taking nonsteroidal anti-inflammatory drugs (NSAIDs).

What is Aricept?

Aricept (donepezil) is a cholinesterase inhibitor used to treat dementia in individuals with mild, moderate, or severe Alzheimer’s disease. Aricept is taken once daily as an oral tablet or as an orally disintegrating tablet (Aricept ODT).

7 side effects of Aricept and how to manage them

Below, we’ll review 7 side effects* of Aricept that you should watch out for. Most side effects are short-term, and can be managed at home. We’ll also go over some tips on how to feel better so that you can continue your treatment.

1. Nausea

Nausea is one of the most common side effects of Aricept, occurring in up to 12% of people patients. This can contribute to other side effects, like not wanting to eat as much.

Nausea and vomiting tend to be the most bothersome at the beginning of treatment and after your dose is increased. For most people, this side effect lasts 1-3 weeks and gets better with continued use of Aricept.

Tips for managing nausea

• Avoid greasy foods
• Eat smaller, more frequent meals
• Try bland foods like crackers or rice
• Eat more slowly
• Stay hydrated
• Keep upright after eating
• Try ginger or peppermint tea

If you experience nausea that gets worse or does not go away, call your healthcare provider for further evaluation.

2. Diarrhea

Diarrhea is another common side effect, particularly at higher doses. Diarrhea from taking Aricept should get better within a few weeks. However, it may return if your dose is increased.

Tips for managing diarrhea

• Drink plenty of fluids to replace those you might be losing
• Avoid foods that may upset your stomach (e.g., greasy or spicy foods)
• Consider an over-the-counter medication for symptom relief

Let your healthcare provider know if you’re having diarrhea. They will monitor you closely to make sure it gets better. Sometimes adjusting the dose of Aricept or trying another medication can help.

3. Insomnia

Trouble sleeping (insomnia) affects up to 9% of Aricept users. This side effect is more common with higher doses. Poor sleep can lead to fatigue and impact daily functioning.

Tips for managing insomnia

• Create a dark, relaxing sleep environment
• Avoid caffeine in the afternoon and evening
• Try not to nap too late
• Don’t use electronics before bedtime
• Exercise regularly
• Avoid eating too close to bedtime

Tell your healthcare provider if you are having trouble sleeping. They can help you determine if Aricept is disrupting your sleep, and might be able to adjust your dose.

Related questions

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4. Fatigue

Fatigue was listed as a side effect of Aricept, but it’s not clear if this is caused by trouble sleeping or another reason. Up to 5% of people reported feeling tired during studies. Contact your healthcare provider if your energy levels are so low that it is affecting your normal daily activities.

Tips for managing fatigue

• Practice good sleep hygiene
• Eat a well-balanced diet
• Stay hydrated
• Take breaks during the day to rest

5. Muscle cramps

Muscle cramps occurred in up to 6% of people in studies with Aricept. However, this should get better with time. Your healthcare provider will slowly raise your dose of Aricept to avoid this side effect.

Tips for managing muscle cramps

• Use a warm compress to relax the muscle
• Eat a well-balanced diet
• Try an over-the-counter pain reliever, like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)

If your muscle cramps seem serious or continue after a few weeks of taking Aricept, contact your healthcare provider for advice.

6. Low appetite

Aricept may reduce appetite, leading to weight loss in about 5% of patients. This side effect might be related to your dose. If you have a low appetite or notice yourself losing weight, speak to your healthcare provider. They might be able to adjust your dose of Aricept.

7. Gastrointestinal bleeding

Aricept increases stomach acid production, which can lead to stomach ulcers and bleeding. In studies, people taking 5 mg to 10 mg of Aricept were not more likely to get a stomach ulcer or experience gastrointestinal bleeding compared to those taking a placebo. However, more people taking a high dose of Aricept (23 mg) had stomach ulcers and gastrointestinal bleeding compared to those taking a lower dose.

You may be at a higher risk for stomach problems if you also take certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Share a list of your current medications with your healthcare provider so they can check for interactions with Aricept. Also tell your healthcare provider about your full medical history, especially if you have a history of ulcers or stomach bleeding.

Tell your healthcare provider right away if you have any symptoms of stomach problems, which may include:

• Stomach pain
• Blood in your urine or stool
• Weight loss
• Feeling tired
• Nausea or vomiting

* This is not a complete list of side effects. See here for more information.

References

Aricept [package insert]. Revised 12/2021. Eisai Inc. - https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=98e451e1-e4d7-4439-a675-c5457ba20975

Kumar, A., et. al. (Updated 2023). Donepezil. In: StatPearls [Internet].  Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513257/

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• Side Effects of Aricept (detailed)
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