Donepezil Viatris (Donepezil Hydrochloride)

Donepezil Viatris is indicated for the symptomatic treatment of mild to moderate Alzheimer’s disease, where it may improve cognition and daily functioning.

• Treatment of mild to moderate Alzheimer’s disease to support cognitive function.
• Adjunct therapy for patients with early‑stage Alzheimer’s disease.
• Use as part of a comprehensive care plan that includes non‑pharmacologic interventions.
• May be considered when cholinergic deficits are identified as contributing to memory impairment.
• Potential use in combination with other Alzheimer’s medications such as memantine under physician guidance.
• May be prescribed for patients who have demonstrated a decline in activities of daily living attributable to Alzheimer’s disease.

Side effects reported with donepezil, the active component of Donepezil Viatris, vary in frequency and severity.

Common

• Nausea, vomiting, or upset stomach, often occurring early in treatment.
• Diarrhea or loose stools, which may be mild to moderate.
• Insomnia, vivid dreams, or other sleep disturbances.
• Muscle cramps, weakness, or general fatigue.

Serious

• Severe bradycardia, heart block, or syncope, requiring medical evaluation.
• Gastrointestinal bleeding or ulceration, especially in patients with risk factors.
• Hepatotoxicity manifested as elevated liver enzymes or jaundice.

When prescribing Donepezil Viatris, clinicians should consider several precautions to ensure safe use.

• Assess cardiac history; avoid in patients with sick sinus syndrome or recent myocardial infarction.
• Monitor for signs of gastrointestinal bleeding, especially in patients on NSAIDs or anticoagulants.
• Evaluate liver function before initiation and periodically during therapy.
• Use caution in patients with asthma or chronic obstructive pulmonary disease due to possible bronchospasm.
• Adjust dose or discontinue if severe bradycardia or syncope occurs.
• Counsel patients about potential sleep disturbances and advise on bedtime dosing.

Donepezil may interact with other medicines; some combinations should be avoided while others require careful monitoring.

Avoid

• Concurrent use with strong anticholinergic agents (e.g., atropine, scopolamine) that counteract cholinergic activity.
• Co‑administration with drugs that significantly prolong the QT interval.

Use with caution

• Beta‑blockers or calcium channel blockers, as additive bradycardic effects may occur.
• NSAIDs, aspirin, or anticoagulants, which can increase risk of gastrointestinal bleeding.
• CYP2D6 inhibitors (e.g., fluoxetine, paroxetine) may raise donepezil plasma levels.
• Memantine or other Alzheimer’s agents, requiring dose adjustments and clinical monitoring.