Initiated by a specialist after confirmed diagnosis of dementia. Not available for self-diagnosis or over-the-counter purchase.
What it treats
Which conditions is Donepezil used for?
Overview
What is Donepezil?
Donepezil is a medicine used to manage the symptoms of Alzheimer's disease. The most common form of dementia. It belongs to a class called acetylcholinesterase inhibitors, which work by preserving the activity of a brain chemical that is reduced in Alzheimer's disease.
It is listed in Kenya's Essential Medicines List 2023 (Section 11, Medicines for Neurological Disorders) at Level 5-6. It is important to understand clearly what this medicine can and cannot do: it can improve thinking, memory, and daily functioning modestly for months to a few years, but it does not cure or reverse Alzheimer's disease.
The decision to start donepezil should be made by a specialist after proper assessment, in a conversation that includes the person with dementia and their family.
How it works
What does it do in the brain?
Formulations in Kenya
How is it available?
Availability across Africa
Where is it available in Africa and what is it called?
| Country | Common Brand Name(s) | Notes |
|---|---|---|
| South Africa | Aricept, Donepezil (generic) | Available in private sector and at larger public hospitals; dementia specialist clinics exist in Cape Town and Johannesburg. |
| Nigeria | Aricept, Donecept | Available at federal teaching hospital pharmacies in Lagos, Abuja, and Ibadan. |
| Ghana | Aricept, Donepezil (generic) | Available at Korle-Bu Teaching Hospital geriatric unit and larger private pharmacies in Accra. |
| Uganda | Aricept, Donepezil | Available at Mulago National Referral Hospital and selected private pharmacies in Kampala. |
| Tanzania | Donepezil (generic) | Available at Muhimbili National Hospital; limited broader access. |
| Ethiopia | Donepezil (generic) | Available at Black Lion Hospital in Addis Ababa. |
| Rwanda | Donepezil (generic) | Available at King Faisal Hospital and private pharmacies in Kigali. |
Side effects
What might you feel while taking it?
These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.
- Nausea, vomiting, and diarrhoea, most common at the start or after dose increases
- Reduced appetite and weight loss
- Difficulty sleeping or vivid dreams, taking it at bedtime helps manage this
- Muscle cramps
- Headache
- Dizziness
- Slowed heart rate, particularly in people with existing heart rhythm problems
- Fainting or syncope
- Severe nausea and vomiting at initiation. If persistent, contact your doctor
- Worsening of asthma or lung disease
Who should not take it
Important warnings before starting
- Known allergy to donepezil or piperidine-based medicines
- Significant heart rhythm disorder
- Active peptic ulcer
Special care needed
Situations that need extra attention
- Tell your doctor about any heart conditions
- Tell your doctor about any history of stomach ulcers or asthma
- Donepezil increases the effects of some anaesthetic medicines. Always tell surgeons and anaesthetists you take it before any procedure
- Review of benefit should be done every six months
Dementia is predominantly a condition of older age. If relevant, specialist advice is required.
Not typically applicable to the age group affected.
Other medicines
Medicines and substances that can interact with it
- Anticholinergic medicines: Work against donepezil, reducing its effectiveness. These combinations should be avoided where possible.
- Medicines that slow the heart rate: Donepezil also slows the heart, combined effect may require monitoring.
- NSAIDs: May increase gastric bleeding risk alongside donepezil.
Tests and follow-up
What your doctor will monitor
- Cognitive function and daily living abilities reviewed every three to six months
- Heart rate and blood pressure monitored
- Weight and nutritional status
- Carer and family wellbeing should be part of every review
Stopping this medicine
What happens if you stop taking it?
In Kenya
What you should know about this medicine in Kenya
Dementia is significantly underrecognised in Kenya. Memory loss in older adults is frequently attributed to old age rather than recognised as a medical condition. This delays diagnosis and treatment.
Donepezil is available at specialist centres and private pharmacies in Kenya. It is not yet widely accessible in public facilities below Level 5, which limits its reach to those who can access urban specialist care.
The burden of dementia care falls heavily on families and particularly on women as carers. Supporting caregivers, through information, respite, and psychological support, is as important as treating the person with dementia.
Sources
References
- Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
- Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
- Birks, J. S., & Harvey, R. J. (2018). Donepezil for dementia due to Alzheimer's disease. Cochrane Database of Systematic Reviews.
- World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.
- Alzheimer's Disease International. (2022). World Alzheimer Report 2022. London: ADI.