Questions about ARICEPT?
We have Answers!
Prepared by Mylène Horth, BPharm, MSc, medical information officer, Pfizer Canada Inc., and
reviewed by Serge Gauthier, MD, FRCPC
The primary goal of this article is to answer some of the technical and practical questions you
may have concerning ...
Q & A
Questions about ARICEPT?
We have Answers!
Prepared by Mylène Horth, BPharm, MSc, medical information officer, Pfizer Canada Inc., and
reviewed by Serge Gauthier, MD, FRCPC
The primary goal of this article is to answer some of the technical and practical questions you
may have concerning ARICEPT. The following questions represent some of the most frequently
asked questions by health care professionals, patients and caregivers, received by the Safety
and Medical Information department at Pfizer Canada Inc.
Q Is it possible to take Aricept in the morning
instead of at bedtime?
Taking Aricept at bedtime may minimize gastro-intestinal
Q Why should patients be maintained on
Aricept 5 mg daily for four to six weeks
before increasing the dose to 10 mg daily?
(GI) side effects or nausea observed with some patients in According to an open-label study, the rate of common
the first weeks of treatment. There could be situations, adverse events was lower in patients who received a
however, when a bedtime dosage is not possible because 5 mg daily dose for six weeks prior to initiating treatment
of a morning visit by a caregiver or nurse, or sleep dis- with 10 mg daily than those seen in patients who received 10
turbance. In these cases, a morning dosage is perfectly mg daily after only one week of treatment with 5 mg daily.
acceptable and will not change the efficacy of Aricept. In this study, the rate of adverse events with 10 mg daily was
comparable to the rate noted in patients treated with 5 mg
daily. Patients are, therefore, recommended to maintain the
Q Do GI side effects secondary to Aricept (e.g.,
nausea, diarrhea) persist for a long time?
GI side effects may appear in the first weeks of treat-
initial dose of 5 mg daily for four to six weeks. After this
period, if the patient is tolerating the 5 mg dosage and it is
concluded that a higher dosage will be beneficial to the
patient, then dosage may be increased to 10 mg daily.
ment with Aricept. A few solutions are suggested to
minimize these adverse events, such as bedtime dos-
ing and taking Aricept with food. In clinical trials,
adverse effects were often mild and generally disap-
peared within a few weeks with continued treatment.
The majority of the patients usually developed toler-
Q How should Aricept
if necessary?
be discontinued,
Aricept has a long half-life and is eliminated very slowly.
ance to GI side effects. Temporary symptomatic Consequently, gradual tapering of Aricept is not neces-
treatment may be necessary in some cases where sary for a patient who has to discontinue the medication.
these adverse events are persistent despite the use of The half life of Aricept is 72 hours and it may take two
the above-mentioned preventative measures. weeks or more for the drug to be completely eliminated
from the system.
Q How long does it take before the effects of
Aricept are visible?
Based on the available clinical information, cognitive
Q Is there any information concerning the use
of high doses of Aricept (> 10 mg)?
effects may be observed within the first month of treat- The maximum recommended dosage for Aricept is 10 mg
ment with Aricept. Clinical benefits in terms of func- daily. According to a multinational Phase III clinical trial,
tional improvement may take longer to appear. Aricept 5 and 10 mg daily demonstrated significant improve-
Beneficial symptomatic effects versus placebo are con- ments in both cognitive and global functioning. Aricept 10
sistently more apparent after 12 weeks of treatment. mg, however, has shown an even greater improvement.
8 • The Canadian Alzheimer Disease Review • December 1998
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