Done

Quick links to important sections

Done

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Done

What is Done?

Done (donepezil) is a prescription medication categorized as an acetylcholinesterase inhibitor. It is primarily utilized in the management of cognitive symptoms associated with various stages of Alzheimer's disease. While the medication does not provide a cure for the underlying condition, it is designed to help stabilize or slow the progression of symptoms related to memory, thinking, and reasoning.

Mechanism of Action

The therapeutic effects of Done are centered on its interaction with neurotransmitters in the brain. In individuals with Alzheimer's disease, there is a progressive decline in the levels of acetylcholine, a chemical messenger essential for communication between nerve cells involved in memory and learning.

Done works by inhibiting the enzyme acetylcholinesterase, which is responsible for the breakdown of acetylcholine. By slowing this degradation process, the medication increases the concentration of the neurotransmitter available in the synaptic clefts of the brain. This enhancement of cholinergic function supports better signaling between neurons, which may help improve or maintain cognitive performance for a period of time.

Clinical Application

This medication is specifically indicated for the treatment of dementia of the Alzheimer's type. Its use spans the clinical spectrum of the disease, including:

  • Mild dementia: Addressing early signs of memory loss and confusion.
  • Moderate dementia: Assisting with increasing difficulties in communication and daily cognitive tasks.
  • Severe dementia: Supporting cognitive function in advanced stages where significant memory impairment is present.

Because the effectiveness of the medication can vary between individuals, ongoing assessment is typically required to determine the continued benefit of the therapy as the neurodegenerative process evolves.

Regulatory References

  1. NICE Guideline: Donepezil for Alzheimer's disease (TA217)

What side effects are possible with Done?

Possible Side Effects and Safety Information for Done

Adverse Reaction Profile

Adverse reactions associated with Done encompass several System-Organ Classes, primarily the Gastrointestinal and Nervous Systems, along with Hematologic/Lymphatic and Hepatobiliary Disorders.

Commonly reported side effects (Very Common or Common) include headache and various gastrointestinal disturbances such as nausea, vomiting, and diarrhea. Less common reactions have been noted across other systems, including skin and musculoskeletal issues.

Serious and Clinically Significant Adverse Reactions

The safety profile includes the potential for rare but serious adverse events, which are subject to stringent regulatory monitoring. These include severe reactions affecting the blood system, such as aplastic anemia and agranulocytosis (rare), and severe skin reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis (rare). Serious hepatotoxicity (liver damage) has also been documented, with the risk potentially increasing with dose or cumulative exposure.

Safety Monitoring and Restrictions

Done is contraindicated in patients with a known hypersensitivity to the drug or its components, as well as those with pre-existing severe hepatic impairment or severe bone marrow depression. Due to the systemic risks, regulatory authorities mandate routine monitoring of liver function tests (LFTs) and complete blood counts (CBCs) throughout therapy. The product labeling also includes specific cautions regarding the potential for severe dermatological and hypersensitivity reactions, which requires careful clinical consideration during use.

Overdose and Emergency Response

The official regulatory profile for Donepezil hydrochloride overdose centers on the clinical state of excessive cholinergic stimulation, specifically known as cholinergic crisis. Symptoms documented in official prescribing information consistently include manifestations such as severe nausea and vomiting, excessive salivation and sweating, severe muscle weakness, and the potential for convulsions (seizures).

Due to the drug's pharmacological classification, the most critical risks identified by regulatory authorities involve the cardiovascular and respiratory systems. A suspected overdose is classified as a potentially severe medical emergency because it carries the risk of profound bradycardia (severe slowing of the heart rate) and respiratory depression, which can lead to life-threatening complications.

Immediate medical attention must be sought at once for any suspected overdose. The required emergency actions, as described in regulatory documents, involve administering an anticholinergic agent, such as atropine, to counteract the effects of cholinergic excess on the body. Supportive measures may also include procedures like gastric lavage or the use of activated charcoal for recent oral exposure. Due to the inherent cardiovascular risk, continuous hospital monitoring, specifically cardiac monitoring, is required until the patient's condition stabilizes.

Therapeutic Uses of Done

What Done Treats: Main Uses and Benefits

The primary role of this medication is used in situations involving certain distressing symptoms associated with dementia of the Alzheimer's type. The medication is considered relevant across the clinical stages, encompassing mild, moderate, and severe manifestations. It is commonly used to help with key symptoms of cognitive decline, specifically forgetfulness, difficulty concentrating, confusion, and impaired reasoning.

This supportive approach is applied across domains where additional symptomatic support is needed. It helps address symptom clusters that interfere with daily comfort, assisting with maintaining functional stability and helping to ease the overall symptom burden. The treatment helps address symptom clusters that may become intense or disruptive and helps patients cope more steadily with symptom fluctuations, thereby supporting general well-being during symptomatic phases.


Quick Fact: Relief for Cognitive Impairment The treatment is applied in clinical settings that involve chronic, progressive symptom patterns, often used when supportive symptom management is appropriate to help preserve a patient's functional abilities.

Eligibility and Restrictions for Use

Official Eligibility and Contraindications for Donepezil

The eligibility profile for Donepezil hydrochloride is defined by the medicine's official government labeling, which establishes specific constraints for use.

Populations for Whom Use is Contraindicated

Category Regulatory Statement
Hypersensitivity Contraindicated in patients with known hypersensitivity to donepezil hydrochloride or to piperidine derivatives.

Age and Specific Population Eligibility

Age Group / Condition Regulatory Statement
Adults Use is established for the treatment of dementia of the Alzheimer's type (mild, moderate, and severe stages).
Pediatric Population Not recommended for use in children and adolescents, as safety and effectiveness have not been established.
Pregnancy Should not be used unless clearly necessary; insufficient data are available on use in pregnant women.
Breastfeeding Not recommended; women on Donepezil should not breastfeed.
Organ Function Use in moderate to severe renal impairment does not require dosage adjustment. Patients with severe hepatic impairment have no available data on use.

Eligibility-Related Restrictions

Caution is required for patients with certain pre-existing conditions. These include individuals with cardiac conduction abnormalities (like symptomatic bradycardia), a history of peptic ulcer disease or gastrointestinal bleeding, asthma or obstructive pulmonary disease, a history of seizures, and conditions leading to bladder outflow obstruction.

What should I know about interactions with other medicines?

Interactions with other medicines and products


Interaction Scope

The official interaction profile is defined by pharmacokinetic and pharmacodynamic mechanisms as documented by regulatory authorities. Documented interacting medicine categories include CYP enzyme inhibitors and inducers, other cholinergic agents, anticholinergic medications, neuromuscular blocking agents, beta-blocking agents, QTc-prolonging medicinal products, and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Clearance values differ among CYP2D6 metabolizer types, and caution is noted for patients with hepatic impairment, as clearance was observed to be reduced.


Regulatory Interaction Statements

  • Co-administration with other Acetylcholinesterase Inhibitors or Cholinergic Agonists should be avoided due to the risk of synergistic cholinergic effects.
  • CYP3A4 inhibitors such as Ketoconazole can increase donepezil plasma concentrations by approximately 30%. Conversely, CYP inducers like Rifampicin may reduce plasma levels.
  • The medicine can exaggerate succinylcholine-type muscle relaxation during anesthesia.
  • Caution is necessary when co-administering with Beta-blocking agents due to potential additive effects on cardiac conduction, increasing the risk of bradycardia.
  • Concurrent use of NSAIDs increases the risk for gastrointestinal bleeding and ulceration.
  • Absorption is not influenced by food. Alcohol and the herbal product St. John's Wort may reduce plasma concentrations.
  • Donepezil does not inhibit the metabolism of warfarin or digoxin, and their co-administration does not affect donepezil metabolism.

Mechanism of Action

Done functions as a synthetic small molecule that preferentially targets the central nervous system. Its primary mechanistic action involves non-competitive antagonism at the N-methyl-D-aspartate (NMDA) receptor, a subtype of ionotropic glutamate receptor. Specifically, Done binds within the ion channel pore of the NMDA receptor complex, blocking the flux of cations, primarily Ca^2+, into the postsynaptic neuron. This blockade impedes the excitatory neurotransmission typically mediated by glutamate at these synapses.

Simultaneously, Done acts as an agonist at the sigma-1 (sigma1) receptor. Activation of the sigma1 receptor is associated with the modulation of intracellular Ca^2+ mobilization and changes in endoplasmic reticulum function. The dual activity on NMDA and sigma1 receptors results in a net depression of central excitatory signaling and modulation of neuronal plasticity. The system-level consequence of this combined molecular interaction is a reduction in overall neuronal excitability and altered signal propagation within specific limbic and cortical pathways.

Dosage and Administration Information

How Donepezil is Used

Donepezil hydrochloride is administered across two main routes: oral (tablet, orally disintegrating tablet, and solution) and transdermal (patch system).

Standardized Dosing and Titration Protocol

The use of oral donepezil is structured by a defined, time-dependent titration schedule that begins with a 5 mg dose taken once daily. This dose is typically administered in the evening, just before retiring. The initial 5 mg dose is maintained for a minimum of four to six weeks. This standardized period is completed before a dose increase to 10 mg once daily is considered. For patients progressing to the maximum daily dose of 23 mg, a minimum duration of three months at the 10 mg maintenance dose is required before this final escalation.

Administration Conditions

The medicine can be taken with or without food. Administration depends on the dosage form: standard tablets, including the 23 mg strength, must be swallowed whole and should not be split, crushed, or chewed to ensure correct release. Orally disintegrating tablets, conversely, are placed on the tongue to dissolve. If a dose is missed, the user is generally expected to skip the missed dose and resume the original schedule the following evening, without taking extra medicine. Dose adjustments are generally not specified for mild renal impairment.

Recent Clinical Evidence

Done: Recent Clinical Evidence

Evidence for Use in Alzheimer's Disease (AD)

The research landscape for donepezil is characterized by short-term and intermediate-term Randomized Controlled Trials (RCTs) involving older adults with Alzheimer's dementia. These studies were used in research exploring how symptoms change over time, often including a placebo comparison group. Research examined outcomes related to cognitive function (memory and thinking assessed by standardized scales) and daily activity level (evaluated through caregiver reports). Researchers report that findings describe patterns observed in the studies related to scores on cognitive scales. However, data collected on the measured scales were often described in regulatory reviews as findings reported as having a modest size. Results apply only to the specific populations studied, and long-term effects are not fully established.

Evidence in Mild-to-Moderate and Severe Disease Stages

Most pivotal RCTs focused on individuals with mild-to-moderate forms of the condition. Later research focused on those with severe forms, with studies evaluating donepezil in combination with other pharmacological approaches. This later evidence includes data from the most advanced stages, but evidence quality varies across studies regarding the consistency of reported findings for this complex population.

Research in Vascular Cognitive Impairment

Donepezil was also evaluated in studies of conditions with vascular components, such as Vascular Dementia (VaD). Research explored short-term symptom changes in these populations, often with follow-up durations limited to around six months. Studies examined outcomes related to systemic imbalance. Findings were mixed when considering the impact on overall global function, and studies faced challenges related to patient heterogeneity.

Exploratory Studies and Research Uncertainty

Research has explored the use of donepezil for Mild Cognitive Impairment (MCI). Studies monitored whether the drug explored whether there was a difference in the rate of conversion from MCI to Alzheimer's disease. Findings were observed related to cognitive scores in some studies, but the evidence is limited, and findings were mixed regarding the study's primary objective: delaying progression. Data for certain long-term groups remain insufficient to draw firm conclusions on outcomes such as the quality of life or the precise rate of functional decline over many years. Scientific literature notes that the reported changes in scores apply only to the populations studied under the specific conditions of the trials, and research does not determine whether an individual will respond similarly.

Key Studies & References

  1. Donepezil for mild cognitive impairment (Cochrane Review informing on MCI conversion uncertainty)
  2. Donepezil, an acetylcholinesterase inhibitor for the management of Alzheimer disease dementia (WHO EML Review)

Frequently Asked Questions (FAQ)

Common questions about Done (FAQ)

Q: Can Done be used for purposes other than what is described in the official indications?

Official regulatory documents define the approved use of Done as symptomatic treatment for dementia of the Alzheimer's type. These documents do not include information or recommendations on using the medicine for conditions other than those specifically stated in the official indication for which it was reviewed and approved.

Q: If I miss a dose of Done, what does the regulatory information suggest I do?

Regulatory instructions advise that if a single dose is missed, the guidance suggests skipping that dose and continuing with the next scheduled dose at the usual time the following evening. If use has been interrupted for one week or more, regulatory guidance suggests that patients contact their prescribing professional before resuming the use of the medicine.

Q: What should be done in the event of taking too much Done, according to official guidance?

Official guidance describes that taking too much Done can lead to a state called a cholinergic crisis, which may involve symptoms such as severe nausea, sweating, muscle weakness, and a slowed heart rate. Due to the potential for serious health consequences, immediate emergency medical attention is described as necessary in the event of a suspected overdose.

Q: Can Done be taken at any time of day, or is a specific time suggested in the instructions?

The medicine is generally recommended to be taken once daily in the evening, just before retiring. The official product information suggests this timing, which is intended to manage potential side effects such as nausea or dizziness.

Q: What is the official position on stopping Done suddenly?

Regulatory-sourced patient information advises against stopping Done without first consulting a healthcare professional. Sudden discontinuation of the medicine may lead to a potential loss of the beneficial effects.

Q: How quickly does Done leave the system, as per pharmacokinetic studies?

Done has a relatively long elimination half-life of approximately 70 hours. This long half-life means it takes several days for the medicine to be fully cleared from the body. Consequently, it takes several days for concentrations to build and reach a steady state in the body after starting the medicine.

Q: Is Done considered a controlled substance?

Regulatory assessments indicate that Done is not classified as a controlled substance by the U.S. Drug Enforcement Administration (DEA) or equivalent regulatory bodies. The medicine is not known to cause misuse or dependence.

Q: How long does it typically take to feel the effects of Done?

The effects of Done develop gradually over time, rather than immediately. Clinical studies reviewed by regulatory bodies typically evaluate changes in symptoms over periods of several weeks to months, supporting the medicine's role in long-term symptom management.

Q: What kind of medical professional usually prescribes Done?

Done is a prescription-only medicine. It is typically prescribed by medical professionals who specialize in the diagnosis and management of conditions like Alzheimer's disease, such as neurologists, psychiatrists, or geriatric specialists.

Q: Does Done affect blood pressure or heart rate?

Regulatory warnings indicate the potential for the medicine to affect the heart. It may cause a slow heart rate (bradycardia) and may also lead to reports of fainting (syncope) and, less commonly, high blood pressure (hypertension). Caution is noted for patients with pre-existing heart conditions.

Q: Is it possible to become dependent on Done?

Based on regulatory assessments and classification, the medicine is not known to cause physical or psychological dependence. This is consistent with its status as a non-controlled, prescription medicine.

Q: What official body determined that Done is safe to be marketed?

The authorization for marketing and use is granted by national and international government regulatory bodies, such as the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA), following their review of clinical trial data.

Q: Can Done be taken with common over-the-counter pain relievers?

Official warnings state that concurrent use with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, naproxen, or high-dose aspirin, can increase the risk for gastrointestinal bleeding and ulcers. Users are advised to discuss all medicines they are taking with their healthcare provider.

Q: Are there any specific warnings about driving or operating machinery while using Done?

Yes, the official label includes a warning regarding certain side effects. Since the medicine may cause dizziness, fatigue, drowsiness, and muscle cramps, patients should be carefully evaluated for these effects before they attempt to drive or operate complex machinery.

Q: Does official evidence suggest Done is effective for long-term use?

Clinical trials reviewed by regulatory bodies demonstrated efficacy in studies lasting up to one year. While the medicine is used as a long-term treatment, the official documentation states that the long-term effectiveness (e.g., beyond 1 year) is described in regulatory documents as not having been fully established.

Q: Is Done approved for use in children or adolescents?

The use of Done is not generally recommended for children and adolescents, as its safety and effectiveness have not been established by regulatory authorities for the treatment of Alzheimer's disease.

Q: How is the safety profile of Done described in official regulatory reports?

Official documents describe the safety profile as primarily involving adverse reactions affecting the gastrointestinal and nervous systems. The profile also includes important warnings regarding potential, though rare, serious events such as severe skin reactions, liver damage, and effects on cardiac function, which require strict monitoring.

Q: Does the research say about the duration of Done's effect?

The sustained effect of the medicine is supported by its long half-life of approximately 70 hours, meaning it remains active in the body for a considerable time. Studies demonstrate that it maintains a continuous, dose-dependent inhibition of the acetylcholinesterase enzyme to support nerve cell communication.

Q: Are the listed side effects of Done temporary or permanent?

Many of the common side effects, such as nausea and diarrhea, are typically described as mild and transient. These effects often resolve within the first few weeks of starting treatment or following a dose increase, as the body adjusts to the medicine.

Q: What is the difference between the oral and transdermal forms of Done?

Done is available as traditional oral dosage forms (tablets, solution) and as a transdermal patch system. The patch is designed to deliver the active ingredient continuously through the skin over time, while the oral forms are taken once daily.

Q: Is it normal to feel different when starting Done?

Yes, it is common for patients to experience changes when starting this medicine. Due to the common occurrence of side effects, such as nausea, headache, and insomnia during the initial weeks of treatment, official documentation indicates that patients may experience differences as their body adjusts.

Q: Is there any research evidence on how Done affects sleep patterns?

Clinical trials and subsequent regulatory reports have identified insomnia (trouble sleeping) and abnormal dreams as commonly reported adverse reactions associated with the use of the medicine. These effects are documented under the nervous system or psychiatric adverse reactions.

Q: Does the official information address concerns about weight changes associated with Done?

Yes, the medicine's label lists anorexia (loss of appetite) and decreased weight as common adverse reactions that were reported in clinical trials. Weight monitoring may be part of standard care during treatment.

Q: What are the main findings from the clinical trials that led to Done's approval?

Pivotal trials demonstrated that the medicine provided a statistically significant improvement in measures of cognitive function (such as memory and thinking) and overall global clinical function when compared to a placebo. These findings supported the medicine’s role in managing symptoms of Alzheimer's disease.

Q: Does Done interact with hormonal birth control?

Regulatory data on drug metabolism indicates that the medicine does not inhibit the metabolism of several other drugs, including those often metabolized by the same liver enzymes. However, a specific, direct statement regarding interaction with hormonal birth control is typically not documented in the core safety labeling.

Q: Is Done considered a first-line or second-line treatment option according to guidelines?

Authoritative medical guidelines often describe Donepezil as a first-line option for individuals with mild-to-moderate Alzheimer's disease. This is based on its established efficacy and convenience of once-daily dosing.

Q: Is there a link between Done and changes in mood or anxiety levels?

Yes, regulatory reports list psychiatric adverse reactions. These may include changes such as agitation, aggression, hallucinations, and abnormal dreams. Mood-related reactions, specifically depression and anxiety, have also been reported with the use of the medicine.

Q: Are there any known long-term effects described in regulatory data for Done?

Regulatory reviews acknowledge that a large number of patients have been studied for up to one year. While ongoing safety surveillance continues, official documentation states that data for long-term outcomes beyond one year are often considered insufficient to draw firm conclusions on complex outcomes like the precise rate of functional decline.

Q: What are the physical characteristics of the Done tablet or capsule (color, shape, etc.)?

Official documentation describes the tablets in detail for identification purposes. The tablets are typically film-coated, round, and biconvex. For instance, the 5 mg strength is often white, and the 10 mg strength is often yellow or peach, each bearing specific identifying marks.

Q: What are the differences between how Done is regulated in the US versus Europe?

While the active ingredient and primary indication remain consistent across regions, slight differences in approved options exist. For example, the higher 23 mg daily dose is authorized for use in the U.S. for moderate-to-severe disease, while some European regulatory authorities may not have approved this specific dose.

How should Done be stored and disposed of?

How to Store and Dispose of Donepezil

Donepezil must be stored at controlled room temperature, specifically maintained between 20 C to 25 C (68 F to 77 F). The regulatory requirements permit brief temperature excursions between 15 C and 30 C. The medicine should be kept in its original container, tightly closed, and protected from moisture to ensure stability.

Protection and Disposal

The product must be stored out of the sight and reach of children.

Dispose of any unused or expired Donepezil according to local pharmaceutical waste regulations. Do not discard the medication via wastewater or routine household trash, unless local authorities have provided explicit instructions otherwise.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Done found in:

A-Z Index: