Donepezil Hydrochloride interactions

Checked as Donepezil in this data source.

Full monograph for Donepezil Hydrochloride Check it against another medicine

Medicines

586 documented

Severity

Mechanism

Medicines documented to interact with Donepezil Hydrochloride, worst severity first.
Medicine	Severity	Mechanism	Effect	Sources
Bupropion Hydrochloride	Major	Metabolism	The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with other agents that can…	23 sources — open the full entry
Dextromethorphan + Bupropion	Major	Metabolism	The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with other agents that can…	23 sources — open the full entry
Iohexol	Major	Synergy	Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of…	5 sources — open the full entry
Iopamidol	Major	Synergy	Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of…	5 sources — open the full entry
Paracetamol + Tramadol Hydrochloride	Major	Synergy · Unknown	The risk of seizures may be increased during coadministration of tramadol with any substance that can reduce the seizure threshold, such as selective serotonin…2 documented mechanisms	8 sources — open the full entry
Tramadol Hydrochloride	Major	Synergy	The risk of seizures may be increased during coadministration of tramadol with any substance that can reduce the seizure threshold, such as selective serotonin…	8 sources — open the full entry
Abametapir	Moderate	Metabolism	Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450…	1 sources — open the full entry
Alectinib	Moderate	Synergy	Coadministration of alectinib with other agents that can slow the heart rate may increase the risk of bradycardia.	4 sources — open the full entry
Alfuzosin Hydrochloride	Moderate	Synergy	Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart…	6 sources — open the full entry
Amiodarone Hydrochloride	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Amitriptyline Hydrochloride	Moderate	Antagonism	Due to opposing effects, agents that possess anticholinergic activity (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal…	6 sources — open the full entry
Amitriptyline Hydrochloride + Chlordiazepoxide	Moderate	Antagonism	Due to opposing effects, agents that possess anticholinergic activity (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal…	6 sources — open the full entry
Amlodipine Besilate	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Amlodipine Besilate + Atenolol	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Amlodipine Besilate + Atorvastatin	Moderate	Synergy · Unknown	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Amlodipine Besilate + Benazepril Hydrochloride	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Amlodipine Besilate + Olmesartan Medoxomil	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Amlodipine Besilate + Telmisartan	Moderate	Synergy · Unknown	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Amlodipine Besilate + Valsartan	Moderate	Synergy · Unknown	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Apalutamide	Moderate	Metabolism	Coadministration with drugs that are inducers of the CYP450 3A4 and/or 2D6 enzymatic pathways may decrease the plasma concentrations of donepezil. The…	8 sources — open the full entry
Aripiprazole	Moderate	Antagonism	Due to opposing effects, agents that possess anticholinergic activity (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal…	6 sources — open the full entry
Arsenic Trioxide	Moderate	Synergy	Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart…	6 sources — open the full entry
Artemether + Lumefantrine	Moderate	Metabolism	Coadministration with lumefantrine may increase the plasma concentrations of drugs that are substrates of the CYP450 2D6 isoenzyme. In vitro, lumefantrine…2 documented mechanisms	5 sources — open the full entry
Asciminib	Moderate	Others	It is uncertain whether asciminib causes clinically significant prolongation of the QT interval of the electrocardiogram.	2 sources — open the full entry
Asenapine Maleate	Moderate	Synergy	Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart…	6 sources — open the full entry
Atenolol	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Atenolol + Chlorthalidone	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Atomoxetine Hydrochloride	Moderate	Synergy	Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart…	6 sources — open the full entry
Atropine Sulfate (Injection)	Moderate	Antagonism	Acetylcholinesterase inhibitors (e.g., donepezil, galantamine, physostigmine, rivastigmine, tacrine) may antagonize the effects of anticholinergic agents and…	9 sources — open the full entry
Atropine Sulfate (Ophthalmic)	Moderate	Antagonism	Acetylcholinesterase inhibitors (e.g., donepezil, galantamine, physostigmine, rivastigmine, tacrine) may antagonize the effects of anticholinergic agents and…	9 sources — open the full entry
Azithromycin Dihydratebase Ophthalmic	Moderate	Synergy	Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart…	6 sources — open the full entry
Beclometasone + Formoterol + Glycopyrronium	Moderate	Antagonism	Acetylcholinesterase inhibitors (e.g., donepezil, galantamine, physostigmine, rivastigmine, tacrine) may antagonize the effects of anticholinergic agents and…	9 sources — open the full entry
Betaxolol Hydrochloride	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Bethanechol Chloride	Moderate	Synergy	A synergistic effect may be expected when acetylcholinesterase inhibitors are administered concurrently with other cholinesterase inhibitors or cholinergic…	3 sources — open the full entry
Bimatoprost + Timolol	Moderate	Synergy · Unknown	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Bisoprolol Fumarate	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Bisoprolol Fumarate + Amlodipine Besilate	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Bisoprolol Fumarate + Hydrochlorothiazide	Moderate	Synergy · Unknown	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Bosentan Monohydrate	Moderate	Metabolism	Coadministration with bosentan may decrease the plasma concentrations of drugs that are substrates of the CYP450 2C9 and/or 3A4 isoenzymes. The mechanism is…	5 sources — open the full entry
Brexpiprazole	Moderate	Antagonism	Due to opposing effects, agents that possess anticholinergic activity (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal…	6 sources — open the full entry
Brigatinib	Moderate	Synergy	Coadministration of brigatinib with other agents that can also slow the heart rate may potentiate the risk of severe bradycardia.	2 sources — open the full entry
Brimonidine Tartrate + Timolol Maleate	Moderate	Synergy · Unknown	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…2 documented mechanisms	6 sources — open the full entry
Brinzolamide + Timolol	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Budesonide + Glycopyrronium Bromide + Formoterol Fumarate	Moderate	Antagonism · Unknown	Acetylcholinesterase inhibitors (e.g., donepezil, galantamine, physostigmine, rivastigmine, tacrine) may antagonize the effects of anticholinergic agents and…2 documented mechanisms	9 sources — open the full entry
Cabozantinib	Moderate	Synergy	Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart…	6 sources — open the full entry
Calcium Dobesilate + Lidocaine + Dexamethasone	Moderate	Metabolism · Unknown	Coadministration with drugs that are inducers of the CYP450 3A4 and/or 2D6 enzymatic pathways may decrease the plasma concentrations of donepezil. The…2 documented mechanisms	8 sources — open the full entry
Carbamazepine	Moderate	Antagonism	Due to opposing effects, agents that possess anticholinergic activity (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal…	6 sources — open the full entry
Carvedilol	Moderate	Synergy	Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive…	6 sources — open the full entry
Cenobamate	Moderate	Metabolism	Coadministration with drugs that are inducers of the CYP450 3A4 and/or 2D6 enzymatic pathways may decrease the plasma concentrations of donepezil. The…	8 sources — open the full entry
Ceritinib	Moderate	Synergy	Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart…	6 sources — open the full entry

Conditions

Conditions in which Donepezil Hydrochloride needs care, as documented in this source.

Bradycardia
Major
Due to their pharmacological action, cholinesterase inhibitors can have a vagotonic effect on the sinoatrial and atrioventricular nodes producing bradycardia or heart block. Therapy with cholinesterase inhibitors should be administered cautiously in patients with preexisting bradycardia or underlying cardiac conduction abnormalities. Syncopal episodes have been reported in patients with and without cardiac abnormalities. Atropine may be used to reverse bradycardia produced by cholinesterase inhibitors.
13 sources
1. Wilcock GK, Surmon D, Forsyth D, Morgan R "Cholinergic side-effects of tetrahydroaminoacridine." Lancet 2 (1988): 1305
2. "Product Information. Cognex (tacrine)." Parke-Davis (2001):
3. Baldessarini RJ, Gelenberg AJ "Using physostigmine safely." Am J Psychiatry 136 (1979): 1608-9
4. Janowsky DS, Risch SC, Huey LY, Kennedy B, Ziegler M "Effects of physostigmine on pulse, blood pressure, and serum epinephrine levels." Am J Psychiatry 142 (1985): 738-40
5. Dysken MW, Janowsky DS "Dose-related physostigmine-induced ventricular arrhythmia: case report." J Clin Psychiatry 46 (1985): 446-7
6. "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
7. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc (2001):
8. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
Show all 13 sourcesShow fewer sources
1. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
2. "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
3. "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
4. "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals (2001):
5. "Product Information. Reminyl (galantamine)." Janssen Pharmaceuticals (2001):
Bronchial Spasm
Major
Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma or obstructive pulmonary disease. Monitoring respiratory function during dosage initiation and adjustment is recommended. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress. Neostigmine may produce more severe muscarinic side effects than does pyridostigmine and ambenonium. However, the duration of action is longest for ambenonium and shortest for edrophonium. Echothiophate iodide ophthalmic may be systemically absorbed and cautious use is recommended in these patients.
10 sources
1. Wilcock GK, Surmon D, Forsyth D, Morgan R "Cholinergic side-effects of tetrahydroaminoacridine." Lancet 2 (1988): 1305
2. "Product Information. Cognex (tacrine)." Parke-Davis (2001):
3. "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
4. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc (2001):
5. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
6. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
7. "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
8. "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
Show all 10 sourcesShow fewer sources
1. "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals (2001):
2. "Product Information. Reminyl (galantamine)." Janssen Pharmaceuticals (2001):
Coronary Artery Disease
Major
The use of cholinesterase inhibitors has been associated with a constriction of coronary arteries. Therapy with cholinesterase inhibitors should be administered cautiously in patients with coronary artery disease.
8 sources
1. "Product Information. Cognex (tacrine)." Parke-Davis (2001):
2. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
3. "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
4. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc (2001):
5. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
6. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
7. "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
8. "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
Parkinsonian Disorders
Major
Cholinesterase inhibitors should be used with caution in patients with parkinsonism. Some of these drugs might be contraindicated in these patients (refer to specific prescribing information). Symptoms of Parkinson's disease may be exacerbated with the increase in cholinergic activity. Caregivers and patients should be advised.
8 sources
1. "Product Information. Cognex (tacrine)." Parke-Davis (2001):
2. el-Yousef MK, Janowsky D, Davis JM, Sekerke HJ "Reversal of antiparkinsonian drug toxicity by physostigmine: a controlled study." Am J Psychiatry 130 (1973): 141-5
3. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
4. "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
5. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
6. "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
7. "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
8. "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals (2001):
Peptic Ulcer
Major
The use of cholinesterase inhibitors is associated with an increase in gastric acid secretion and gastric contractions. Therapy with cholinesterase inhibitors should be administered cautiously in patients with peptic ulcer disease.
9 sources
1. "Product Information. Cognex (tacrine)." Parke-Davis (2001):
2. "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
3. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc (2001):
4. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
5. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
6. "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
7. "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
8. "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals (2001):
Show all 9 sourcesShow fewer sources
1. "Product Information. Reminyl (galantamine)." Janssen Pharmaceuticals (2001):
Seizures
Major
Cholinesterase inhibitors have been associated with convulsions and tremor. Therapy with cholinesterase inhibitors should be administered cautiously in patients with seizure disorders.
9 sources
1. "Product Information. Cognex (tacrine)." Parke-Davis (2001):
2. Stewart GO "Convulsions after physostigmine." Anaesth Intensive Care 7 (1979): 283
3. "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
4. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc (2001):
5. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
6. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
7. "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
8. "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
Show all 9 sourcesShow fewer sources
1. "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals (2001):
Hyperthyroidism
Moderate
Many of the manifestations of hyperthyroidism may be exacerbated by increased levels of acetylcholine produced by cholinesterase inhibitors. Therapy with cholinesterase inhibitors should be administered cautiously to patients with hyperthyroidism. Monitoring of thyroid levels is recommended.
5 sources
1. "Product Information. Cognex (tacrine)." Parke-Davis (2001):
2. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
3. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc (2001):
4. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
5. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
Liver Diseases
Moderate
Donepezil is extensively metabolized by the liver (CYP450-2D6/3A4) to two active and various minor forms. The clearance of donepezil was decreased 20% in patients with stable alcoholic cirrhosis compared to healthy patients. Care should be exercised when using donepezil in patients with liver disease.
2 sources
1. "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals (2001):
2. Rogers SL, Friedhoff LT "The efficacy and safety of donepezil in patients with Alzheimer's disease: results of a US multicentre, randomized, double-blind, placebo-controlled trial." Dementia 7 (1996): 293-303

Therapeutic duplication

Drug classes that overlap with Donepezil Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

cholinergics
The recommended maximum number of medicines in the 'cholinergics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cholinergics' category.
Example product in the source data (US market): Glycopyrrolate/neostigmine

Medicines

Conditions

Bradycardia

Bronchial Spasm

Coronary Artery Disease

Parkinsonian Disorders

Peptic Ulcer

Seizures

Hyperthyroidism

Liver Diseases

Therapeutic duplication

cholinergics