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Donepezil dose titration — GPhC CRA MCQ

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ModerateCNS TherapeuticsDonepezil dose titrationGPhC CRA

A 65-year-old woman with Alzheimer's disease has been prescribed donepezil 5 mg at night. After 4 weeks, her family report no improvement. They ask the pharmacist whether the medication should be stopped. What is the most appropriate advice?

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Correct answer: E — The dose may be increased to 10 mg after 4-6 weeks; treatment response should be assessed after at least 3 months at optimal dose

Donepezil is started at 5 mg daily and may be increased to 10 mg after a minimum of 4-6 weeks, depending on tolerability. Meaningful clinical response may take 3-6 months to become apparent. It would be premature to abandon treatment at 4 weeks on the starting dose. NICE recommends continuing treatment as long as the patient's MMSE remains above 10 and the drug is considered to have a worthwhile effect on cognition, function, or behaviour.

Reference: NICE TA217; BNF Donepezil