NSTK · 01.2026Independent supplement reference
NutriStack
Edition 1.0Updated July 13, 2026

Donepezil

Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026

Donepezil is a centrally-acting reversible acetylcholinesterase inhibitor indicated for the treatment of mild, moderate, and severe Alzheimer's disease. It is the most widely prescribed medication for Alzheimer's dementia and provides modest improvements in cognition, behavior, and daily function, though it does not alter disease progression.

Evidence tier
Moderate
Indexed sources
10 2008–2025
Interactions
0
Category
Prescription
Read the sources → Compare profiles
Publication status

Exploratory record, not a reviewed medical publication.

See the editorial and medical-review policies for the publication gate.

This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.

In short

What the research says.

A quick, data-only summary. The full evidence, dosing, and sources are below.

Donepezil is a centrally-acting reversible acetylcholinesterase inhibitor indicated for the treatment of mild, moderate, and severe Alzheimer's disease. NutriStack rates the supporting evidence as moderate. Common adult dosing is 5 mg once daily at bedtime for 4-6 weeks, then may increase to 10 mg once daily; 23 mg once daily for moderate-to-severe AD (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 10 sources.

What it's good for
  • Modest improvement in cognitive function (ADAS-cog scores)2,4
  • May stabilize or slow decline in activities of daily living
  • Once-daily dosing with simple titration
  • Approved for all stages of Alzheimer's disease1,7
What to watch for
  • Nausea and vomiting
  • Diarrhea
  • Insomnia and vivid dreams
  • Known hypersensitivity to donepezil or piperidine derivatives1,2
  • Sick sinus syndrome or cardiac conduction disorders without a pacemaker3

The bottom line

Evidence rating moderate. Most-documented uses: modest improvement in cognitive function (adas-cog scores), may stabilize or slow decline in activities of daily living, once-daily dosing with simple titration. 10 sources indexed (2008–2025), with 0 interaction records on file.

The science

How it works, mechanistically.

Core mechanism

Reversibly inhibits acetylcholinesterase (AChE), the enzyme responsible for breaking down acetylcholine in the synaptic cleft. By preventing acetylcholine degradation, it increases cholinergic neurotransmission in the cerebral cortex and hippocampus, partially compensating for the loss of cholinergic neurons characteristic of Alzheimer's disease. Highly selective for AChE over butyrylcholinesterase.

Class
Cholinesterase Inhibitor / Alzheimer's
Dosing

Dosing & protocol.

Common range
5 mg once daily at bedtime for 4-6 weeks, then may increase to 10 mg once daily; 23 mg once daily for moderate-to-severe AD (as prescribed by your physician)
Recommended form
Oral tablet or orally disintegrating tablet; 23 mg sustained-release tablet for advanced disease

Well absorbed (~100% bioavailability); food does not affect absorption. Usually taken at bedtime to minimize GI side effects. Long half-life supports once-daily dosing.

Safety

Full safety detail.

Side effects

  • Nausea and vomiting
  • Diarrhea
  • Insomnia and vivid dreams
  • Muscle cramps
  • Fatigue
  • Bradycardia
  • Decreased appetite and weight loss

Contraindications

  • Known hypersensitivity to donepezil or piperidine derivatives1,2
  • Sick sinus syndrome or cardiac conduction disorders without a pacemaker3
  • Active GI bleeding or peptic ulcer disease
  • Severe COPD or asthma (cholinergic bronchoconstriction risk)10
Sources

Sources, by evidence tier.

Numbered references. Citations throughout the page link here.

Meta-analyses & systematic reviews

7

Reference material

3
FAQ

Common questions.

Quick answers about Donepezil, drawn from the data on this page.

What is Donepezil?

Donepezil is a centrally-acting reversible acetylcholinesterase inhibitor indicated for the treatment of mild, moderate, and severe Alzheimer's disease. It is the most widely prescribed medication for Alzheimer's dementia and provides modest improvements in cognition, behavior, and daily function, though it does not alter disease progression.

What is Donepezil used for?

Commonly cited benefits of Donepezil include: Modest improvement in cognitive function (ADAS-cog scores); May stabilize or slow decline in activities of daily living; Once-daily dosing with simple titration; Approved for all stages of Alzheimer's disease. NutriStack rates the overall evidence as moderate.

What is a typical dose of Donepezil?

A typical adult dose of Donepezil is 5 mg once daily at bedtime for 4-6 weeks, then may increase to 10 mg once daily; 23 mg once daily for moderate-to-severe AD (as prescribed by your physician). The commonly recommended form is Oral tablet or orally disintegrating tablet; 23 mg sustained-release tablet for advanced disease. These are general ranges, not personalized advice; confirm the right dose with a clinician.

What are the side effects of Donepezil?

Reported side effects include nausea and vomiting, diarrhea, insomnia and vivid dreams, muscle cramps, fatigue, bradycardia. This is educational information; check with a healthcare professional before use.

How strong is the evidence for Donepezil?

NutriStack rates this as Moderate, meaning several aligned RCTs or one large RCT plus supporting reviews. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.

Use this with your stack

Donepezil in NutriStack.

Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.

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NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.