ALZAMED (donepezil hydrochloride) belongs to a group of medicines called acetyl
cholinesterase inhibitors. Donepezil increases the levels of a substance (acetylcholine) in the
brain involved in memory function by slowing down the breakdown of acetylcholine.
It is used to treat the symptoms of dementia in people diagnosed as having mild and moderately
severe Alzheimer’s disease. The symptoms include increasing memory loss, confusion and
behavioral changes.
As a result, sufferers of Alzheimer’s disease find it more and more difficult to carry out their
normal Daily activities.
ALZAMED is for use in adult patients only.

Do not take ALZAMED
 if you are allergic (hypersensitive) to donepezil hydrochloride, or to piperidine derivatives, or
any of the other ingredients of ALZAMED listed in section 6.

Take special care with ALZAMED
Tell your doctor or pharmacist before starting to take ALZAMED if you have or have had:
 stomach or duodenal ulcers
 seizures (fits) or convulsions
 a heart condition (irregular or very slow heart beat)
 asthma or other long term lung disease
 liver problems or hepatitis
 difficulty passing urine or mild kidney disease.
Also tell your doctor if you are pregnant or think you might be pregnant.

Taking other medicines
Please tell your doctor or pharmacist if you are taking, or have recently taken, any other
medicine. This includes medicines that your doctor has not prescribed for you but which you
have bought yourself from a chemist/pharmacist. It also applies to medicines you may take some
time in the future if you continue to take ALZAMED. This is because these medicines may
weaken or strengthen the effects of ALZAMED.
Especially tell your doctor if you are taking any of the following types of medicines:
 other Alzheimer’s disease medicines, e.g. galantamine
 pain killers or treatment for arthritis e.g. aspirin, non-steroidal anti-inflammatory
(NSAID) drugs such as ibuprofen, or diclofenac sodium
 anticholinergic medicines, e.g. tolterodine
 antibiotics e.g. erythromycin, rifampicin
 anti-fungal medicine e.g. ketoconazole
 anti-depressants e.g. fluoxetine
 anticonvulsants e.g. phenytoin, carbamazepine
 medication for a heart condition e.g. quinidine, beta-blockers (propanolol and atenolol)
 muscle relaxants e.g. diazepam, succinylcholine
 general anesthetic
 medicines obtained without a prescription e.g. herbal remedies.

If you are going to have an operation that requires you to have a general anesthetic, you should
tell your doctor and the anesthetist that you are taking ALZAMED. This is because your
medicine may affect the amount of anesthetic needed.
ALZAMED can be used in patients with kidney disease or mild to moderate liver disease. Tell
your doctor first if you have kidney or liver disease. Patients with severe liver disease should not
take ALZAMED.

Tell your doctor or pharmacist the name of your caregiver. Your caregiver will help you to take
your medicine as it is prescribed

Taking ALZAMED with food and drink
Food will not influence the effect of ALZAMED.
ALZAMED should not be taken with alcohol because alcohol may change its effect.
Pregnancy and breastfeeding
ALZAMED should not be used while breastfeeding.
If you are pregnant, or think you might be pregnant, ask your doctor for advice before taking any
medicine.
Driving and using machines
Alzheimer’s disease may impair your ability to drive or operate machinery and you must not
perform these activities unless your doctor tells you that it is safe to do so.
Also, your medicine can cause tiredness, dizziness and muscle cramp. If you experience any of
these affects you must not drive or operate machinery

Important information about some of the ingredients of ALZAMED
This medicine contains lactose. If you have been told by your doctor that you have intolerance to
some sugars, you should contact your doctor before taking ALZAMED.

How much ALZAMED should you take?
Usually, you will start by taking 5 mg (one tablet) every night. After one month, your doctor may
tell you to take 10 mg (one tablet) every night.
Swallow your ALZAMED tablet with a drink of water before you go to bed at night.
The tablet strength you will take may change depending on the length of time you have been
taking the medicine and on what your doctor recommends. The maximum recommended dose is 10 mg each night. Always follow your doctor’s, or pharmacist’s advice about how and when to
take your medicine.
Do not alter the dose yourself without your doctor’s advice.

For how long should you take ALZAMED?
Your doctor or pharmacist will advise you on how long you should continue to take your tablets.
You will need to see your doctor from time to time to review your treatment and assess your
symptoms.
If you stop taking ALZAMED
Do not stop taking the tablets unless told to do so by your doctor. If you stop taking ALZAMED,
the benefits of your treatment will gradually fade away.
If you take more ALZAMED than you should
DO NOT take more than one tablet each day. Call your doctor immediately if you take more than
you should. If you cannot contact your doctor, contact the local hospital Accident and Emergency
department at once. Always take the tablets and the carton with you to the hospital so that the
doctor knows what has been taken.
Symptoms of overdosing include feeling and being sick, drooling, sweating, slow heart rate, low
blood pressure (light-headedness or dizziness when standing), breathing problems, losing
consciousness and seizures (fits) or convulsions.
If you forget to take ALZAMED
If you forget to take a tablet, just take one tablet the following day at the usual time. Do not take a
double dose to make up for a forgotten tablet.
If you forget to take your medicine for more than one week, call your doctor before taking any
more medicine.

Like all medicines, Donepezil can cause side effects, although not everybody gets them.
The following side effects have been reported by people taking Donepezil.
Tell your doctor if you have any of these effects while you are taking ALZAMED.
Serious side effects:
You must tell your doctor immediately if you notice these serious side effects mentioned. You
may need urgent medical treatment.
 liver damage e.g. hepatitis. The symptoms of hepatitis are feeling or being sick, loss of
appetite, feeling generally unwell, fever, itching, yellowing of the skin and eyes, and dark colored
urine (affects 1 to 10 users in 10,000).
 stomach or duodenal ulcers. The symptoms of ulcers are stomach pain and discomfort
(indigestion) felt between the navel and the breast bone (affects 1 to 10 users in 1,000)
 bleeding in the stomach or intestines. This may cause you to pass black tar like stools or
visible blood from the rectum (affects 1 to 10 users in 1,000).
 seizures (fits) or convulsions (affects 1 to 10 users in 1,000).
Very common side effects (affects more than 1 user in 10):
 Diarrhoea
 feeling or being sick
 headaches
Common side effects (affects 1 to 10 users in 100):
 muscle cramp
 tiredness
 difficulty in sleeping (insomnia)
 the common cold
 loss of appetite

 hallucinations (seeing or hearing things that are not really there)

 unusual dreams including nightmares
 Agitation
 aggressive behavior
 fainting
 Dizziness
 stomach feeling uncomfortable
 Rash
 itching
 passing urine uncontrollably
 pain
 accidents (patients may be more prone to falls and accidental injury)
Uncommon side effects (affects 1 to 10 users in 1,000):
 slow heart beat
Rare side effects (affects 1 to 10 users in 10,000):
 stiffness, shaking or uncontrollable movement especially of the face and tongue but also
of the limbs
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.

DO NOT use ALZAMED tablets after the expiry date that is printed on the label. The expiry date
refers to the last day of that month.
Store below 25°C. Keep out of the reach and sight of children.
If your doctor tells you to stop taking your medicine, you should return any you have not used to
your pharmacist.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist
how to dispose of medicines no longer required. These measures will help to protect the
environment