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Stop selling higher dose Alzheimer's drug, group says
May 18th, 2011
05:05 PM ET

Stop selling higher dose Alzheimer's drug, group says

A specific dose of Alzheimer’s drug should be pulled from the market because it poses a risk to patients, according to a consumer  group.

The drug, donepezil, sold under the brand Aricept, is administered in several doses – the highest being 23 milligrams – for patients with moderate to severe Alzheimer’s disease.

It is prescribed to improve mental function, such as memory, attention and reasoning by increasing a brain chemical. Aricept which is taken daily,  could slow the mental decline, but it does not cure or prevent Alzheimer's. 

The Public Citizen’s Health Research Group called the 23-milligram dose of Aricept “significantly more toxic” than the 10-milligram dose and said it  “should be immediately withdrawn from the market.”

The group says that the drug in higher dose compared with the 10-milligrams could pose increased adverse effects such as slowed pulse rate, nausea, vomiting, diarrhea, urinary incontinence, fatigue, dizziness and agitation.  The group also said the higher dose does not appear to give any benefits to the patients.

Three stages of Alzheimer's

Patients often stop taking the higher dose because of its strong side effects such as vomiting. And Alzheimer’s patients are particularly sensitive to vomiting because it can lead to other problems such as pneumonia, massive gastrointestinal bleeding, esophageal rupture and even death, the group said.

In response, Pfizer, which co-promotes Aricept with another company, Eisai, wrote in an emailed statement: "We are reviewing the petition and will respond accordingly; however, it is important to note that the Aricept (donepezil HCl) 23 mg tablet has been approved by the U.S. Food and Drug Administration for the treatment of moderate-to-severe Alzheimer’s disease. "

Dr. James Lah, director of the cognitive neurology program at Emory University"s Department of Neurology, regularly prescribes Aricept to patients, but doesn't prescribe the 23-milligram dose.

“Being Americans, the notion is that bigger is better, more is better... it’s simply not true in this particular instance,” Lah said.

He said he was concerned when the FDA approved the 23-milligram version.

“There is very little evidence that it’s superior,” Lah, an Alzheimer's clinician and associate professor said.  “There is a lot of evidence that it’s worse in terms of causing side effects.  If you look at the one study, only one clinical trial reported about the 23 versus 10 milligram Aricept. The results were entirely mixed in terms of effectiveness.”


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  45. Davidssasw

    so to this point. There has been a 78 percent increase in e-cigarette use by U.S. high school students, and 3.6 million high school and middle school students now
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  48. Davidssasw

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    it I notice a somewhat rapid heartbeat and some head flushing also but its well worth it as once again for me at least for some reason the side effects hit me later on then most people it seems After getting hit-and-miss results with testosterone creams and gels prescribed by family
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    doctor I went to a urologist who prescribed T injections along with Viagra. Now batting 100 percent. Viagra gives me the confidence I haven't had for a long time. I've found that effects can last up to 12 hours. Slight flushing and sniffles only drawback but well worth it All three cause unpleasant side effects that get worse once you pass 60 especially back and leg pain. The side effects are dosage related. Cialis stays in your system for a couple of days and kicks
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  50. Davidssasw

    very strong erection but reduced the sensations and gave me a slight headache . So I reckon it's worth experimenting to find the minimum dose you can get away with Works pretty well. I have tried Levitra and the quick tab version also with not much positive results. Nonetheless I was given a prescription by
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    my doc for this and for me 100 mg is the right dose. I can achieve erection but have at times a problem keeping it so this medicine will allow me to complete the act and enjoy it for a few too without orgasming too quick. It's a wonderful medicine that I can get generically (legitimately) and save some money also so shop around. I have minimal side
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    effects at first. What I mean is 4-5 hours after take it I notice a somewhat rapid heartbeat and some head flushing also but its well worth it as once again for me at least for some reason the side effects hit me later on then most people it seems After getting hit-and-miss results with testosterone creams
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