Side Effects of Donepezil

Common Side Effects

The American College of Cardiology is not mentioned in this article, however, the Praxis Medical Insights guideline reports that nausea and vomiting (relative risk 2.54) are among the most frequently reported adverse effects 1
Diarrhea (relative risk 2.57) is significantly more common than with placebo 1
Anorexia has the largest effect size among gastrointestinal symptoms (relative risk 3.21) 1
These gastrointestinal effects are dose-related, with higher incidence at 10mg compared to 5mg dosing 1, 2
Initial increase in agitation that typically subsides after the first few weeks of therapy 1, 3
Dizziness (relative risk 1.47) is a common side effect 1
Muscle cramps, particularly leg cramps, occur with a very high relative risk in vascular dementia patients 1

Start at 5mg daily and gradually increase to 10mg after 4 weeks to minimize side effects 1
Taking donepezil in the morning rather than at bedtime may minimize sleep disturbances 2
Unlike some other cholinesterase inhibitors, donepezil does not cause hepatotoxicity and does not require liver function monitoring 1

Withdrawal rates due to adverse events ranged from 0% to 57% in treatment groups compared to 0% to 20% in placebo groups 1