Donepezil Side Effects and Precautions

Gastrointestinal and Cardiovascular Considerations

Taking donepezil with food significantly reduces gastrointestinal effects, as recommended by the American Academy of Family Physicians 1, 2
The American Academy of Family Physicians notes that donepezil can cause mild, transient gastrointestinal side effects, such as nausea, vomiting, and diarrhea, due to its cholinergic mechanism 1
No hepatotoxicity occurs with donepezil, unlike tacrine, according to the American Academy of Family Physicians and other guidelines 1, 3

Initial increase in agitation may occur in some patients but typically subsides after a few weeks, as reported by the American Academy of Family Physicians 1
The American Academy of Family Physicians also notes that seizures are a theoretical risk with cholinomimetics, though seizures may also represent disease progression 1

Conflicting evidence exists regarding interactions with cimetidine, theophylline, warfarin, and digoxin, as reported by the American Academy of Family Physicians 1