ARICEPT 5 mg FILM-COATED TABLETS

2. What you need to know before you take Aricept

Do not take Aricept:

• if you are allergic to donepezil hydrochloride, piperidine derivatives, or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Consult your doctor before starting to take Aricept if you have or have had:

• a history of stomach or duodenal ulcers
• heart disease (such as irregular or very slow heartbeats, heart failure, myocardial infarction)
• a heart condition called "prolongation of the QT interval" or a history of certain abnormal heart rhythms called torsades de pointes, or if a family member has "prolongation of the QT interval"
• low levels of magnesium or potassium in the blood
• seizures
• asthma or chronic pulmonary disease
• difficulty urinating or mild kidney disease.

You should avoid taking Aricept with other acetylcholinesterase inhibitors and other agonists or antagonists of the cholinergic system.

Other medicines and Aricept

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines, especially if you are taking any of the following medicines:

• medicines for heart rhythm problems, such as amiodarone or sotalol
• medicines for depression, such as citalopram, escitalopram, amitriptyline, fluoxetine
• medicines for psychosis, such as pimozide, sertindole, or ziprasidone
• medicines for bacterial infections, such as clarithromycin, erythromycin, levofloxacin, moxifloxacin, rifampicin
• antifungal medicines, such as ketoconazole
• other medicines for treating Alzheimer's disease, such as galantamine
• analgesics or treatments for arthritis, such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or diclofenac sodium.
• quinidine and beta-blockers for treating irregular heartbeats, such as propranolol and atenolol
• phenytoin and carbamazepine (for treating epilepsy)
• cholinergic agonists and medicines with anticholinergic activity (acting on the central nervous system) such as tolterodine
• succinylcholine, diazepam, and other neuromuscular blockers (for producing muscle relaxation)
• general anesthesia

In the event of surgical intervention with general anesthesia, you should inform your doctor that you are taking Aricept, as this may affect the amount of anesthetic needed.

Aricept can be used in patients with mild to moderate kidney or liver disease. Inform your doctor before starting treatment if you have kidney or liver problems. Patients with severe liver disease should not take Aricept.

Taking Aricept with food, drinks, and alcohol

This medicine should be taken with a little water.

Aricept should not be taken with alcohol, as alcohol may alter the effect of this medicine.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

You should not take Aricept if you are breastfeeding.

Driving and using machines

Your illness may affect your ability to drive or use machines, and you should not carry out these activities unless your doctor tells you it is safe to do so. Aricept may cause fatigue, dizziness, somnolence, and muscle cramps, mainly at the start of treatment or when increasing the dose. If you experience these effects, you should not drive or use machines.

This medicine contains lactose. If your doctor has told you that you have an intolerance to some sugars, consult them before taking this medicine.

3. How to take Aricept

Follow exactly the administration instructions of this medicine given by your doctor. If you are unsure, consult your doctor or pharmacist again.

Aricept is administered orally.

Treatment with Aricept starts with one 5 mg tablet, taken once daily with a little water, at night, immediately before bedtime. After one month of treatment, your doctor may tell you to increase the dose to 10 mg, once daily, at night. The maximum recommended dose is 10 mg per day.

If you have abnormal dreams, nightmares, or difficulty sleeping (see section 4), your doctor may recommend that you take Aricept in the morning.

If you have mild to moderate liver or kidney disease, you can take Aricept. Inform your doctor before starting treatment if you have liver or kidney problems. Patients with severe liver disease should not take Aricept.

Use in children

Aricept is not recommended for use in children.

If you take more Aricept than you should

If you have taken more Aricept than you should, contact your doctor, pharmacist, or call the Toxicology Information Service, telephone: 91 562 04 20, stating the medicine and the amount used.

Symptoms of overdose may include nausea (feeling sick), vomiting (being sick), drooling, sweating, decreased heart rate, low blood pressure (dizziness or fainting when standing up), breathing problems, loss of consciousness, and seizures.

If you forget to take Aricept

Do not take a double dose to make up for forgotten doses.

If you stop taking Aricept

Do not stop taking Aricept unless your doctor tells you to. If you stop taking Aricept, the benefits of the treatment will gradually disappear.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Aricept can cause side effects, although not everybody gets them.

The following side effects have been reported by people taking Aricept.

Contact your doctor if you have any of these side effects during treatment with Aricept.

Serious side effects:

You should tell your doctor immediately if you notice any of the following serious side effects, as you may need urgent medical treatment.

• Liver damage, for example, hepatitis. The symptoms of hepatitis are nausea or vomiting (feeling or being sick), loss of appetite, general malaise, fever, itching, yellowing of the skin and eyes, and dark-colored urine (affecting between 1 and 10 in every 10,000 people).
• Ulcers in the stomach or duodenum. The symptoms of ulcers are stomach pain and discomfort (indigestion) between the navel and the sternum (affecting between 1 and 10 in every 1,000 people).
• Bleeding in the stomach or intestine. This can cause you to have black, tarry stools or visible blood from the rectum (affecting between 1 and 10 in every 1,000 people).
• Dizziness (fits) or seizures (affecting between 1 and 10 in every 1,000 people).
• Fever with muscle stiffness, sweating, decreased level of consciousness (which can be symptoms of a condition called "Neuroleptic Malignant Syndrome") (affecting less than 1 in every 10,000 patients).
• Weakness, sensitivity, or muscle pain, particularly if you also feel unwell, have a fever, or have dark-colored urine. This can be due to abnormal muscle breakdown, which can be life-threatening and cause kidney problems (a condition called rhabdomyolysis).

The estimated frequency of occurrence of side effects is as follows:

Very common: may affect more than 1 in 10 people

• Diarrhea
• Nausea
• Headache

Common: may affect up to 1 in 10 people

• Cold
• Loss of appetite
• Hallucinations
• Agitation
• Aggressive behavior
• Abnormal dreams and nightmares
• Fainting
• Dizziness
• Difficulty sleeping
• Vomiting
• Abdominal discomfort
• Urinary incontinence
• Rash
• Itching
• Muscle cramps
• Fatigue
• Pain
• Accidents (patients may be more prone to falls and accidental injuries)

Uncommon: may affect up to 1 in 100 people

• Seizures
• Decreased heart rate (bradycardia)
• Gastrointestinal bleeding, stomach and duodenal ulcers (affecting between 1 and 10 in every 1,000 people)
• Increased levels of a type of enzyme (creatine kinase) in the blood

Rare: may affect up to 1 in 10,000 people

• Extrapyramidal symptoms (such as tremor or rigidity of the hands or feet)
• Changes in heart conduction
• Liver function disorders, including hepatitis

Frequency not known (cannot be estimated from the available data)

• Increased libido, hypersexuality
• Pisa syndrome (a condition involving involuntary muscle contraction with abnormal flexion of the body and head to one side)
• Changes in heart activity that can be seen on an electrocardiogram (ECG) called "prolongation of the QT interval"
• Rapid and irregular heartbeat, fainting that can be symptoms of a potentially life-threatening disorder known as torsades de pointes

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Spanish Medicines Monitoring System for Human Use, Website: www.notificaRAM.es

5. Storage of Aricept

Keep this medicine out of the sight and reach of children.

Store below 30°C.

Do not use Aricept after the expiry date stated on the carton. The expiry date is the last day of the month stated.

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 protect the environment.

6. Contents of the pack and further information

Composition of Aricept 5 mg film-coated tablets

• The active substance is donepezil hydrochloride. Each tablet contains 5 mg of donepezil hydrochloride.
• The other ingredients are: lactose monohydrate, maize starch, microcrystalline cellulose, hypromellose, magnesium stearate, talc, polyethylene glycol, hypromellose, and titanium dioxide (E171).

Appearance of the product and pack contents

• Aricept 5 mg is presented as film-coated tablets. The tablets are round, biconvex, white, and engraved with "5" on one face and "ARICEPT" on the other.

Aricept 5 mg film-coated tablets are available in a pack size of 28 tablets, in a blister pack formed by PVC with an aluminum foil on the back.

Marketing authorization holder and manufacturer

Marketing authorization holder:

Eisai GmbH

Edmund-Rumpler-Straße 3

60549 Frankfurt am Main

Germany

Manufacturer:

Fareva Amboise

Zone Industrielle

29 route des Industries

37530 Pocé-sur-Cisse

France

or

Eisai GmbH

Edmund-Rumpler-Straße 3

60549 Frankfurt am Main

Germany

You can obtain further information on this medicine by contacting the local representative of the marketing authorization holder:

Eisai Farmacéutica, S.A.

Parque Empresarial Cristalia.

Calle Via de los Poblados 3, Edf. 7/8

4th floor

28033 Madrid

Tel: + (34) 91 455 94 55

Date of last revision of this leaflet: December 2022

"Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/"