If you or a loved one just started donepezil for Alzheimer’s, you’ll want to know if it’s doing its job and whether any side effects pop up. The good news is you can keep an eye on things yourself and with your doctor. Below are the key things to check, how often to check them, and what to do when something looks off.
First, pay attention to daily mood and memory changes. Write down any new forgetfulness, confusion, or improvements on a simple notebook. Note how the person feels after meals – donepezil can sometimes cause nausea or loss of appetite. Also, track sleep patterns; a few patients feel more restless at night.
Don’t forget the basics: weight, blood pressure, and heart rate. Donepezil can lower heart rate a little, so if you notice a consistently slow pulse (<60 BPM) or dizziness, write it down. A quick weekly weigh‑in can catch unwanted weight loss early, which is common with cholinesterase inhibitors.
Schedule a follow‑up about a month after starting the drug. During that visit, the doctor will likely use a cognitive test like the MMSE or MoCA to see if there’s any measurable change. Bring your notebook so they can see trends over time.
Blood work isn’t required for everyone, but some doctors order liver function tests and electrolytes after the first few weeks, especially if you’re on other meds that affect the liver. If you have a history of heart problems, an ECG might be requested to rule out any rhythm issues.
If you’re on a higher dose (10 mg or more) and notice stomach cramps, diarrhea, or increased sweating, tell your doctor. They may lower the dose to 5 mg for a while before trying to increase again.
Most side effects happen early and improve after a few weeks. However, if severe nausea, vomiting, or black stools (possible GI bleeding) appear, stop the drug and call your doctor right away. Also, if memory and thinking get noticeably worse despite staying on the medication for at least six weeks, it may be time to reconsider the dose.
Never change the dose on your own. If you miss a dose, take it as soon as you remember unless it’s almost time for the next one. In that case, skip the missed dose and continue with the regular schedule – doubling up can cause more stomach upset.
Set a daily alarm on your phone to take donepezil at the same time each day – consistency helps keep side effects low. Keep the pill bottle in a visible spot, like next to your toothbrush, so you don’t forget.
Get a family member or caregiver involved. They can notice subtle changes you might miss and help keep the medication log accurate. Sharing the log with your doctor makes appointments smoother and more productive.
Finally, remember that donepezil isn’t a cure; it’s a tool to slow decline. Keeping a close eye on how it works for you or your loved one can make the difference between a few extra good days and unnecessary discomfort.
Clear, step-by-step guide to track if donepezil is helping in Alzheimer’s: what to measure, when to check, side effects to watch, and how to decide on dose changes or stopping.
