What is this medication?

DONEPEZIL (doe NEP e zil) treats memory loss and confusion (dementia) in people who have Alzheimer disease. It works by improving attention, memory, and the ability to engage in daily activities. It is not a cure for dementia or Alzheimer disease.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): ADLARITY

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Heart disease
• Irregular heartbeat or rhythm
• Liver disease
• Lung or breathing disease (asthma, COPD)
• Seizures
• Stomach ulcers, other stomach or intestinal problems
• Trouble passing urine
• An unusual or allergic reaction to donepezil, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is for external use only. Use it as directed on the prescription label. Apply the patch to your skin. Select a clean, dry area of skin on your back, but avoid the spine. The upper buttocks or upper, outer thigh may also be used. Do not apply the patch to broken, burned, cut, or irritated skin. Apply to an area of skin that does not have much hair. Do not shave the area of skin. Do not cut or trim the patch. Do not wear more than 1 patch at a time. Remove the old patch before using a new patch. Use a different site each time to prevent skin irritation. Keep using it unless your care team tells you to stop.

Take one pouch from the refrigerator and allow it to reach room temperature before opening the pouch. Take the patch out of the pouch. Do not use the patch if the packaging or patch is damaged. Take off the protective strip from the back of the patch. Press the sticky surface to your skin with the palm of your hand. Press the patch to the skin for 30 seconds. Wash your hands with soap and water.

Take off the old patch before putting on a new patch. Apply each new patch to a different area of skin. Do not use the exact same area of skin for 14 days. If a patch comes off, apply a new patch to a different skin area. Then replace the patch 7 days later.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

A patient package insert for the product will be given with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, apply it as soon as you can. If it is almost time for your next dose, apply only that dose. Do not apply double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Cisapride
• Dextromethorphan; quinidine
• Dronedarone
• Pimozide
• Quinidine
• Thioridazine

This medication may also interact with the following:

• Antihistamines for allergy, cough and cold
• Atropine
• Bethanechol
• Carbamazepine
• Certain medications for bladder problems like oxybutynin, tolterodine
• Certain medications for fungal infections like itraconazole, fluconazole, posaconazole, and voriconazole
• Certain medications for Parkinson's disease like benztropine, trihexyphenidyl
• Certain medications for stomach problems like dicyclomine, hyoscyamine
• Certain medications for travel sickness like scopolamine
• Dexamethasone
• Dofetilide
• Ipratropium
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Other medications for Alzheimer's disease
• Other medications that cause heart rhythm changes
• Phenobarbital
• Phenytoin
• Rifampin, rifabutin or rifapentine
• Ziprasidone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Check with your care team if your symptoms do not get better or if they get worse.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

This patch is sensitive to body heat changes. If your skin gets too hot, more medication will come out of the patch and can cause a deadly overdose. Call your care team if you get a fever. Do not take hot baths. Do not sunbath. Do not use hot tubs, saunas, hairdryers, heating pads, electric blankets, heated waterbeds, or tanning lamps.

If you get black, tarry stools or vomit up what looks like coffee grounds, call your care team right away. You may have a bleeding ulcer.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Peptic ulcer—burning stomach pain, loss of appetite, bloating, burping, heartburn, nausea, vomiting
• Seizures
• Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
• Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
• Trouble passing urine

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Diarrhea
• Fatigue
• Irritation at application site
• Loss of appetite
• Muscle pain or cramps
• Nausea
• Trouble sleeping
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store in the refrigerator. Do not freeze. Keep it in the original carton until you are ready to use it. Remove one pouch from the carton and allow it to reach room temperature before opening the pouch. Use it within 24 hours of removing it from the refrigerator. Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.