Acetylcholinesterase inhibitor
Reversibly inhibits acetylcholinesterase, increasing acetylcholine levels and enhancing cholinergic neurotransmission in the brain
Mild to moderate Alzheimer’s disease (AD)
Vascular dementia, dementia with Lewy bodies (DLB), cognitive impairment in Parkinson’s disease (PD), post-stroke apathy
Oral tablets, orally disintegrating tablets
Start at 5 mg p.o. nightly; increase to 10 mg nightly after 4–6 weeks as tolerated
5–10 mg/day
Half-life approximately 70 hours; metabolized via CYP2D6 and CYP3A4
Nausea, diarrhea, insomnia, muscle cramps, fatigue
Gastrointestinal bleeding, cardiac conduction abnormalities (e.g., bradycardia, heart block)
Monitor for gastrointestinal symptoms and cardiac conduction issues in at-risk patients
None
May benefit cognitive symptoms in vascular dementia, post-stroke cognitive impairment, and other neurodegenerative conditions. Use cautiously in patients with history of gastrointestinal bleeding or cardiac conduction abnormalities.