Donepezil Dosage: Simple Guide for Patients

If you or a loved one has been prescribed Donepezil, the first question is usually, "How much should I take?" Donepezil is a cholinesterase inhibitor used to slow memory loss in Alzheimer’s disease. The right dose can keep symptoms from getting worse too fast, but taking too much can cause nausea, cramps, or dizziness. Below you’ll find the typical dosing schedule, how doctors decide on a dose, and what to do if you need a change.

How Doctors Choose the Right Dose

Most doctors start you on a low dose – usually 5 mg once daily. Starting low helps your body get used to the medicine and reduces the chance of side‑effects. After four to six weeks, your doctor may increase the dose to 10 mg if you’re handling the first dose well. Some people may stay on 5 mg for the whole time, especially if they’re older or have liver problems.

In a few cases, the doctor may push the dose up to 23 mg once daily. That higher dose is only for people who have already been on 10 mg for at least three months and still need extra help with memory or daily tasks. The jump from 10 mg to 23 mg is big, so doctors usually spread it over a few weeks and watch for any stomach upset.

Adjusting Your Dose Safely

If you miss a pill, take it as soon as you remember—unless it’s almost time for your next dose. In that case, just skip the missed one and keep your regular schedule. Doubling up can raise the risk of nausea, vomiting, or loss of appetite.

Tell your doctor right away if you notice severe stomach pain, trouble sleeping, or a fast heartbeat. Those could be signs the dose is too high. On the other hand, if you feel nothing is changing after a few months, ask if a dose increase makes sense. Your doctor might run a quick blood test to check liver function before moving up.

Never change the dose on your own. Donepezil works best when you stick to the plan your doctor set, and sudden changes can make side‑effects worse. If you’re taking other meds—like anticholinergics, certain heart drugs, or other Alzheimer’s treatments—let your doctor know. Some combos can bump up the risk of dizziness or slow heart rate.

For people with kidney or liver issues, doctors often keep the dose at 5 mg. The body clears Donepezil slower when those organs aren’t working well, so a lower dose avoids drug buildup.

Remember, Donepezil isn’t a cure; it’s a tool that can keep daily life a bit easier for a while. Staying consistent with the dose and reporting any new symptoms help you get the most out of the medicine.

Bottom line: start low, move up slowly, and keep the conversation open with your healthcare team. That way you’ll find the sweet spot where the drug helps without causing too many side‑effects.