{ "schema_version": 1, "kind": "condition", "id": "alzheimers-disease", "name": "Alzheimer's Disease", "category": "chronic", "sources": "Alzheimer Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK499922/ · Donepezil Hydrochloride 5 mg Film-coated tablets SmPC section 4.2 Posology (eMC product 4428) · Ebixa 10 mg film-coated tablets SmPC section 4.2 Posology (eMC product 8222) · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PD01.00 - condition scope only, no dose", "review_status": "reviewed", "verified_against": "Donepezil Hydrochloride 5 mg Film-coated tablets SmPC section 4.2 Posology (eMC product 4428) · Ebixa 10 mg film-coated tablets SmPC section 4.2 Posology (eMC product 8222) · Alzheimer Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK499922/", "verified_date": "2026-09", "treatments": [ { "id": 145, "generic": "Donepezil", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 5.0, "adult_dose": "5 mg once daily in the evening, held at 5 mg for at least one month; then 10 mg once daily if further benefit is wanted. Maximum 10 mg daily", "adult_duration": "long-term, benefit reassessed on a regular basis", "dose_source": "Donepezil Hydrochloride 5 mg Film-coated tablets SmPC section 4.2 Posology (eMC product 4428); place in therapy from Alzheimer Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK499922/", "rationale": "Acetylcholinesterase inhibitor. StatPearls names donepezil the medication of choice among the cholinesterase inhibitors, used in Alzheimer's disease with mild dementia, given once daily in the evening. The SmPC sets the amounts: start at 5 mg/day, hold that for at least a month so the earliest response can be judged and steady state reached, then 10 mg/day, which is the maximum recommended daily dose - doses above 10 mg/day have not been studied.", "cautions": [ "Diagnosis and the first prescription belong to the specialist service. The SmPC states treatment should be initiated and supervised by a physician experienced in diagnosing and treating Alzheimer's dementia, and started only if a caregiver is available who will regularly monitor that the patient takes it.", "Cholinesterase inhibitors are vagotonic and can slow the heart. The SmPC singles out sick sinus syndrome and other supraventricular conduction problems such as sinoatrial or atrioventricular block, and records syncope and seizures; in such a patient consider heart block or long sinus pauses.", "Post-marketing reports of QTc prolongation and Torsade de Pointes. Take care with a personal or family history of QTc prolongation, other QT-affecting drugs, uncompensated heart failure, recent myocardial infarction, bradyarrhythmia, or low potassium or magnesium. ECG monitoring may be needed.", "Nausea, vomiting and diarrhoea are the common effects. Peptic ulcer risk rises with a history of ulcer or concurrent NSAIDs.", "If it causes abnormal dreams, nightmares or insomnia, the SmPC allows moving the dose to the morning." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The SmPC states donepezil is not recommended for use in children and adolescents below 18 years of age.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ALKAPEZIL 5 MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 25.8, "pack_count": 10, "unit_price": 2.58, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALZEPIZIL 5MG 14 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 62.0, "pack_count": 14, "unit_price": 4.43, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DONAZIL 5 MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 144.0, "pack_count": 30, "unit_price": 4.8, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALZIMER 5MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 76.0, "pack_count": 10, "unit_price": 7.6, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DONEPEZIL 5MG 14 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 168.0, "pack_count": 14, "unit_price": 12.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ARICEPT 5 MG 14 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 392.0, "pack_count": 14, "unit_price": 28.0, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DONAZIL 5 MG 20 ODT TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 88.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LIDEMTZIL 5MG 30 ORALLY DISP. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > LIFE", "price_egp": 282.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "alzheimers-disease" }, { "id": 146, "generic": "Memantine", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "Titrate 5 mg per week: 5 mg once daily in week 1, 10 mg in week 2, 15 mg in week 3, then the maintenance dose of 20 mg once daily from week 4. Maximum 20 mg daily. Patients over 65 take the same 20 mg daily", "adult_duration": "long-term; reassess tolerance and dose within three months of starting, and regularly after that", "dose_source": "Ebixa 10 mg film-coated tablets SmPC section 4.2 Posology (eMC product 8222); place in therapy from Alzheimer Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK499922/", "rationale": "Partial NMDA antagonist; it blocks NMDA receptors and slows intracellular calcium accumulation. StatPearls records it as approved for moderate to severe Alzheimer's disease, and says it can be combined with a cholinesterase inhibitor such as donepezil. The SmPC sets the amounts: a maximum of 20 mg a day, reached by upward titration of 5 mg a week over the first three weeks to reduce undesirable effects.", "cautions": [ "Diagnosis and the first prescription belong to the specialist service. The SmPC states treatment should be initiated and supervised by a physician experienced in diagnosing and treating Alzheimer's dementia, and started only if a caregiver is available who will regularly monitor that the patient takes it.", "Caution in epilepsy, in a past history of convulsions, and where anything predisposes to seizures.", "Avoid other NMDA antagonists alongside it - amantadine, ketamine and dextromethorphan act at the same receptor, so central nervous system effects may be more frequent or more pronounced.", "Renal impairment changes the dose. No change is needed for creatinine clearance 50-80 ml/min; at 30-49 ml/min give 10 mg a day, raising to 20 mg only after at least 7 days if it is well tolerated; at 5-29 ml/min give 10 mg a day.", "Not recommended in severe hepatic impairment - the SmPC has no data there. No dose change in Child-Pugh A or B." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The SmPC records no paediatric data for memantine. This is a disease of later life and the card is adult-only.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DEMENTEXA 10MG 14 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 27.0, "pack_count": 14, "unit_price": 1.93, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CONDOMANIA 10 MG 30 F.C.TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > RAMEDA", "price_egp": 60.0, "pack_count": 30, "unit_price": 2.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PENTABIXA 10 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PENTA PHARMA-EGYPT > PENTA PHARMA", "price_egp": 66.0, "pack_count": 30, "unit_price": 2.2, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALZIXA 10 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 180.0, "pack_count": 30, "unit_price": 6.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MANTINE 10MG 30 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 180.0, "pack_count": 30, "unit_price": 6.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RAVEMANTINE 10MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 180.0, "pack_count": 30, "unit_price": 6.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EBIXA 10MG 28 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LUNDBECK > MULTIPHARMA", "price_egp": 475.0, "pack_count": 28, "unit_price": 16.96, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEMANTCARE 10 MG 20 SCORED F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > PHARMACARE", "price_egp": 62.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZALHINAPEX 2MG/ML SYRUP 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 33.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "MEMEXA 10MG/ML ORAL DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA > COPAD PHARMA", "price_egp": 51.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "alzheimers-disease" }, { "id": 147, "generic": "Recognition, reversible-cause work-up and referral (Referral & Advice)", "line": 3, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "The most common cause of dementia, with insidious memory loss and progressive cognitive decline; a GP recognises the pattern, arranges basic work-up to exclude reversible causes, and refers to neurology/psychiatry for formal diagnosis and initiation of a cholinesterase inhibitor or memantine, continuing prescriptions once established.", "adult_duration": "Refer, with advice", "dose_source": "No dose - a recognition and referral pathway, not a medicine", "rationale": "The most common cause of dementia, with insidious memory loss and progressive cognitive decline; a GP recognises the pattern, arranges basic work-up to exclude reversible causes, and refers to neurology/psychiatry for formal diagnosis and initiation of a cholinesterase inhibitor or memantine, continuing prescriptions once established.", "cautions": [ "The drugs above are started by the service the patient is referred to, not in primary care. They are listed so that the GP who continues the prescription knows the amounts, the titration and what to watch for.", "RED FLAG - Rapid (weeks to months) cognitive decline is atypical for Alzheimer's and needs urgent work-up for another cause. Refer also for new focal neurological signs, or depression that mimics or coexists with dementia." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "alzheimers-disease" } ] }