Drug interactions
Donepezil + Procainamide
Severity: Major
Donepezil and Procainamide: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs can prolong the QT interval, and procainamide is a class IA antiarrhythmic with a known risk of torsades de pointes. Donepezil may add to this risk and can also cause bradycardia.
What this interaction means in plain words
Donepezil and Procainamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive pharmacodynamic QT prolongation, with possible additive bradycardia.
What to do
Monitor ECG continuously or frequently, together with electrolytes and heart rate. Consider an alternative antiarrhythmic or hold donepezil if QTc becomes prolonged.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Apozyl 10 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: Class IA antiarrhythmics; "Class IA antiarrhythmics (e.g. quinidine)") — electronic medicines compendium (UK SmPC)
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Donepezil with Procainamide?
MediHelp rates the interaction as major. Donepezil and Procainamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs can prolong the QT interval, and procainamide is a class IA antiarrhythmic with a known risk of torsades de pointes. Donepezil may add to this risk and can also cause bradycardia.
How serious is the interaction between Donepezil and Procainamide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG continuously or frequently, together with electrolytes and heart rate. Consider an alternative antiarrhythmic or hold donepezil if QTc becomes prolonged.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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