Donepezil
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GI haemorrhage in an elderly patient: case report An 86-year-old woman developed GI haemorrhage during treatment with donepezil for Alzheimer’s disease. The woman had started receiving donepezil 6 months before admission and had discontinued it after an episode of melaena [dosage and duration of treatment before reaction onset not stated]. She took a proton pump inhibitor and was then asymptomatic until her recent admission where she presented with a 2-day history of epigastric pain, haematemesis and melaena. She had been receiving donepezil [Aricept] 5 mg/day for the last month. On admission, her haematocrit was 27%, and her haemoglobin and urea levels were 7.7 g/dL and 92 mg/dL, respectively. A gastric ulcer was revealed by emergency endoscopy of her upper GI tract. Donepezil was discontinued and the woman received RBC transfusions and omeprazole. She recovered uneventfully and was discharged. Her ulcer had not recurred at follow-up 12 months later. Author comment: "[A]lthough the cause of the first episode of melaena was not confirmed endoscopically, the second episode was shown to be caused by an ulcer, which developed after reexposure to donepezil." Cholongitas E, et al. Recurrence of upper gastrointestinal bleeding after donepezil administration. Alzheimer Disease and Associated Disorders 20: 326, No. 4, Oct801060816 Dec 2006 - Greece
0114-9954/10/1136-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 27 Jan 2007 No. 1136
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