Opps I posted this in the wrong place so here I go again.  My husband who has AD asked me to post for him - he doesn't use computers.

He is 68, was diagnosed with AD in Aug this year but has shown signs of it for about 8 years. He also has colitis. His doctor put him on Aricept  which has made a profound difference - he still has AD but feels a lot more focused and in control.  Since we live in Mexico we don't have the resources that many of you have.

The problem is the side effects -- diaheria and nausea.  He is getting very little sleep - is in the bathroom all night and has stopped eating because it  makes him go to the bathroom.

He would like to know if any of you can suggested an alternative to the

Exclon patch which we can't get here  or if anyone can suggest how he can get some relief from the side effects.  We have asked his DR. here but I am not sure he does much AD care.  We plan to ask him for a referral to someone who does.

Any suggestions would be greatly appreciated.

Hi, Your post is fine.

I do have the disease and I wish more doctors would discuss possible side effects with patients.

For the diarrhea: try a lactose free diet. I also take an acidophalyus pill in the morning. In the evening, with my bed time meds, I have a yogurt. I use Silk Soy for cereal and to cook with. Also evaporated Goats milk works instead of regular. evaporated milk.  I use goat cheese. Examine labels carefully. In this country, regular feta, which should not be cows milk, was.

If the above still gives problems, call the doctor who prescribed the meds.

Thanks JAB and Mimi;

I just feel so bad for DH and want to help.  I suggested a good breakfast to him this AM and at least he didn't have nausea.  He was diagnosed in Canada  and we live in Mexico so we plan to see his neurologist, here, next week and ask if he can refer us to a DR who treats a lot of  AD - can't fly back to Canada all the time  --  don't want to in winter.

Hope you both have a Merry Christmas

Anne

His diaheria and nausea should not last long. Mine cleared up in a month or two. It just rearer its ugly head again (3 years after starting Aricept) but I reduced my intake of sugars and starches. All cleared up again! 

Mini:

   He has a neurologist here but I want to ask him if he specializes in AD care and if not get a referral.  I don't know about gerontologists but I can ask.  We live in a vlllage about a half hour from town but if need be we can drive to Merida - about 4 hours from here, where they have top quality health care.  We have to go there for an MRI  and to play tourist) in Feb.  Like AD is not enough he also had a tumor in his head that we need to check regularly..

For now I am just going to  wish you  all a VERY MERRY CHRISTMAS and then  have a good one with my beloved DH 

Hi Anne,

Hello and Welcome.

when I was diagnosed four years ago with EOAD, I was started on Aricept.  I suffered terribly with nausea and diarrhea.  I did so for about 3 months.  I was miserable!  My neurologist switched me to an Exelon patch instead of Aricept.  It was so much better.  Little or no nausea and no more diarrhea.

Later, my doctor added Namenda too.

Perhaps you can speak with your hubby,s doctor about an Exelon patch??

Happy Holidays!

Lisa 

Anne, I had googled "Mexico+Alzheimer's Association" before and came up with two chapters, one in Acupulco, which I know is far from you, and I forgot the other one.  You can check them out, perhaps they have some local resources for you and DH.

Iris L.

Hi Anne,  I hope you and DH had a Merry Christmas together!  

Welcome to our boards.  I can see you have made some good friends that gave you some excellent advice.  Like Lisa, I had terrible diarrhea for several months when i was diagnosed with  Alzheimer's and prescribed Aricept.

   After switching to the Exelon patch about 3 months ago, my stomach issues are much improved.

I'm wishing improvements for your DH in the New Year.  Welcome to our online family!  Come back often when you need harp.  We all learn by sharing our experiences.

Anne, ordering from a Canadian pharmacy should be right up your alley.

Iris L.

I take that generic form of Aricept, in the US called Donepezil HCL. It did upset my stomach when I took it without food. I take it this same time as I eat now, and I don't have the same upset stomach problems. I also take medicine at night to help me sleep.  

My mom has had zero issues with Aricept.  She has been taking 10 mg daily for 1 year and a half.   She seems to be declining a little bit, but I can still leave her alone in the house but only for an hour or two. Sooner or later I will have to find a daycare center to leave her because have noticed she has lost interest in doing word puzzles and all she does is sit now.  I talk and talk and she says very little.  The neurologist might want to up her to 23 mg, but its expensive and she'll hit the doughnut hole really fast.  Also, I have heard 23 mg has terrible side effects.  Does anyone take the 23 mg pill?

Oh yeah Steve and I also buy Aricept from Canada.  It costs $67 for 100 pills.  Not bad, huh?  However, I just checked this website where 30 pills of 23 mg cost $280!

John

Yeah she is taking Namenda as well.  Two 10 mg pills a day.   Thanks for the suggestion Myriam.

John

John, please take a look at the info on:

http://www.alzconnected.org/discussion.aspx?g=posts&t=2147484733

I am on Medicare for prescriptions it is strange that they cover 5 and 10 mg of Aricept, but not 23 mg. So I take two 10 mg tablets a day, or 20 mg. Do you think the 3 mg difference will make a difference in effectiveness? I still need to take it with food so it does not upset my stomach.

Steve, there is a pretty big difference between two 10mg regular Aricept and 23mg extended release Aricept.

Because the 23mg formulation is extended release, that changes the way it's absorbed and metabolized, which in turn changes the highest concentrations that are reached in your bloodstream.

It's not a good idea to take two 10mg pills.

Dear Steve,

Did your doctor advise you to take two?

If so, you might want to discuss JAB's comments with him.

Hi Steve,

I'm glad your doctor ordered them. However, what you are taking are not slow release. 

But, if you've been on it for a while. And you are better before the dose was doubled. Great.

Taking two 10mg tablets a day is not the same thing as taking one 23mg extended release pill. 

No one has tested the safety of taking two 10mg tablets a day.  They produce a higher level of Aricept in the blood than the single 23mg extended release pill does.

If you are doing OK on the two tablets, Steve, that's fine, but other people should not try that without thoroughly discussing it with the pharmacist and the doctor.

Many doctors do not realize that the 23mg pill is an extended release formulation.  The rest of you need to be sure your doctor realizes this when discussing how much Aricept you should try.

Also, many factors affect the "real" dose of Aricept that a person is getting, including gender, age, and weight.  Again, many doctors do not know this.  I found the information in the FDA review of the application to have the 23mg formulation approved for sale. 

Even when they take the same number of pills, the levels of Aricept in the blood of a heavy-set younger man are not nearly as high as those in the blood of an older, lighter-weight woman.  Therefore, the younger man would need to take more pills to reach the same therapeutic level as the older woman.

On top of that, about 15-20% of patients have abnormal metabolism of Aricept.

Half of these metabolize the drug much more quickly, which means they need to take a much higher dose to reach a therapeutic threshold.

The other half have a very poor metabolism, which means that they develop adverse side effects even at very low doses.

Hi Steve,

What difference do you see doubling the dosage. hopefully your doctor is keeping a check on various blood levels.

There has bee a very mixed reaction to the larger dose. For many people it has been a huge waste of money.

Steve,  Just make sure your doctor knows what Medicare does and does not cover. 

 He can prescribe your medication accordingly. 

 You want to make sure you are prescribed the best for your situation.

You don't want to take it the wrong way and not get the most benefit you can.

I also just learned that  we get the maximum benefit from our AD meds by taking them in the morning.

I Take 10mg with breakfast and 10mg with dinner. My doctor conferms twice a day, like the bottle says.He said since 23mg is not Medi-Care covered; only 5 and 10mg is;takeing two regular 10 mg tablets twice a day is closest to the extended release once daily 23mg form. Best time of day to take is one of the quections I ask on taking a new med. Here is what I ask -

1 What is this med for ?

2 How long do I take it ?

3 What are the side effects ?

4 Best time of day to take it ?

5 What if I miss a dose ?

6 Is it Medi-Care covered ?

.Number 2 - with memory problems, short turm meds, liekm a antibyodic when you get the flu, is confusing when you stop taking it.  I code this bottle ST - short term. Now I just have to remenber all this.