Medication	Typical dosage	Cost*	Adverse effects
Cholinesterase inhibitors
Donepezil (Aricept)	5 mg orally at bedtime for 4 to 6 weeks, then 10 mg orally at bedtime; can increase to 23 mg at bedtime after 3 weeks at 10-mg dose	$11 ($512) for 30 10-mg tablets	Atrioventricular block, decreased appetite, diarrhea, dizziness, headache, hypertension, nausea, syncope, torsades de pointes, vomiting, weight loss
Galantamine (Razadyne)	Immediate release: 4 mg orally 2 times per day for 4 weeks, then increase to 8 mg 2 times per day for 4 weeks, then 12 mg 2 times per day	$78 ($335) for 60 12-mg immediate-release tablets; $43 ($335) for 30 24-mg extended-release capsules	Atrioventricular block, decreased appetite, diarrhea, dizziness, headache, nausea, vomiting, weight loss
	Extended release: 8 mg orally per day for 4 weeks, then increase to 16 mg per day for 4 weeks, then 24 mg per day
Rivastigmine (Exelon)	For Alzheimer disease: 1.5 mg orally 2 times per day for 2 weeks, then increase each dose in 1.5-mg increments every 2 weeks as tolerated to maximal dosage of 12 mg per day	$81 ($359) for 60 6-mg capsules; $198 ($611) for 30 13.3-mg patches	Abdominal pain, atrial fibrillation, atrioventricular block, decreased appetite, diarrhea, dizziness, headache, myocardial infarction, nausea, vomiting
	For Parkinson disease dementia: 1.5 mg orally 2 times per day for 4 weeks, then increase each dose in 1.5-mg increments every 4 weeks as tolerated to maximal dosage of 12 mg per day
	Transdermal patch (for Alzheimer disease and Parkinson disease dementia): 4.6-mg patch every 24 hours for 4 weeks, then 9.5-mg patch every 24 hours for 4 weeks, then 13.3-mg patch every 24 hours†
N-methyl-d-aspartate receptor antagonist
Memantine (Namenda)	Immediate release: 5 mg orally per day for 1 week, then 5 mg 2 times per day for 1 week, then 10 mg every morning and 5 mg every night for 1 week, then 10 mg 2 times per day	$23 ($422) for 60 10-mg immediate-release tablets	Confusion, constipation, diarrhea, dizziness, vomiting; rarely, cerebrovascular event or acute kidney injury
	Extended release (approved but not yet available): 7 mg orally per day for 1 week, then increase in 7-mg increments every week to target dosage of 28 mg per day
Combination drug and vitamin E
Memantine/donepezil (Namzaric)	7 mg/10 mg orally at bedtime for 4 weeks, then increase by 7 mg/10 mg every week as tolerated to target dosage of 28 mg/10 mg every night	Not available generically ($412) for 30 28-mg/10-mg capsules	Decreased appetite, diarrhea, heart block, syncope, vomiting
Vitamin E	1,000 IU orally 2 times per day	$10 for 90 softgels	Hemorrhage (including cerebral); may increase all-cause mortality