Drug General Information (ID: DDIC8O6B3X)
Drug Name			Donepezil		Drug Info		Metronidazole		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Cholinesterase Inhibitors				Antiinfective Agents
Structure

Mechanism of Donepezil-Metronidazole Interaction (Severity Level: Moderate)
Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Drug Name		Donepezil				Metronidazole
Mechanism 1		Bradycardia				Prolong QT interval
Key Mechanism Factor 1
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Donepezil and Metronidazole
Mechanism 2		Delay atrioventricular conduction				Prolong QT interval
Key Mechanism Factor 2
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Donepezil and Metronidazole

Recommended Action
Management		Caution is advised when acetylcholinesterase inhibitors are used with drugs that can prolong the QT interval. Patients should be monitored for bradycardia, atrioventricular block and syncope, and advised to seek medical attention if they experience dizziness, lightheadedness, fainting, shortness of breath, or slow or irregular heartbeat.

References
1	Canadian Pharmacists Association.
2	Cerner Multum, Inc. "Australian Product Information.".
3	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
4	Product Information. Aricept (donepezil). Pfizer US Pharmaceuticals, New York, NY.
5	Product Information. Exelon (rivastigmine) Novartis Pharmaceuticals, East Hanover, NJ.
6	Product Information. Razadyne (galantamine). Johnson and Johnson Medical Inc, Arlington, TX.