Chong-Zhi Wang, PhD; Guang-Jian Du, PhD; Zhong Zhen, MD, PhD; Tyler Calway, BS; Chun-Su Yuan, MD, PhD
Grant Support: By grants AT004418 and AT005362 from the National Center for Complementary and Alternative Medicine/National Institute of Health and the Tang Foundation.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L10-0078.
Wang C, Du G, Zhen Z, Calway T, Yuan C. Significant Dose Differences in Donepezil Purchased From the United States and Canada. Ann Intern Med. 2011;155:279-280. doi: 10.7326/0003-4819-155-4-201108160-00026
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Published: Ann Intern Med. 2011;155(4):279-280.
Background: Donepezil is a cholinesterase inhibitor that is commonly used to ameliorate the symptoms of Alzheimer disease (1). Because the high cost of this drug can be a burden to patients, consumers often purchase a generic form online from pharmacies based in Canada.
Objective: To measure the content of donepezil in tablets purchased from the United States and Canada and to compare the measured dose with the labeled dose.
Methods: We purchased brand-name donepezil tablets (Aricept, Eisai, Woodcliff Lake, New Jersey). We also purchased brand-name donepezil tablets from a hospital pharmacy in China in a package labeled “Eisai, China.” Using an Internet search engine, we selected 3 drugstores in Canada on the basis of high frequency of their appearance in our search. These Web sites listed donepezil as “generic.” We placed 5 prescription orders at these stores between March 2010 and September 2010 and received packages from India that contained tablets manufactured by Cipla, an Indian pharmaceutical company. We could not determine whether the tablets were packaged by Cipla or another company, a practice that is not unusual in some Asian countries.
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