Yasnal 5 mg and 10 mg film-coated tablets – donepezil for the symptomatic treatment of Alzheimer’s dementia

Yasnal contains the active substance donepezil hydrochloride, which belongs to a group of medicines called acetylcholinesterase inhibitors. It increases the level of acetylcholine in the brain – a substance involved in memory – by slowing down its breakdown.

Yasnal is used to treat the symptoms of dementia in patients diagnosed with mild to moderately severe Alzheimer’s disease. These symptoms include memory loss, confusion and behavioural changes. The medicine is intended for adult patients only and is authorised in Serbia as 5 mg and 10 mg film-coated tablets.

What is Yasnal (donepezil) used for and how should it be taken?

Basic information about the medicine

What is Yasnal used for?

According to the Summary of Product Characteristics, Yasnal is indicated for the symptomatic treatment of mild to moderately severe Alzheimer’s dementia. Patients with Alzheimer’s disease find it increasingly difficult to carry out normal daily activities; the medicine may relieve symptoms but does not cure the disease.

Use in severe Alzheimer’s dementia, other types of dementia or age-related memory decline has not been studied.

How is it used and dosed?

The tablet is swallowed with enough water in the evening, just before bedtime. The tablet strength may change depending on the duration of treatment and the doctor’s assessment. Maintenance treatment continues as long as the patient benefits, and the doctor assesses this regularly. After stopping, the beneficial effects gradually decline.

This is the general dosage from the official documentation and is not an individual recommendation.

Special patient groups

• Kidney impairment: a similar dosing regimen, as kidney disease does not affect the clearance of donepezil.
• Mild to moderate liver impairment: the dose is increased according to individual tolerability; there are no data for severe liver impairment.
• Children and adolescents under 18: use is not recommended.

Contraindications – when the medicine must not be used

Hypersensitivity to donepezil hydrochloride, piperidine derivatives or any excipient of the medicine.

Precautions and warnings

• Heart: the medicine may slow the heart rate; special caution in sick sinus syndrome and other conduction disorders (sinoatrial or atrioventricular block). Fainting and convulsions have been reported.
• Stomach: caution in patients with a history of ulcers and with concomitant NSAIDs – monitor for symptoms.
• Bladder: cholinomimetics may cause difficulty passing urine.
• Convulsions and extrapyramidal symptoms may occur or worsen.
• Neuroleptic malignant syndrome (fever, muscle stiffness, altered consciousness) has been reported very rarely, especially with antipsychotics – treatment must be stopped.
• Asthma and chronic lung disease: caution is required.
• Anaesthesia: the medicine is likely to enhance muscle relaxation caused by succinylcholine.
• The medicine contains lactose.

Interactions with other medicines, alcohol and food

• Ketoconazole, itraconazole, erythromycin, quinidine and fluoxetine may increase donepezil levels.
• Rifampicin, phenytoin, carbamazepine and alcohol may reduce donepezil levels.
• Other Alzheimer’s medicines (e.g. galantamine), anticholinergics (e.g. tolterodine), beta blockers (propranolol, atenolol), muscle relaxants (diazepam, succinylcholine) and general anaesthetics – inform the doctor.
• Acetylsalicylic acid and NSAIDs (ibuprofen, diclofenac) – caution because of the stomach.
• Herbal medicines and non-prescription products – inform the doctor.
• Alcohol: the medicine should not be taken with alcohol.

Pregnancy and breast-feeding

There are no adequate data on use in pregnancy; Yasnal should not be used during pregnancy unless absolutely necessary. Women taking donepezil should not breast-feed.

Driving and using machines

Donepezil has a minor to moderate influence on the ability to drive. Dementia itself reduces this ability, and the medicine may cause fatigue, dizziness and muscle cramps, especially at the start of treatment or when the dose is increased. The doctor assesses whether the patient may drive.

Possible side effects

• Very common (more than 1 in 10): diarrhoea, nausea, headache.
• Common (up to 1 in 10): muscle cramps, tiredness, insomnia, common cold, loss of appetite, hallucinations, unusual dreams and nightmares, agitation, aggressive behaviour, brief loss of consciousness, dizziness, vomiting, stomach discomfort, rash, itching, urinary incontinence, pain, tendency to falls and injuries.
• Uncommon (up to 1 in 100): slow heart rate, increased salivation, increased creatine kinase; stomach or duodenal ulcer, bleeding in the stomach or intestines, epileptic seizures.
• Rare (up to 1 in 1,000): extrapyramidal symptoms (stiffness, tremor, involuntary movements), sinoatrial and atrioventricular block, liver damage including hepatitis.
• Very rare (up to 1 in 10,000): neuroleptic malignant syndrome, rhabdomyolysis (severe muscle damage).

Report suspected side effects to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose: nausea, vomiting, increased salivation, sweating, slow heart rate, low blood pressure (dizziness on standing), breathing difficulty, loss of consciousness, seizures and muscle weakness. Contact a doctor or the nearest hospital immediately and take the pack with you.
• Missed dose: take the next dose at the usual time; do not take a double dose. If the medicine has not been taken for more than a week, contact the doctor before restarting.
• Stopping treatment: only on the doctor’s advice; after stopping, the improvement achieved is gradually lost.

Related information

For additional care and support when monitoring pulse and blood pressure during treatment, see also the category Blood pressure monitors – products in this category do not replace the medicine prescribed to you.

Composition, packaging and manufacturer

• Active substance: donepezil hydrochloride, 5 mg or 10 mg per film-coated tablet.
• Core: lactose monohydrate, maize starch, microcrystalline cellulose (E460), hydroxypropylcellulose (E463), magnesium stearate.
• Coating 5 mg: titanium dioxide (E171), hypromellose, macrogol 400 (white tablets); coating 10 mg: titanium dioxide, hypromellose (E464), macrogol 400 and yellow iron oxide (E172) (yellow tablets).
• Pack: OPA/Al/PVC//Al blister with 7 tablets; carton with 4 blisters (28 film-coated tablets).
• Manufacturer: KRKA D.D., NOVO MESTO, Šmarješka cesta 6, Novo mesto, Slovenia.
• Marketing authorisation holder: KRKA-FARMA D.O.O. BEOGRAD, Jurija Gagarina 26/V/II, Belgrade.

Storage

• Store below 30 °C in the original package.
• Keep out of the sight and reach of children; do not use after the expiry date.
• Return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

When should Yasnal be taken – morning or evening?

According to the leaflet, the tablet is taken in the evening just before bedtime with enough water. If insomnia or unusual dreams occur, talk to the doctor – do not change the schedule on your own.

How quickly does Yasnal start to work?

The starting dose of 5 mg is taken for at least one month so the doctor can assess the first results. Individual response cannot be predicted, so the doctor regularly evaluates the benefit of treatment.

What if the patient forgot to take the medicine for several days?

A single missed dose should not be made up – the next dose is taken at the usual time. If the medicine has not been taken for more than a week, contact the doctor before restarting.

Does Yasnal affect the heart?

It may slow the heart rate and rarely cause conduction disorders and fainting. The doctor must therefore know about all heart conditions and heart medicines (e.g. beta blockers). Report fainting or a very slow pulse to the doctor immediately.

Sources

• ALIMS – Summary of Product Characteristics Yasnal® 5 mg and 10 mg film-coated tablets (May 2020, Serbian)
• ALIMS – Patient leaflet Yasnal® 5 mg and 10 mg film-coated tablets (May 2020, Serbian)
• ALIMS – Summary of Product Characteristics Yasnal® (10 mg authorisation, Serbian)
• ALIMS – Patient leaflet Yasnal® (10 mg authorisation, Serbian)

Sources checked on: 25.10.2026.