Acofide is a selective acetylcholinesterase inhibitor primarily used for symptom improvement in Alzheimer's disease. Special attention should be paid to cardiovascular monitoring, gastrointestinal reactions, and drug interactions during medication. Dose adjustments should be individualized for elderly patients.

1. Indications

(1) Alzheimer's disease: It is suitable for improving mild to moderate dementia symptoms and can delay the decline of cognitive function.

(2) Vascular dementia: Assist in improving memory impairment and executive dysfunction, requiring combination with basic treatment.

2. Medication precautions

(1) Cardiovascular monitoring: Before treatment, heart rate needs to be assessed. Patients with bradycardia should be cautious when using the medication, and their electrocardiogram should be regularly reviewed during the medication period.

(2) Gastrointestinal reactions: It is recommended to take the medication after meals. In case of severe nausea and vomiting, consider reducing the dosage or discontinuing the medication.

(3) Drug Interactions: Co-administration with anticholinergic drugs may reduce efficacy, and combination with beta blockers may exacerbate bradycardia.

3. Medication for special populations

(1) Hepatic insufficiency: For patients with mild to moderate impairment, reduce the dosage by 50%. For patients with severe hepatic impairment, the drug is contraindicated.

(2) Renal insufficiency: Reduce the dosage by 25% when creatinine clearance rate is 30-60 ml/min, and prohibit use when it is below 30 ml/min.

(3) Elderly patients: Those aged 65 and above should start with the lowest recommended dose and gradually titrate up to an effective dose.

4. Adverse reaction management

(1) Dizziness: It often occurs in the early stages of treatment. It is recommended to take medication before bedtime to alleviate symptoms.

(2) Weight loss: Regular monitoring of body weight is necessary. If the weight loss exceeds 5% of the baseline value, nutritional status should be assessed.

(3) Sleep disorders: If insomnia symptoms persist, adjust the medication time to morning.