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20.12.2019.

The truth about eyelash extensions and lice

There's a cringeworthy headline you've likely seen on social media this month.Eyelash extension supplier

Article after article claims doctors are sounding the alarm that eyelash extensions lead to an increase in cases of lash lice.

The frenzy started earlier this month with a story from a television station in Houston. An optometrist told the station she's seeing an increase in something called "Demodex."A quick Google search reveals Demodex is actually a microscopic mite that lives on your skin. According to Women's Health, there's "a really, really good chance you've already got a troop of eyelash mites calling your lashes home."

If too many mites build up around the lash line, they can cause itching, irritation and redness.

So why would Demodex be linked to eyelash extensions? Experts say it's because some people with extensions aren't washing their faces as often as they should."Some patients who have eyelash extensions, where they don't want to disrupt them because they don't want those extensions to fall off, they might decrease their hygiene of their eyelids," said Dr. Greg Nixon, an optometrist with the Ohio State University College of Optometry.

To prevent problems, all you have to do is use warm soapy water on a regular basis to clean around your eyes. Diluted tea tree oil can be used to treat a buildup of mites.

Eyelash lice does exist, but it has not been linked to extensions. Lice can usually be seen with the naked eye, unlike the microscopic mites.

20.12.2019.

Eyelash extensions can bring mites, health officials warn

Many women are getting eyelash extensions from technicians that apply lash by lash. But now, some optometrists say they're seeing an increase of tiny mites, similar to lice.

If you're a fan of eyelash extensions, you might want to think about the last time you cleaned them. Eyelash extensions

While you might not want to ruin your new set of lashes by cleaning them, one nurse said you really should -- if you don't, it can get pretty gross. Optometrists are seeing more mite infestations, or "Demodex." This is due to eyelash extensions that are glued lash by lash.

"People are getting these instructions, don't rub on them, don't clean them with harsh remover, but people are completely disregarding cleaning them at all," Piedmont Medical Center Registered Nurse Lindsey Neal said.

Neal said the lack of cleaning can lead to a build-up of bacteria."If you're not taking care of them, [you] can get an infestation of eyelash mites," Neal said.

While we all have mites on our bodies naturally, they flock to dirty eyelashes. If they overpopulate, they can cause a serious infection. Symptoms include itching, redness, and swelling.

Even more alarming? Neal said they are contagious. She said it's critical not to share eye makeup. In addition, she urges people to regularly clean their eyelids and make sure tools used to apply extensions are clean.

The condition is treatable but, it can take some time. Doctors say even if you don't have extensions, you can still get mites if you don't clean your eyes, or if you don't change out your eye makeup.

20.12.2019.

Amid popularity of eyelash extensions

As eyelash extensions become a popular trend, some doctors say they are seeing an uptick in lash mites due to poor hygiene.Easy Fan Blooming Lash Extensions

Dr. Sairah Malik, an optometrist in Houston, said she’s seen an increase in Demodex, which is the medical term for the mites.

“This is due to the fact that a lot of people who get extensions are afraid to wash their eyes and eyelashes due to the fact that they may damage the extensions which are costly and time consuming. As a result of not washing, this area becomes a breeding ground for bacteria and other parasites such as the Demodex,” Malik said. Demodex is a genus of tiny parasitic mites that live in or near hair follicles of mammals, according to an article from the Indian Journal of Dermatology, published on the National Institutes of Health.

Demodex is a parasite that lives inside the hair follicle, so naturally anywhere there is a hair follicle, Demodex can survive there, as long as there is enough food/bacteria for it to thrive in,” Malik added.

“The eyelash extensions act as a sort of sponge for bacterial buildup which is an ideal environment for Demodex to thrive,” said Dr. Kam Silani, an optometrist in Beverly Hills, California, who said he has also seen cases of the mites.

He said there seems to be an increase in the number of diagnosed case of Blepharitis (inflammation of the eyelids) among his patient population. Two main contributors to anterior Blepharitis are bacterial overgrowth and Demodex.

“Demodex has a classical presentation known as cylindrical dandruff which resides at the base of the eyelashes,” Silani said, adding that the terms eyelash “mites” and “lice” are sometimes used interchangeably, but refer to the same organism — Demodex.

Malik said the technical term for the eyelash mites is Demodex, but it is similar to lice. Janet Figueroa, a cosmetologist and owner of Kiss My Lash in Ontario, California, said the reason people often cite for not washing their eyelash extensions is a myth.

“There is an increase in women thinking if they don’t wash them they’ll fall out faster but that’s just a bad myth, they only fall out of the technician doesn’t apply then properly,” Figueroa said. But she said she doesn’t see the mites with her clients because she does proper after-care education with them.

“New clients don’t come in with this, the only times I have seen it it started with my clients admitting that they don’t wash them, and as they come in for a fill you notice gunk (yellow/flesh colored) build up of old cells or makeup. After that it becomes these yellow bulb like bumps on the lashes at the base of the natural lash and then that grows into the lash mites,” the cosmetologist said. Silani also said she has encountered patients who avoid washing their eyelash extensions.

“Demodex live dormant on skin, when there’s an imbalance or overgrowth then they can cause various issues and symptoms for the patient(s). Unfortunately many of these women with false lashes avoid washing their eyelashes because they are worried that they may ruin the extensions; thus, creating an ideal environment for Demodex to flourish.”

Malik also said it’s important to ask one’s eyelash facility to demonstrate the proper way to clean the extensions.

“We see a very young population and in our age demographic, eyelash extensions are very popular and common. So we see many many cases in a month and treat this (Demodex) on a very regular basis,” the optometrist said. Malik wanted to be clear that eyelash extensions do not cause Demodex.

“The lack of hygiene and proper maintenance of the extensions is what leads to this condition. We must also note that individuals who do not get extensions and also do not wash or cleanse their eyelash margins appropriately are at risk as well,” she said. Malik said she has seen Demodex cases with patients who don’t have eyelash extensions, particularly in men.

“We have observed many cases of Demodex in those individuals without eye lash extensions. For example, we have seen this condition in a lot of men due to the fact that most only use soap and water to wash their face,” she said. “Most women pay more attention to cleansing due to removing eye make up, etc., so we have to educate the men, that they must cleanse their eyes and eyelashes to keep the bacterial load down which naturally increases with age.”

“The frequency with which we diagnose Demodex seems to be on the rise among male patients who don’t have good eyelid hygiene techniques as well as women with eyelash extensions,“ Silani added.

20.12.2019.

Living in best city - Tianjin

anjin is a buzzing city that draws a diverse mix of people. You can see why, when Tianjin has a higher GDP than Beijing and Shanghai. And, reports 14% annual economic growth – fastest for any region in the country. You'll find excellent value for money in Tianjin. The cost of living here is significantly cheaper than the UK or US. You'll be able to make the most of your time in China on a student budget.living in tianjin
Tianjin has a history of internationalism – you'll see lots of European architecture from throughout the 20th Century in the Five Avenues district. The beautiful Bohai river flows through the city, popular for evening walks, jogging and late night dancing.
As an international student, you'll probably attract curiosity from the locals. They'll want to get to know you and your story. Some of our students say they feel like rockstars on campus! The biggest international community in Tianjin is South Korean. Numbers of African and South Asian people are growing at the fastest rate. We'll help you make friends with other international students on campus, and local Chinese students, too. You'll find good restaurants, pool halls and bars for students just across the street from campus. Tianjin has multiple universities, it's a big student-friendly city to live in.

Your studies at Nankai University will likely include an internship or placement. Tianjin is a great place to be for this. 285 Fortune 500 companies have a presence in the city, including Samsung, Toyota, Motorola, Yamaha and luxury brand hotels. You’re also just 30 minutes on the bullet train from the capital, Beijing. Tianjin is home to one of China’s leading mini-invasive surgery training centres.
The Nankai University campus is so vast that it will feel like your own close-knit student town. New friends are around every corner and we organise lots of activities to help you meet people. Concerts, sports and talent shows are popular here, so bring that acoustic guitar with you! The YICA (Chinese Culture Exchange Society) club offers a platform to share and celebrate your culture with other students. Although there isn't any religious provision on campus, you'll find a number of registered churches and mosques nearby which will welcome you.

The international student accommodation building will be your home from home for the next few years. It’s the best option for your first semester, as you’ll be close to everything you need on campus. The building has 24-hour security and key card access. Can’t cook? Don’t cook! You’ll find a number of canteens and restaurants either on-site or within 10 minutes’ walk of your accommodation, serving breakfast, lunch and dinner. Facilities are similar to dorms in a UK or US university – Wi-Fi, phones, post and laundry are all right where you need them. The international student dormitory gives you the best start to your studies.

It's the real deal here. Chinese food in China is unlike the Chinese food you get back home. You'll taste the eight main cuisines of Chinese food, which vary significantly in flavour and style. Between the two campuses there are six student canteens, a halal canteen, four large Chinese restaurants, a cafeteria for international students and countless small independent traders selling snacks and drinks around campus. The Tianjin campus also has a fruit, meat and vegetable xafs. You'll never go hungry – even on a student budget. Typical meals in the canteen cost around RMB 10 – less than a loaf of bread in the Europe.

Need your fries fix? Who doesn't? There are small cafes and western food outlets on campus serving burgers and sandwiches. You can also find a few familiar brands including Subway and Gloria Jeans Coffee just minutes away from the international student dormitory on the Jin Nan campus.

20.12.2019.

Shanghai International High School

Established at a time in a time when China vies for a place on the world stage, Xiwai International School focuses on preparing students not only for higher levels of education, but, more importantly, for an increasingly boundary-less world. The School aims to cultivate within each of its students a balance of Chinese values and a global perspective. The School strives to achieve this mandate through the delivery of high-level programs that foster excellence in all areas of a student's development—all within a stimulating and nurturing residential environment. Students are encouraged to think independently, creatively and critically, and are motivated to achieve their intellectual, artistic, and athletic potential.Shanghai international school admission

Xiwai founders and Advisory Board members are passionate about contributing to the development of education in China. A number of the school's Advisory Board members hail from the private sector, and draw upon a wealth of knowledge and experience, including such figures as Mr John Thornton, ex- President of Goldman Sachs and Nicholas Rockefeller, from the Rockefeller Foundation. Others have a lot of experience in the area of education, both in China and internationally, and at such prestigious institutions as Fudan University, Harvard University, Yale University, Oxford University and Leeds University. They include such respected scholars and educators as Professor Tony Saich, Harvard University; Dr Laura Newby, Oxford University; Professor Xu Tian, Yale University; Professor Dai Weidong, President of Shanghai International Studies University; Mr Tang Shengchang, Principal of Shanghai High School; Mr Rong Xinmin, ex-Acting Principal of Shanghai International High School (affiliated to Shanghai International Studies University); and Professor Ye Lan from East China Normal University, a well-known Chinese education expert.

Xiwai International School aims to be a multi-cultural community marked by a sense of integrity, and respect for self, for others, and for the natural environment. The Xiwai experience hence nurtures in its members a life-long commitment to develop what is finest in themselves and others, and create the best for others and themselves.

As a multi-cultural community, Xiwai fosters a spirit of unbridled support, regardless of a student's background, and encourages every member of the community to contribute to the wider community. With both Chinese and English as the official languages of the community, students and teachers communicate in two languages, an approach that embodies a true form of bilingual education, and enables Xiwai's students to prepare themselves to reach out to the wider world. The school's residential management has adopted the English House Master system, in order to enrich the range of extra-curricular activities and provide a stimulating and nurturing environment for students.

Xiwai is an active, participating community. Xiwai encourages students, as well as parents, to participate in the school's management and the teaching and learning processes. The school's learning environment is interactive and discussion-oriented, using a “round table” approach wherever appropriate. It will also organizes seminars, given by prominent speakers from home and abroad, including scientists, theorists, educators and artists, who will also participate in the school's curriculum development. As a result, Xiwai students are able to expand their horizons and make valuable contributions not only to their school, but also to the wider community.

Xiwai has opened its doors wide in order to recruit the most highly qualified and dedicated teaching and administration team. A look at the composition of Xiwai teaching staff (including kindergarten and primary section staff) reveals that more than 98 % possess at least a Bachelor's degree; more than 40% hold a Master's or Doctoral degree from home and/or abroad; a high percentage have had experience studying and working in the U.S., the U.K., Australia and New Zealand; and over 60% are competent in bilingual education. We thus have a range of excellent, committed teachers in the classroom, representing a balance between the young and energetic, and the highly experienced, to enable students to benefit from a variety of teaching styles and approaches. The school has, in addition, invited municipal and district researchers, as well as subject experts from East China Normal University and Shanghai Normal University, to advise and help coordinate the school's academic program.

20.12.2019.

Very Dense Fog Forecast over North India After Intense Spell of Rain

Just as the Western Disturbance (WD) weakens, the fog threat looms over northern, central and eastern parts of the country. Under these favourable conditions—clear skies, calm winds and low temperatures—dense fog is forecast across the Indo-Gangetic plain at least till Tuesday. Road traffic, railways and flight operations are likely to be affected.To get more fog forecast, you can visit shine news official website.

The WD dominated north India on Friday, an intense spell of rain and snow affected the daily life across the region. Multiple places in northern India witnessed more than 100 mm rainfall along with heavy snow at higher reaches and hail at isolated areas.

Now, forecasts suggest very dense fog at isolated pockets over Punjab, Haryana, Chandigarh, Delhi, north Rajasthan and Uttar Pradesh, especially during the morning hours. The India Meteorological Department (IMD) has issued orange level alerts in these regions for Sunday and Monday mornings. Orange alert signifies 'be prepared' for the possible extreme weather event.
Fog risks also prevail over north Madhya Pradesh and Bihar during the same period. As the temperatures have started to fall significantly across northwest and central India, the IMD forecasts the likelihood of cold wave conditions over Jammu and Kashmir, Ladakh, Himachal Pradesh and Uttarakhand during the next three days.

The WD along with its induced cyclonic circulation resulted in scattered to widespread rain, snow, hail and thunderstorms in Jammu and Kashmir, Ladakh, Himachal Pradesh, Uttarakhand, Rajasthan, Punjab, Haryana, Delhi and east Madhya Pradesh. As the WD weakens, the rain and snowfall have drastically reduced on Saturday. But the remnants of the system will continue to give light rain and snow with one or two moderate spells over Western Himalayas till Sunday morning.

As per the IMD records, Manali in Himachal Pradesh received 100 mm rainfall while Moradabad in Uttar Pradesh, Pahalgam in Kashmir, and Dharamsala in Himachal received around 9o mm each.

Farmers in Rajasthan suffered significant crop damage during the last two days. A hailstorm hit Nagaur district in the state during the evening hours and night which blanketed the streets with what looked like snow. Many parts of Rajasthan also witnessed a hailstorm leading to losses in crops and livestock.

Rajasthan Chief Minister Ashok Gehlot held a meeting with Chief Secretary DB Gupta and other officials on Friday and directed them to survey the crop loss. Disaster relief Secretary Siddharth Mahajan said eight district collectors had informed the government about the crop loss.

In Himachal Pradesh, road links were hampered on Saturday, blocking highways and link roads. A large number of commuters were stranded across the state, officials said. The entire Kinnaur district is cut off. There was no loss of life.

"There is no movement of traffic towards Kinnaur district on the National Highway-5 beyond Tapri. Work is on to restore electricity in Kinnaur. The Pangi valley in Chamba district is also cut off from the rest of the state," an official said. Weather in Himachal Pradesh is likely to clear by Sunday.

The Kashmir Valley witnessed blockade of highways and affecting commuting for the locals. "The highway has been blocked at three places due to landslides and shooting stones," a police official said. "Many trucks are stranded on the highway, but they have been halted in safe zones."

In the current winter season, rain and snow began in the hills of north India in November itself, and that too in excess. By the end of the month, Kashmir was a surplus of 379 per cent, Himachal Pradesh by 143 per cent and Uttarakhand by 239 per cent.

20.12.2019.

Local doctor receives national praise again

A local doctor received more praise on the nationally televised daytime TV show "The Doctors" for his efforts to help his patients beyond his clinic.To get more local doctors, you can visit shine news official website.
Dr. Ray Altamirano, who runs Casa Salud Family Medicine Clinic, was recently featured on the "Kelly Clarkson Show" in September for running a business that treats patients with no insurance. Additionally, Altamirano sells some of his artwork to help pay for some of his patients' medical costs.
A few weeks ago, a producer for "The Doctors" heard about Altamirano's work and asked if the show could share his artwork and clinic model with its audience. The South Side doctor agreed and was highlighted on a national stage again in an episode of "The Doctors" that aired Wednesday.The show's host Dr. Travis Stork said the efforts of Altamirano are "amazing," adding his artwork is "beautiful." Co-host Dr. Nita Landry said she appreciates Altamirano's work as she said she believes everyone deserves excellent medical care regardless of cost.
"It's the sense of community that has continued to humble me," Altamirano said. "I am lucky to bear witness to this caring community helping each other, like the ornery laborer with calloused hands who felt so compelled to pay for the next person in line. I know how hard it is for him to earn that money. But it's happening and it's beautiful."

Seven doctors from CaroMont Medical Group filed a complaint on Thursday to separate from the Gastonia-based system. The group is planning to join Tryon Medical Partners, a Charlotte-based independent practice.
The seven doctors see patients at South Point Family Practice in Belmont and specialize in adult medicine, pediatrics and urgent care. As part of Tryon Medical, they would continue to practice in Gaston County.
In the complaint, the doctors stated that they believe joining a smaller, independent practice will allow them to better serve patients.
“I think they were struggling with the bureaucracy and didn’t see a method within the system to improve what they felt like were the goals to improve,” said Dr. Dale Owen, head of Tryon Medical.
CaroMont contends, however, that leaving the practice would violate the doctors’ contracts, which state that the “physician shall not assist a competing system at any location within the restricted territory.”

08.08.2019.

Randomized Placebo Controlled Trial of Low-Dose Tamoxifen to Prevent Local

Tamoxifen administered for 5 years at 20 mg/d is effective in breast cancer treatment and prevention, but toxicity has limited its broad use. Biomarker trials showed that 5 mg/d is not inferior to 20 mg/d in decreasing breast cancer proliferation. We hypothesized that a lower dose given for a shorter period could be as effective in preventing recurrence from breast intraepithelial neoplasia but have a lower toxicity than the standard dose.Nolvadex uses

PATIENTS AND METHODS
We conducted a multicenter randomized trial of tamoxifen, 5 mg/d or placebo administered for 3 years after surgery in women with hormone-sensitive or unknown breast intraepithelial neoplasia, including atypical ductal hyperplasia and lobular or ductal carcinoma in situ. The primary end point was the incidence of invasive breast cancer or ductal carcinoma in situ.

RESULTS
Five hundred women 75 years of age or younger were included. After a median follow-up of 5.1 years (interquartile range, 3.9-6.3 years), there were 14 neoplastic events with tamoxifen and 28 with placebo (11.6 v 23.9 per 1,000 person-years; hazard ratio, 0.48; 95% CI, 0.26 to 0.92; P = .02), which resulted in a 5-year number needed to treat of 22 (95% CI, 20 to 27). Tamoxifen decreased contralateral breast events by 75% (three v 12 events; hazard ratio, 0.25; 95% CI, 0.07 to 0.88; P = .02). Patient-reported outcomes were not different between arms except for a slight increase in frequency of daily hot flashes with tamoxifen (P = .02). There were 12 serious adverse events with tamoxifen and 16 with placebo, including one deep vein thrombosis and one stage I endometrial cancer with tamoxifen and one pulmonary embolism with placebo.
Breast intraepithelial neoplasia, including atypical ductal hyperplasia (ADH), lobular carcinoma in situ (LCIS), and ductal carcinoma in situ (DCIS), has a five to 10 times higher risk of developing into invasive breast cancer compared with the general population and accounts for 15% to 25% of breast neoplasms on the basis of screening mammography.1 The natural history of breast intraepithelial neoplasia is heterogeneous. Some forms remain indolent, whereas other forms can progress to life-threatening invasive disease, which has led to controversial issues with regard to its optimal approach.1,2

08.08.2019.

Low-Dose Tamoxifen Halves Breast Cancer Risk in Women With Preinvasive Breast Lesions

5 mg/d, given for 3 years rather than 5 years—halved the risk of breast cancer recurrence or new lesions over placebo in women with breast intraepithelial neoplasia, without producing the usual toxicities seen with the standard dose, Italian researchers reported at the 2018 San Antonio Breast Cancer Symposium.1
“We believe our results have external validity and—given their pragmatic nature and the easy accessibility of tamoxifen—are generalizable,” said Andrea De Censi, MD, of the National Hospital E.O. Ospedali Galliera–Division of Medical Oncology in Genoa, Italy. “Tamoxifen, 5 mg a day (splitting the tablet) or 10 mg every other day, is applicable in clinical practice tomorrow.”Nolvadex dosage

Breast cancer experts at the meeting said this is news they can use. “Looking at these data, I would definitely give lower doses of tamoxifen, especially in patients with atypical ductal hyperplasia and lobular carcinoma in situ,” said Virginia G. Kaklamani, MD, Professor of Medicine at The University of Texas at San Antonio and leader of the Breast Cancer Program at The University of Texas MD Anderson Cancer Center, Houston.
This information tells me I can perhaps cut back on the dose for patients who are not tolerating tamoxifen. This would help me keep them on the dose, rather than have them abandon therapy,” said John Cole, MD, of the Ochsner Health System in New Orleans.

ALTHOUGH TAMOXIFEN is effective in preventing breast cancer recurrence, its side effects—menopausal symptoms, endometrial cancer, deep-vein thrombosis, and pulmonary embolism— are barriers for its use as a preventive measure. The aim of this de-escalation study was to determine whether a lower dose and shorter duration of tamoxifen therapy would be as efficacious as and better tolerated than the standard dose.

Dr. De Censi and colleagues had previously shown that a dose as low as 1 mg/d is noninferior to 20 mg in decreasing Ki67 (a marker of proliferation), though less effective in modulating serum biomarkers.2 For the current study, the investigators decided 5 mg/d would be a reasonable compromise between activity and safety. He explained that the government- and charity-funded study could not afford to financially support the use of a very large noninferiority trial of tamoxifen at 20 mg/d for 5 years as the control arm.

08.08.2019.

NOOTROPICS DONEPEZIL HCL CAS 120011-70-3

Donepezil improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah SEET il KOE leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning. Donepezil is used to treat mild to moderate dementia caused by Alzheimer's disease.crl-40 940 powder buy
Donepezil Hydrochloride is a noncompetitive acetylcholinesterase inhibitor (IC50 = 11.6 nM. It is known that Donepezil Hydrochloride is a useful tool in the study of Alzheimer's disease. Studies indicate that Donepezil Hydrochloride protects the brain against diisopropylfluorophosphate-induced effects. Studies indicate that Donepezil Hydrochloride selectively inhibits acetylcholinesterase, whereas it has little effect on butyrylcholinesterase. Alternate studies suggest that Donepezil Hydrochloride increases the concentration of extracellular acetylcholine.

Donepezil HCl Application (indications)
Donepezil is approved for the symptomatic treatment of mild to moderate dementia of the Alzheimer's type. It can relieve the symptoms of dementia and slow the progression of symptoms for some time. Although the effect was statistically significantly demonstrated in scientific clinical trials using different measuring methods, it is very low. In severe Alzheimer's dementia, it is outside the drug approval in the form of a so-called off-label use as a second-line choice. Also without drug approval Donepezil is occasionally used in vascular dementia and is therefore the first choice. Its effectiveness in treating mild cognitive impairment, often heralding or showing signs of dementia, is considered minimal and poorly documented.
Contraindications (Contraindications)
Donepezil is contraindicated in a known hypersensitivity to this drug or other piperidine derivatives such as domperidone. In patients with gastric ulcers, arrhythmia (sick sinus syndrome, supraventricular conduction disorders), syncope, seizures, obstructive pulmonary disease (eg, bronchial asthma, chronic obstructive pulmonary disease), bladder obstruction or regular use of non-steroidal anti-inflammatory drugs, such as acetylsalicylic acid or naproxen, special Precautions and the use of donepezil are subject to a benefit-risk assessment.

Monitoring
Since donepezil may be ineffective for the individual and in this case should be discontinued after 15 to 20 weeks, the possible improvement in cognitive performance must be monitored. Patients should also be monitored for possible gastrointestinal complaints (which may indicate gastric ulcers or gastrointestinal bleeding) and for their ECG (which may indicate new cardiac arrhythmias). Therefore, a comparison ECG should be derived before starting therapy.
Due to its effect on acetylcholine metabolism, donepezil may show pharmacodynamic interactions with other drugs with effects on the acetylcholine system. These include in particular muscle relaxants, such as succinylcholine, anticholinergics and acetylcholine agonists. Pharmacodynamic interactions with beta-blockers are also possible.

Since donepezil is metabolised via the cytochrome P450 enzyme system, there is, at least in theory, the possibility of an interaction with substances that inhibit or induce this enzyme system. For example, CYP3A4 inhibitors, such as ketoconazole and erythromycin, and CYP2D6 inhibitors, such as fluoxetine, may inhibit the degradation of donepezil, leading to an increase in the blood plasma level of the drug. On the other hand, enzyme inducers such as rifampicin, phenytoin, carbamazepine and alcohol can accelerate the degradation of donepezil and thus lower its plasma levels. However, the extent of these interactions and their clinical relevance has not been sufficiently investigated.


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