Perinatal EvidenceCompass
Prepopulated workbenchMED-260

Special psychiatric indications — cholinesterase inhibitor appendix

Donepezil

Cognitive-disorder medication included for rare-exposure completeness

Not a categorical safety rating

This record organizes questions; it does not close them.

The clinical fields and position statements are prepopulated from the public-source corpus. They have not completed individual dual extraction, formal appraisal, exact-label reconciliation, or multidisciplinary sign-off. Do not use this page to justify abrupt discontinuation or reflexive switching.

Inventory identity

What this record represents

Canonical generic name
Donepezil
Entity type
single-ingredient drug
Active component(s)
Donepezil
Formulation / route / interval
Oral; formulation varies
Attachment entry
Donepezil
Separate monograph status
No — cross-reference shared molecule monograph
Identity and cross-reference
Not populated in v0.95
Inventory verification confidence
Moderate — molecule-level source; exact product/jurisdiction pending

Decision taxonomy

Five positions kept separate

These are workbench statements for reviewer execution. They are not independently commissioned, patient-specific recommendations.

  1. 01

    Stable continuation

    Workbench statement

    Do not withhold or discontinue solely because of pregnancy or lactation. For this record, assess indication, prior response, relapse severity, dose/formulation, alternatives, exposure timing, and mapped evidence; individual commissioned adjudication remains pending.

  2. 02

    New initiation in pregnancy

    Workbench statement

    For a new start, prefer an effective option with the strongest diagnosis-specific efficacy and reproductive evidence when clinically suitable. This record has not received an individual, independently verified initiation ranking.

  3. 03

    Switch before conception

    Workbench statement

    Before conception, consider a switch only when expected benefit exceeds relapse, withdrawal, failed-switch, and dual-exposure risks. Build and monitor the plan before pregnancy when feasible; no universal switch direction is assigned here.

  4. 04

    Unplanned exposure

    Workbench statement

    After unplanned exposure, confirm product, route, dose, timing, indication, co-exposures, and symptoms; do not advise abrupt cessation. Use the mapped evidence and current label to decide whether any targeted fetal assessment is indicated.

  5. 05

    Delivery, postpartum & lactation

    Workbench statement

    Create separate delivery, postpartum-dose, neonatal-observation, and lactation plans. Do not infer breastfeeding suitability from pregnancy evidence or routinely taper before delivery without drug-specific support.

Linked evidence

1 mapped claim summaries

Mapping can include class-wide, framework, formulation, regulatory, or evidence-gap claims. A linked claim is not necessarily a drug-specific causal estimate.

C-044Provisional public source

Donepezil, rivastigmine and galantamine have inadequate human pregnancy and lactation outcome data; nonpregnant cognitive efficacy does not establish perinatal benefit.

Public-source certainty descriptor
Very low reproductive certainty
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Pregnancy and lactation
Comparator
Cholinesterase inhibitor versus nonpharmacologic or alternative care
Effect or numbers carried forward

No adequate comparative pregnancy cohorts

Limitations

Diseases requiring these drugs during reproductive years are uncommon; bradycardia, syncope, vomiting and weight loss affect maternal risk

Sources, citation controls, and verification state

Linked sources

PMID
Not populated in v0.95
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending