Donepezil: Difference between revisions
From Pharmacopedia
More actions
| [unchecked revision] | [checked revision] |
MDElliottMD (talk | contribs) Auto-created stub |
MDElliottMD (talk | contribs) parser-claude: Donepezil MedTemplate refill, Top 300 stub upgrade |
||
| (7 intermediate revisions by 2 users not shown) | |||
| Line 1: | Line 1: | ||
{{MedTemplate | {{MedTemplate | ||
| generic = Donepezil | | generic = Donepezil | ||
| brand = Aricept | | brand = Aricept (oral), Adlarity (transdermal patch) | ||
| classes = Anti-dementia, | | structure = | ||
| mechanism = | | classes = [[:Category:Anti-dementia medicines|Anti-dementia medicine]], [[:Category:Acetylcholinesterase inhibitors|Acetylcholinesterase inhibitor]] | ||
| uses = <vote slug="alzheimer-mild-moderate-use">Alzheimer disease dementia, mild to moderate (FDA)</vote>, <vote slug="alzheimer-severe-use">Alzheimer disease dementia, severe (FDA, 23 mg/day formulation)</vote>, <vote slug="lewy-body-dementia-use">Lewy body dementia (off-label)</vote>, <vote slug="parkinson-disease-dementia-use">Parkinson disease dementia (off-label)</vote> | |||
| starting_dose = 5 mg PO once daily at bedtime; titrate to 10 mg/day after 4-6 weeks. Severe Alzheimer disease: may escalate to 23 mg/day. Adlarity patch: 5 or 10 mg/day applied weekly | |||
| preparations = Oral tablets 5, 10, 23 mg; ODT 5, 10 mg; Adlarity transdermal patch 5, 10 mg/day (weekly application) | |||
| fda_max = 23 mg/day | |||
| pill_id = | |||
| routes = Oral, transdermal | |||
| onset = Cognitive effect emerges gradually over weeks to months; ceiling effect at the therapeutic dose | |||
| duration = 24 hours (once-daily dosing) | |||
| halflife = ~70 hours (long, supports once-daily dosing without peak-trough variation)<ref name="aricept-label">FDA Prescribing Information, Aricept (donepezil hydrochloride), Eisai/Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020690s039lbl.pdf</ref> | |||
| bioavailability = ~100% (oral)<ref name="aricept-label" /> | |||
| pregnancy = Limited human data; rarely indicated in pregnancy given the patient population.{{citation needed}} | |||
| legal = [[USLegal:Prescription only|Rx-only]] in US | |||
| mechanism = <vote slug="donepezil-mech-claim">Selective, reversible acetylcholinesterase inhibitor with central nervous system penetration. Increases synaptic acetylcholine in cortical and hippocampal circuits, partially compensating for the characteristic cholinergic deficit of Alzheimer disease.</vote> The effect is symptomatic only: donepezil does '''not''' alter the underlying neurodegenerative trajectory. CYP3A4 and CYP2D6 metabolism. '''Cholinergic adverse effects''' (nausea, diarrhea, vomiting, vivid dreams, bradycardia, syncope) are dose-limiting; bradyarrhythmia and syncope are clinically important, with risk elevated by concurrent β-blockers or non-dihydropyridine calcium channel blockers. The bedtime dosing convention minimizes nausea and vivid-dream burden<ref name="aricept-label" />. | |||
}} | }} | ||
== References == | |||
<references /> | |||
[[Category:Anti-dementia medicines]] | |||
[[Category:Acetylcholinesterase inhibitors]] | |||