Indication

• Gastritis, Lactation, Migraine, Nausea and vomiting, Gastroparesis, Non ulcer dyspepsia

Administration

• Should be taken on an empty stomach. Take 15-30 min before meals.

Adult Dose

• Oral Adults: Nausea and vomiting 10-20 mg 4-8 hrly. Max: 80 mg/day. Non ulcer dyspepsia 10 mg 3-4 times daily. Max: 20 mg 3-4 times daily. Last dose to be taken at bedtime. Migraine 20 mg 4 hrly. Max: 4 doses/24 hr. Rectal: Nausea and vomiting 60 mg twice daily. Elderly: No dosage adjustment needed. Hepatic impairment: No dosage adjustment needed.

Child Dose

• Oral Children : 0.2 - 0.4 mg/kg every 4 - 8 hours daily. Rectal Child: <12 yr >15 kg: 30 mg bid; >12 yr >35 kg: 60 mg bid.

Renal Dose

• Renal impairment: Mild to moderate: No dosage adjustment needed. Severe: Reduce dosing to 1-2 times daily w/ prolonged treatment.

Contraindication

• Hypersensitivity. GI haemorrhage, obstruction and perforation, patients with prolactin releasing pituitary hormone, chronic admin or routine prophylaxis of postoperative nausea and vomiting.

Mode of Action

• Domperidone is a peripheral dopamine-receptor blocker. It increases oesophageal peristalsis, enhances gastroduodenal coordination and lowers oesophageal sphincter pressure, gastric motility and peristalsis, thus facilitating gastric emptying and decreasing small bowel transit time.

Precaution

• Phaeochromocytoma; children<2 yr, elderly; renal or hepatic impairment. Risk of cardiac arrhythmias and hypokalaemia if administered IV. Pregnancy and lactation.

Side Effect

• Drowsiness, extrapyramidal reactions, galactorrhoea, gynaecomastia; constipation or diarrhoea, lassitude, decreased libido, skin rash, itch. Potentially Fatal: Convulsions, arrhythmias and cardiac arrest, dysrrhythmias in patients with CV disease or hypokalaemia, patients on cancer chemotherapy. Seizures; hypertensive crisis in patients with phaeochromocytoma.

Interaction

• May antagonise the hypoprolactinaemic effect of bromocriptine. May antagonise the prokinetic effect w/ opioid analgesics and antimuscarinics. Potentially Fatal: Potent CYP3A4 inhibitors (e.g. ketoconazole, erythromycin or ritonavir) may increase serum domperidone levels and subsequently increasing the risk of QT prolongation.