Indications

Complicated dyspeptic symptoms, often associated with delayed gastric emptying, gastroesophageal reflux, and esophagitis:

•  Epigastric fullness, the feeling of abdominal distension, and abdominal pain upper
•  Discomfort, gas, early satiety
• Nausea and vomiting
• Acid with or without reflux acid in the mouth
• Inedible indigestion
• Acute nausea and vomiting of functional, organic, infectious origin, abstinence from food either due to radiotherapy or to drug treatment or induced in migraine.
• Parkinson’s disease: In dopamine causes nausea and vomiting.
• Radioactivity studies: Acceleration of barium transport in subsequent radiological studies.

Pharmacology

Domperidone is a dopamine antagonist that primarily blocks dopamine receptors located in the chemoreceptor trigger zone (CTZ) and the stomach. Its gastric stimulating effect is based on the blocking effect of dopamine receptors which affect gastrointestinal motility. Due to its poor ability to penetrate the blood-brain barrier, domperidone has virtually no effect on dopaminergic receptors in the brain, thus ruling out neuroleptic and psychotropic side effects. Domperidone restores normal peristalsis and tone of the upper gastrointestinal tract, facilitates gastric emptying, improves intestinal and duodenal motility, and regulates pyloric contraction. Domperidone also increases esophageal motility and lowers the pressure of the esophageal sphincter, thus preventing acid reflux.

Dosage & Administration

Domperidone should be taken 15-30 minutes before meals and, if necessary, before retiring.

The usual recommended oral dose of Domperidone is as follows:

Adults: 10-20 mg (1-2 tablets or 10-20 ml suspension), every 6-8 hours daily. The maximum dose of Domperidone is 80 mg daily.

Children: 2-4 ml suspension/10 kg body weight or 0.4-0.8 ml pediatric drops/10 kg body weight, every 6-8 hours daily.

In dyspeptic symptoms:

Adults: 10-20 mg (1-2 tablets or 10-20 ml suspension), every 6-8 hours daily.

Children: 0.2-0.4 mg/kg (2-4 ml suspension/10 kg or 0.4-0.8 ml pediatric drops/10 kg) body weight, every 6-8 hours daily.

In acute and sub-acute conditions (mainly in acute nausea and vomiting):

Adults: 20 mg (2 tablets or 20 ml suspension), every 6-8 hours daily

Children: 0.2-0.4 mg/kg (2-4 ml suspension/10 kg or 0.4-0.8 ml pediatric drops/10 kg) body weight, every 6-8 hours daily. (In acute nausea and vomiting maximum period of treatment is 12 weeks).

By rectum in suppositories:

Adults (including elderly): 30-60 mg every 4-8 hours.

Children: The maximum daily dose rectally in children is 30 mg for those weighing 10 to 25 kg. The dose may be divided throughout the day if necessary.

The maximum period of treatment is 12 weeks.

Interactions

Domperidone may reduce the risk of the blood-flow-reducing effects of bromocriptine. The effect of domperidone on Gl function may be interfered with by analgesics and opioid analgesics. Caution should be exercised when domperidone is used in combination with MAO (monoamine oxidase) inhibitors.

Contraindications

Domperidone is contraindicated in patients and newborns who are known to be allergic to this drug. Domperidone should not be used when gastrointestinal irritation is dangerous, that is, gastrointestinal bleeding, mechanical obstruction, or perforation. Patients with prolactin-releasing pituitary tumors (prolactinomas) are also contraindicated.

Side Effects

Domperidone may cause hyperprolactinemia (1.3%). This can lead to bleeding, breast enlargement, pain, and decreased sex drive. Dry mouth (1%), thirst, headache (1.2%), anxiety, drowsiness (0.4%), diarrhea (0.2%), rash, and itching (0.1%) may occur during treatment with domperidone. Extrapyramidal reactions were observed in 0.05% of patients in clinical studies.

Pregnancy

The safety of domperidone has not been established and is therefore not recommended during pregnancy. Animal studies have not demonstrated teratogenic effects in the fetus. Domperidone can precipitate galactorrhea and improve lactation after delivery. It is secreted in breast milk but in very small amounts not enough to be considered harmful.

Precautions

Domperidone should be used with extreme caution in children due to the possible increased risk of extrapyramidal reactions in young children due to incomplete development of the blood-brain barrier. Since domperidone is extensively metabolized in the liver, it should be used with caution in patients with hepatic impairment.

Therapeutic Class

Motility Stimulants, Motility stimulants/Dopamine antagonists, Prokinetic drugs

Storage Conditions

Store below 30°C, Protected from light & moisture. Keep out of children’s reach.

Generic of Domilux

Domperidone Maleate

Pharmaceutical Name

Popular Pharmaceuticals Ltd.