What is Domperidone?

Domperidone is a drug which increases gastric emptying. It reduces time required to dump the food from stomach to small intestines. It is effective in treatment of nausea and vomiting.

How It Works?

Dopamine is present in gastrointestinal tract in significant amount. It slows down gastric movements. Dopamine also has inhibitory effect on lower esophageal sphincter (a valve that helps to pass food from food pipe to stomach). Domperidone opposes effects of dopamine. It acts as dopamine receptor antagonist. Domperidone increases tone of this valve that stops movement of food from stomach back to food pipe. This mechanism helps to stop vomiting.

Uses:

1. Indigestion: relief from indigestion and related fullness of stomach.
2. Nausea and vomiting: Domperidone is effective in reducing nausea and vomiting. Includes chemotherapy induced nausea and vomiting (CINV), post-operative nausea and vomiting (CINV).
3. Gastroparesis: it is a condition where gastric movements are slowed down. Domperidone is used to increase gastric emptying. Best example of such description includes diabetic gastroparesis.
4. Heartburn
5. Gastroesophageal reflux disease (GERD): a condition where acid comes back in lower part of food pipe (esophagus) and causes heartburn.

Dosage:

• Adults: 10 mg up to 3 times a day can be given, 30 minutes before a meal. Dose is available in oral/Intravenous/intramuscular routes.
• Children: 0.2 to 0.4mg/kg/dose, up to 3 times per day before meals. Dosage depends on their weight. Consult a pediatrician before using in children.

Safety Precautions:

• Alcohol: It is not safe to consume alcohol while you are on domperidone therapy.
• Pregnancy: Safe to use in pregnancy. It is safe to use under guidance of treating physician to combat nausea and vomiting in early pregnancy.
• Breastfeeding: Consult your attending physician before taking domperidone while breastfeeding.
• Liver: Domperidone is safe in liver disease. Please consult your doctor before taking it.
• Kidney: Dose reduction is needed in kidney diseases. It is not advised to take more than prescribed by your doctor.

Quick Tips from Experts:

1. Avoid taking domperidone for duration more than prescribed by doctor.
2. Abstain from alcohol and smoking.

Side Effects:

Metoclopramide therapy comes with adverse effects including:

• Restlessness
• Fatigue
• Dizziness
• Prolonged QT interval in ECG
• Ventricular arrhythmia: rare side effect seen in older population (>60 yr)

Drug Interactions:

1. With CYP3A4 inhibitors: increases the levels of domperidone, so risk of QT prolongation increases. This can lead to serious cardiac arrhythmias. Examples of CYP3A4 inhibitors are ERYTHROMYCIN, KETOCONAZOLE, RITONAVIR, DILTIAZEM, VERAPAMIL.
2. With drugs causing ventricular arrhythmias: amiodarone, sotalol, antipsychotics and antidepressants. Combining these drugs with domperidone can cause serious cardiac arrhythmia known as 'Torsades de pointes'.

📦 Storage

• Store at room temperature (68-77°F or 20-25°C)
• Keep in original container, tightly closed
• Protect from moisture and light