Domperidone
Mechanism :
Domperidone is an antidopaminergic drug, and is used orally, rectally or intravenously to suppress nausea and vomiting. It has also been used to stimulate lactation.
Indication :
- Vomiting
- Gastroesophageal reflux disease (GERD)
Contraindications :
Contraindicated in patients with known hypersensitivity to domperidone, in the presence of gastro-intestinal haemorrhage, obstruction or perforation and in patients with a prolactin-releasing pituitary tumour. Prolonged QT-intervals have been seen in neonates.
Dosing :
1 month-12 years:
200-400 microgram/kg/dose 3-4 times a day before food.
12-18 years:
10-20 mg 3-4 times a day.
Adverse Effect :
Dystonic reactions, reversible raised serum prolactin levels that may lead to galactorrhoea and gynaecomastia, hypertensive crises in patients with pheochromocytoma, urticaria and abdominal cramps.
Interaction :
Anti-cholinergic drugs: May inhibit the anti-dyspeptic effects.
Anti-muscarinic agents and opioid analgesics: May antagonise the effect.
May enhance the absorption of concurrently administered drugs.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Unlikely to be dialysed. Dose as in normal renal function |
| HDF/High flux | Unlikely to be dialysed. Dose as in normal renal function |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
Mild impairment: There are no dosage adjustments provided in the manufacturer’s labelling. Use with caution as it undergoes hepatic metabolism.
Moderate or severe impairment: Use is contraindicated.