Pharmacology: Domperidone is a benzimidazole derivative with prokinetic and antiemetic effects, with the latter effect very similar to metoclopramide. Extrapyramidal reactions are rare as domperidone generally does not cross the blood-brain barrier. Oral administration prolongs the contraction of the anthrum and duodenum, increases gastric emptying and pressure of lower esophagus sphincter. There is no side effect to gastric secretion.
Dyspepsia syndrome, which is accompanied by delayed gastric emptying, esophageal reflux and esophagitis; epigastric and abdominal fullness, nausea and vomiting; heartburn with or without regurgitation.
Nausea and Vomiting Due to Various Causes: Gastrointestinal intolerance due to anti-cancer chemotherapy, digitalis, L-dopa and others including radiotherapy; abdominal, gastrointestinal, hepatobiliary, peritoneal and renal pathology; pediatric pathology due to functional disorders (pylorospasm, cyclic vomiting) or organic disorders, intoxication by infection, dietary or acetonemia.
Chronic Dyspepsia: Adults: Fast-Melting Tablet: 10-20 mg 3 times daily before meals and 10-20 mg before bedtime.
Children: Suspension: 2.5 mg/10 kg body weight, 3 times daily before meals.
Nausea and Vomiting: Adults and Elderly: 10-20 mg, 3-4 times daily, with 4-8 hours interval.
Children: Suspension: 2.5-5 mg/10 kg body weight or 0.3-0.6 mL/5 kg body weight, 3-4 times daily before meals.
Drops: 0.2-0.4 mg/kg body weight 3-4 times daily. Doses should be taken with 4-8 hrs interval.
Symptoms: Sleepiness, disorientation, extrapyramidal reaction especially in children. The anticholinergic effect can help control extrapyramidal reactions.
Treatment: There is no specific antidote for overdosage, but activated charcoal can be given and it is better to observe and give symptomatic treatment.
Patients with intolerance to domperidone.
Domperidone cannot be administered if gastric motility causes bleeding, mechanical obstruction or gastrointestinal perforation. Domperidone is also contraindicated in patients with prolactinoma and tumor hypohyloma which produce prolactin.
Use in pregnancy & lactation: Not recommended in pregnant women or nursing mothers.
If an antacid is to be administered concomitantly with an antisecretion drug, this must be given after meals and not administered concomitantly with domperidone.
Domperidone is not recommended for long-term treatment.
Use with caution in patients with hepatic impairment.
Not recommended in pregnant women or nursing mothers.
Domperidone rarely causes central nervous symptoms, including extrapyramidal symptoms, because of its poor penetration to the blood-brain barrier. Domperidone can induce hyperprolactinemia in many patients, resulting in breast tenderness and enlargement, galactorrhea and gynecomastia. Domperidone rarely causes allergic reaction like rash and urticaria.
Concomitant administration with an anticholinergic antagonizes the antidyspepsia effects of domperidone while concomitant administration with antacids decreases the bioavailability of domperidone. Theoretically, gastrokinetic effects of domperidone disturbs the absorption of oral drugs when administered concomitantly, especially sustained-release or enteric-coated drugs. Concomitant administration with digoxin or paracetamol does not affect the blood concentration of domperidone.
Domperidone can be administered concomitantly with neurologic drugs with no potentiation effects, dopaminergic agonists (bromocriptine, L-dopa), whereas peripheral effects eg, gastric disorders, nausea and vomiting can be decreased without reducing the central activity.
Store at temperatures not exceeding 30°C. Protect from light.
A03FA03 - domperidone ; Belongs to the class of propulsives. Used in the treatment of functional gastrointestinal disorders.
Vometa: Oral susp 5 mg/5 mL x 60 mL. Oral drops 5 mg/mL x 10 mL. Vometa FT: Fast-melting tab 10 mg x 50's.