Domperidone

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Domperidone.jpg

[edit] MECHANISM OF ACTION

Domperidone is a peripheral dopamine D2-receptor antagonist with antiemetic properties. Domperidone does not readily cross the blood-brain barrier and its antiemetic activity is due to blockade of dopamine receptors in the chemoreceptor trigger zone, which lies in the area postrema and is regarded as being outside the blood brain.

Domperidone acts also as a gastrointestinal emptying adjunct and peristaltic stimulant. The gastroprokinetic properties of domperidone are related to its peripheral dopamine receptor blocking properties.

Domperidone elevates also serum prolactin levels.

[edit] INDICATIONS

  • Domperidone is NO LONGER authorised to treat conditions such as bloating or heartburn. [1]
  • Treatment of nausea and vomiting of various origins.
  • To prevent nausea and vomiting associated with the use of dopamine agonist antiparkinsonian agents (Levodopa).
  • To improve lactation in breast-feeding women (off label)

[edit] DOSAGE

Domperidone should be taken 15-30 minutes before meals and, if necessary, before retiring. Domperidone should not normally be used for longer than one week.

  • Adults and adolescents weighing 35 kg or more:
    • Orally: 10 mg up to three times daily by mouth.
    • Suppositories: 30 mg twice daily
  • Children and adolescents weighing less than 35 kg: it should be given by mouth at a dose of 0.25 mg per kg bodyweight up to three times daily.:

[edit] CONTRAINDICATIONS

  • Known hypersensitivity to Domperidone
  • Prolactin-releasing pituitary tumour (prolactinoma)
  • Co-administration with oral ketoconazole, erythromycin, or other potent CYP3A4 inhibitors which prolong the QTc interval such as fluconazole, voriconazole, clarithromycin, amiodarone, and telithromycin.
  • Domperidone should not be used whenever stimulation of gastrointestinal motility might be dangerous such as in the presence of gastrointestinal hemorrhage, mechanical obstruction, or perforation.
  • Domperidone must not be given to patients with moderate or severe impairment of liver function
  • Patients who have existing abnormalities of electrical activity in the heart or heart rhythm, or who are at increased risk of such effects

[edit] PRECAUTIONS

[edit] INTERACTIONS

[edit] PREGNANCY AND LACTATION

[edit] SIDE EFFECTS

Domperidone is associated with a small increased risk of potentially life-threatening effects on the heart. This was seen particularly in patients older than 60 years, those taking daily doses of more than 30 mg and those taking other medicines that have similar effects on the heart or reduce the breakdown of domperidone in the body. [2]

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES

  1. http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2014/03/news_detail_002039.jsp&mid=WC0b01ac058004d5c1
  2. http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2014/03/news_detail_002039.jsp&mid=WC0b01ac058004d5c1
Antiemetics
5-HT3 receptor antagonists Dolasetron   Granisetron   Ondansetron   Palonosetron   Tropisetron
Dopamine antagonists Alizapride   Bromopride   Clebopride   Domperidone   Metoclopramide   Prochlorperazine   Thiethylperazine
H1 antagonists Dimenhydrinate   Meclizine
NK1 receptor antagonists‎ Aprepitant   Fosaprepitant   Maropitant
Motion sickness‎ Cinnarizine   Dimenhydrinate   Meclizine   Meclizine/Pyridoxine   Scopolamine (Patch)
Pregnancy Meclizine/Pyridoxine   Ondansetron
Veterinary Maropitant