DOMPERIDONE
MOTILITY STIMULANTS/DOPAMINE ANTAGONISTS
Tablet/Suspension/-Suppositories Introduction & mode of action: Domperidone is a dopamine antagonist. It acts peripherally rather than central action; since it can't readily enter the central nervous system due to the blood-brain barrier, its effects are confined to the periphery and acts principally at the receptor site in the chemoreceptor trigger zone.
Ind: In the adult-
i. prevention and symptomatic relief of acute nausea and vomiting from any cause including cytotoxic therapy, radiotherapy, and anti-parkinsonism therapy:
ii. functional dyspepsia: not recommended for routine prophylaxis of postoperative vomiting or for chronic administration. In children- the use of domperidone is restricted to nausea and vomiting following cytotoxic or radiotherapy only, not recommended for other causes
C: The known case of hypersensitivity to this drug: neonates.
Use in pregnancy & lactation: In pregnancy, the safety of domperidone has not been proven and hence it is not recommended during pregnancy. In lactating mother, domperidone may precipitate galactorrhoea & improve postnatal lactation; it is also secreted in breast milk but in very small quantities insufficient to be considered harmful, but its use in lactating mother should be very cautiously observed
S/E: Domperidone may cause increased prolactin production (1.3%), which may result in galactorrhoea gynaecomastia; soreness and reduced libido. Other gynecomastia; soreness and reduced libido. Other side-effects may include- dry mouth, nervousness, drowsiness, skin rash, and itching. Extra-pyramidal reactions are also reported very rarely in some clinical studies.
Cautions: Domperidone should be used with absolute caution in case of young children, because there may be an increased risk of extrapyramidal reactions, since the drug may enter into the central nervous system due to an incompletely developed blood-brain barrier.
Dosage &Admin: Adults- acute nausea and vomiting (including drug-induced), 10-20 mg every 4-8 hours daily orally; maximum period of treatment is 12 weeks. Functional dyspepsia, 10- 20mg 3 times daily orally before foods & at night: the maximum period of treatment is 12 weeks.
Children- nausea and vomiting following cytotoxic or radiotherapy only, 0.2-0.4mg/kg every 4-8 hours daily. Functional dyspepsia- not recommended.
Note: Domperidone oral preparations should be taken15-30 minutes before a meal.
Drug interactions: Domperidone may reduce the hyperprolactinemic effect of bromocriptine. The action of domperidone on g.i function may be antagonized by antimuscarinics and opioid analgesics.