Domperidone - Uses, Dosage, Side Effects, Drug Warnings, And Precautions.

Overview:

Domperidone is an antiemetic that primarily affects the motility of the muscles and nerves of the upper gastrointestinal tract.” The drug is known as an anti-sickness drug” The medicine influences the motor function messages from the brain to the stomach and intestine and reduces nausea and vomiting. Domperidone provides relief in symptoms like bloating, distension and abdominal pain, reflux, and gastritis. The drug is also used to treat nausea and vomiting caused by other drugs.

The drugs in this group are available in various forms like tablets, capsules, and rectal suppositories. It has to be taken before meals or as per the instructions given by the doctor. The medicine is to be taken only if prescribed. It is a well-tolerated drug and does not cause any adverse neurological symptoms.

Drug Group:

Domperidone belongs to a class of medicines called the D2 receptor antagonists. The medications in this group are Dopamine antagonists that speed the contractions and relaxations of the digestive tract. The other drugs in this group include Bethanechol, Cisapride, and Metoclopramide. These drugs treat nausea and vomiting caused due to motility of the stomach and intestines and decrease acid reflux. Unlike the other dopamine antagonists, Domperidone does not readily enter the central nervous system.

What Is Domperidone Used For?

1. Nausea and Vomiting - Domperidone is the most commonly prescribed drug to control nausea and vomiting as it acts on the chemoreceptor trigger zones of the stomach.

2. Drug-Induced Nausea and Vomiting- Domperidone can also be used to treat nausea and vomiting caused by medicines like Aspirin, Ibuprofen, chemotherapy, and antibiotics.

3. Gastroenteritis - Domperidone is readily used in emergency departments to manage nausea in gastroenteritis patients.

4. Gastroparesis - The other use of this drug is to treat gastroparesis (a rare condition that affects proper emptying of the stomach) which can interfere with normal digestion and cause nausea and vomiting.

5. Gastrointestinal Motility Disorders - Domperidone is more effective in treating gastric reflux and strengthens gastric motility. It promotes digestion and clearance of gastric secretions.

6. Duodenal Ulcers- The drug can be used with Omeprazole in managing nausea and vomiting triggered due to erosions of the stomach and duodenal lining.

IMPORTANT - Domperidone is given under the supervision of a doctor, and its consumption should not exceed 12 weeks.

How Does Domperidone Work?

Domperidone acts by blocking the neurotransmitters from the brain to the gastrointestinal tract. It increases the contractions of the muscles at the entrance of the stomach and relaxes the muscles at the exit. This limits the flow of messages from the brain and reduces the sick feeling.

• Nausea and Vomiting - It acts as an antiemetic and prokinetic agent and reduces the trigger zone and motor function of the stomach and intestines. It is used to relieve gastrointestinal symptoms in Parkinson and rsquo's disease as it blocks the dopamine receptor

• Gastrointestinal Motility Disorder - The drug increases the motility of the upper gastrointestinal tract and increases the esophageal sphincter pressure.

• Gastroparesis - Domperidone provides relief from the discomfort of nausea and vomiting caused due to delayed emptying of the stomach. It increases the motility of the gastrointestinal tract.

What Is the Onset of Action of Domperidone?

The drug is to be taken on an empty stomach or at bedtime for best results. The absorption of Domperidone is fast when administered orally. It starts to work in 30 to 60 minutes and facilitates emptying at the gastric level. The drug is rapidly absorbed and metabolized by the liver and excreted in the urine.

Habit-Forming:

There have been no reports of habit-forming tendencies in people taking Domperidone.

Expiry Date:

Avoid taking this medicine after it expires. Check for the expiry on the back of the medicine pack.

What Is the Dosage of Domperidone?

The recommended oral dose for an adult is 10 mg and is taken three times a day. The dosage and duration of the drug are adjusted according to the patient's weight. It should be used at the lowest effective dose and is swallowed whole.

IMPORTANT - Do not increase the dose of medicines yourself without consulting the doctor. For children, women, and patients with kidney and liver disease, the dosage will be adjusted by your doctor.

How to Use Domperidone?

Domperidone is available orally (tablets, suspension) and in rectal suppositories.

Oral Tablets - The drug is taken before meals. If taken after meals there is a delay in absorption of the drug.

Rectal Suppositories - It is used in the treatment of intractable nausea and vomiting.

The medicine is not recommended for children under12 years and should be taken with the consultation of a doctor.

Missed Dose:

In case of a missed dose, take it soon after you remember. However, do not take two tablets together at one time as it may cause adverse reactions. Always space the doses at least eight hours apart.

What Are the Drug Warnings and Precautions?

• Pregnancy and Breastfeeding - Domperidone is not usually recommended for pregnant and breastfeeding women and should be taken only with consultation with the doctor.

• Allergic Reactions - The drug should not be given to those allergic to Domperidone or other related drugs. The doctor should also be informed if you have any other allergies to food or dyes.

• Blood pressure - Domperidone increases the blood pressure and heart rate in an erect position. Regular monitoring should be done for people with high blood pressure.

• Heart diseases - Domperidone increases the risk of irregular heartbeats. Do not take it if you have a history of heart attack or arrhythmias.

• Liver and Hepatic Impairment - It is contraindicated in patients with hepatic impairment and must not be given to patients with moderate or severe impairment of liver function.

• Alcohol - It is best to avoid alcohol when taking Domperidone as it can worsen the side effects.

• Body Weight - It should be taken after consulting with a doctor for people with weight less than 35 kgs.

• Geriatrics - People over 60 years may experience heart problems and should talk to a doctor.

• Children - The safety and effectiveness of the drug are not medically established.

What Are the Side Effects of Domperidone?

The most common side effects are

• Abdominal cramps.

• Dry mouth.

• Diarrhea.

• Migraine.

• Rashes.

• Nervousness

• Breast pain and tenderness

• Although severe side effects are rare, they may include

• Irregular heartbeat.

• Dizziness.

• A sudden abnormal irregular rhythm of the heartbeat.

• Urinary retention.

• Muscle rigidity.

• Difficulty in breathing.

• Menstrual irregularities.

• Milk flowing from the nipples.

• Allergic reactions.

• Cardiac arrest.

If the symptoms are mild, they go away in a few days. However, it is best to inform your doctor immediately if we notice severe symptoms.

What Are the Interactions of Domperidone?

There can be drug interactions with other drugs and food supplements which may affect their action or intensify the side effects.

1. Drug Interactions:

The most common drugs that can interact with Domperidone are the following:

Mild to Moderate Interactions -

• Amiodarone.

• Antihistamines like Cetirizine, Diphenhydramine, Hydroxyzine, Loratadine, and Doxylamine.

• Antifungals like Fluconazole, Itraconazole, Ketoconazole Voriconazole.

• Antipsychotic medicines like Haloperidol, Pimozide, Quetiapine, Ziprasidone, and Risperidone.

• Calcium channel blockers like Amlodipine, Diltiazem, Nifedipine, and Verapamil.

• Cobicistat.

• Chloroquine.

• Flavoxate.

• Flecainide.

• Disopyramide.

• Dronedarone.

• Glycopyrrolate.

• Glycopyrronium.

• Galantamine.

• HIV protease inhibitors like Indinavir, Atazanavir, Nelfinavir, Ritonavir, and Lopinavir.

• Macrolide antibiotics like Azithromycin, Clarithromycin, and Erythromycin.

• Maprotiline.

• Methadone.

• Mifepristone.

• Narcotic pain relievers like Fentanyl, Hydromorphone, Morphine, and Oxycodone.

• Monoamine oxidase inhibitors (MAO) like Moclobemide, Phenelzine, Rasagiline, Selegiline, and Tranylcypromine.

• Orphenadrine.

• Pentamidine.

• Probucol.

• Procainamide.

• Propafenone.

• Protein kinase inhibitors like Bosutinib.

• Quinoline.

• Serotonin Antagonists like Granisetron, and Ondansetron.

• Sirolimus.

• Solifenacin.

• Sotalol.

• Tiotropium.

• Tolterodine.

Severe Drug Interaction -

• Tricyclic Antidepressants such as Amitriptyline and Nortriptyline.

• Trospium Iodine.

• Quinine.

• Scopolamine.

• Selective Serotonin reuptake inhibitors (SSRIs) Like Citalopram, Fluoxetine, and Paroxetine.

2. Food Interactions:

• Grapefruit - Avoid taking grapefruit or grapefruit juice with Domperidone as it may increase the chances of side effects.

What Are the Common Brands or Trade Names of Domperidone?

1. Tablet Domet 10 mg.

2. Tablet Domfast DT 10 mg.

3. Tablet Gastrium 10mg.

4. Tablet Cezvom 10 mg.

5. Tablet Vomistop 10 mg.

6. Tablet Domel MT 10mg.

7. Tablet Domperidone DT 10 mg.

8. Tablet Maridom 10 mg.

9. Tablet Prodom 10 mg.

10. Tablet Domstal 10 mg.