Domperidone: Uses, Dosage, and Side Effects Overview

Summary of Key Points

Domperidone is a medication commonly used to manage nausea, vomiting, and digestive conditions such as gastroparesis and gastroesophageal reflux disease (GERD). It works by promoting the movement of food through the digestive tract, thereby improving gastrointestinal motility. While Domperidone is not readily available in the United States without special approval, it is widely used in many other countries. Always consult a healthcare provider before starting or adjusting your Domperidone dosage.

Names of Medication

US Brand Name: Domperidone (Generic: domperidone)

The generic name refers to the active ingredient, while the brand name is the commercial name under which the drug is marketed. In this article, the generic name will always appear in parentheses.

Pharmacologic Category

Domperidone belongs to the following pharmacologic categories:

1. Prokinetic Agents
2. Dopamine Antagonists

Domperidone Dosage Guidelines

Domperidone is prescribed for a variety of conditions. Below are the recommended doses for adults. Always consult your doctor before making any changes to your medication. You can also schedule a telemedicine appointment with one of our providers to discuss your treatment options.

1. Nausea and Vomiting: 10 mg taken 3 times daily. The duration of treatment depends on the underlying cause of nausea.
2. Gastroparesis: 10 mg taken 3 times daily, 15-30 minutes before meals. Treatment may continue for several weeks or longer, depending on symptom severity.
3. Gastroesophageal Reflux Disease (GERD): 10 mg taken 3 times daily, 15-30 minutes before meals. The length of treatment depends on how well symptoms are controlled.
4. Dyspepsia (Indigestion): 10 mg taken 3 times daily, 15-30 minutes before meals. Treatment duration varies based on the severity of symptoms.
5. Motion Sickness: 10 mg taken 3 times daily, 15-30 minutes before meals. Treatment duration depends on the length of travel or exposure to motion.
6. Chemotherapy-Induced Nausea: 10 mg taken 3 times daily. The duration of treatment depends on the chemotherapy regimen.
7. Postoperative Nausea: 10 mg taken 3 times daily. Treatment is typically short-term, depending on recovery.
8. Peptic Ulcer Disease: 10 mg taken 3 times daily, 15-30 minutes before meals. The duration of treatment depends on the underlying cause.
9. Functional Dyspepsia: 10 mg taken 3 times daily, 15-30 minutes before meals. Treatment duration varies based on symptom control.

Dosage Forms and Strengths

Domperidone is available in the following forms and strengths:

1. Tablets: 10 mg
2. Oral Suspension: 1 mg/mL

Administration Instructions for Domperidone

Take Domperidone 15-30 minutes before meals to aid digestion. Swallow the tablet whole with water. If using the oral suspension, measure the dose carefully with a medicine spoon or syringe. Do not exceed the prescribed dose, and always follow your healthcare provider’s instructions. If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule.

Contraindications for Domperidone Use

A contraindication is a specific condition where a medication should not be used due to potential harm. If you have any of the following conditions, Domperidone may not be safe for you. Always consult your healthcare provider before starting any new medication. Our telemedicine providers are also available to help you make informed decisions.

1. Severe liver impairment: Domperidone is processed by the liver. If your liver is not functioning properly, the medication may not be metabolized correctly, leading to potential toxicity.
2. Prolonged QT interval: Domperidone can affect the heart’s electrical activity, potentially worsening QT prolongation, which can lead to dangerous heart rhythms.
3. Moderate or severe electrolyte disturbances: Low levels of potassium, magnesium, or calcium in the blood can increase the risk of heart rhythm problems when taking Domperidone.
4. Gastrointestinal bleeding or obstruction: Domperidone increases stomach and intestinal movement, which could worsen conditions like gastrointestinal bleeding or blockages.
5. Known allergy to Domperidone: If you have had an allergic reaction to Domperidone in the past, avoid taking it to prevent severe allergic reactions such as anaphylaxis.

Drug-to-Drug Interactions with Domperidone

Domperidone can interact with other medications, increasing the risk of side effects or reducing the effectiveness of either Domperidone or the other drugs. Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Here are some common medications that may interact with Domperidone:

1. Ketoconazole (Nizoral): This antifungal medication can increase Domperidone levels in the blood, raising the risk of heart-related side effects.
2. Erythromycin (Ery-Tab): This antibiotic can also increase Domperidone levels and the risk of heart rhythm disturbances.
3. Amiodarone (Pacerone): Used to treat irregular heartbeats, Amiodarone can increase the risk of QT prolongation when taken with Domperidone.
4. Verapamil (Calan): This calcium channel blocker can raise Domperidone levels and increase the risk of heart-related side effects.
5. Ritonavir (Norvir): This antiviral medication used in HIV treatment can increase Domperidone levels and the risk of side effects.

Domperidone Safety During Pregnancy

Is it safe to take Domperidone during pregnancy? The safety of Domperidone in pregnant women has not been well established. While animal studies suggest there may be some risk to the fetus, there is a lack of comprehensive studies in humans. Domperidone should only be used during pregnancy if the potential benefits clearly outweigh the risks. If you are pregnant or planning to become pregnant, it is essential to consult your healthcare provider before using Domperidone. Our telemedicine providers are available to help you assess the risks and benefits based on your individual circumstances.

Domperidone for Breastfeeding: Is It Safe?

Is it safe to take Domperidone while breastfeeding? Domperidone is sometimes prescribed off-label to help increase milk production in breastfeeding mothers. However, it is not approved for this use in many countries, including the United States, due to concerns about potential heart-related side effects. Although only small amounts of Domperidone pass into breast milk, the effects on a nursing infant have not been thoroughly studied. If you are breastfeeding, it is important to discuss the potential risks and benefits with your healthcare provider before starting Domperidone. Our telemedicine team can guide you in determining whether Domperidone is a suitable option for you.

Domperidone Cost: What to Expect

The cost of a 30-day supply of Domperidone without insurance can vary. With a GoodRX coupon, the estimated price typically ranges from $25 to $50, though this may differ depending on the pharmacy and your location. Be sure to explore available discounts or coupons to help lower the cost of your medication.

Domperidone Alternatives for Various Conditions

Depending on the condition you are treating, there may be alternative medications or lifestyle changes that can help manage your symptoms. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are here to help you explore alternatives that may be more suitable for your needs.

Alternatives for Nausea and Vomiting

Medications such as ondansetron (Zofran) or prochlorperazine (Compazine) are common alternatives. Additionally, lifestyle adjustments like eating smaller, more frequent meals and avoiding strong odors may provide relief.

Alternatives for Gastroparesis

Metoclopramide (Reglan) is another medication option for gastroparesis. Dietary changes, such as consuming low-fiber, low-fat foods and eating smaller meals, can also help alleviate symptoms.

Alternatives for Gastroesophageal Reflux Disease (GERD)

Proton pump inhibitors (PPIs) like omeprazole (Prilosec) or H2 blockers such as ranitidine (Zantac) are commonly used alternatives. Lifestyle modifications, such as elevating the head of the bed and avoiding trigger foods, can also be effective in managing GERD symptoms.

Alternatives for Dyspepsia

Antacids or H2 blockers like famotidine (Pepcid) are often used to treat dyspepsia. Reducing stress, avoiding spicy foods, and eating smaller meals may also help ease symptoms.

Alternatives for Motion Sickness

Medications like dimenhydrinate (Dramamine) or meclizine (Antivert) are commonly used for motion sickness. Non-medication options, such as wearing acupressure bands or focusing on a stable object during travel, may also be helpful.

Alternatives for Chemotherapy-Induced Nausea

Ondansetron (Zofran) or aprepitant (Emend) are frequently prescribed for nausea caused by chemotherapy. Discussing dietary adjustments and hydration strategies with your healthcare provider may also provide additional relief.

Alternatives for Postoperative Nausea

Ondansetron (Zofran) or dexamethasone are common alternatives for managing nausea after surgery. Your healthcare provider may also recommend avoiding certain foods or activities that could trigger nausea.

Alternatives for Peptic Ulcer Disease

Proton pump inhibitors (PPIs) like omeprazole (Prilosec) or H2 blockers such as ranitidine (Zantac) are standard treatments for peptic ulcer disease. Avoiding NSAIDs and reducing alcohol consumption can also help manage symptoms.

Alternatives for Functional Dyspepsia

Antacids or prokinetic agents like metoclopramide (Reglan) may be prescribed for functional dyspepsia. Stress management techniques, such as mindfulness or yoga, can also help reduce symptoms.

Recent Updates on Domperidone Research

Recent studies have focused on the safety and effectiveness of Domperidone, particularly for conditions like gastroparesis and lactation. Some research has raised concerns about potential heart-related side effects, especially in older adults or individuals with pre-existing heart conditions. Ongoing studies are exploring whether lower doses of Domperidone could provide symptom relief while minimizing these risks. Additionally, researchers are investigating alternative medications for conditions like gastroparesis that may offer a better safety profile. If you have concerns about the latest research on Domperidone, our telemedicine providers can help you understand how this information may affect your treatment plan.

James Kingsley

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