Phaeochromocytoma; children<2 yr, elderly; renal or hepatic impairment. Risk of cardiac arrhythmias and hypokalaemia if administered IV. Pregnancy and lactation.
Indication
Gastritis, Lactation, Migraine, Nausea and vomiting, Gastroparesis, Non ulcer dyspepsia
Contra Indication
Hypersensitivity. GI haemorrhage, obstruction and perforation, patients with prolactin releasing pituitary hormone, chronic admin or routine prophylaxis of postoperative nausea and vomiting.
Dose
N/A
Side Effect
Drowsiness, extrapyramidal reactions, galactorrhoea, gynaecomastia; constipation or diarrhoea, lassitude, decreased libido, skin rash, itch.
Potentially Fatal: Convulsions, arrhythmias and cardiac arrest, dysrrhythmias in patients with CV disease or hypokalaemia, patients on cancer chemotherapy. Seizures; hypertensive crisis in patients with phaeochromocytoma.
Pregnancy Category
Name :
C
Description
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Domperidone is a peripheral dopamine-receptor blocker. It increases oesophageal peristalsis, enhances gastroduodenal coordination and lowers oesophageal sphincter pressure, gastric motility and peristalsis, thus facilitating gastric emptying and decreasing small bowel transit time.
Interaction
May antagonise the hypoprolactinaemic effect of bromocriptine. May antagonise the prokinetic effect w/ opioid analgesics and antimuscarinics.
Potentially Fatal: Potent CYP3A4 inhibitors (e.g. ketoconazole, erythromycin or ritonavir) may increase serum domperidone levels and subsequently increasing the risk of QT prolongation.
Pregnancy Category Note
N/A
Adult Dose
Oral
Adults:
Nausea and vomiting 10-20 mg 4-8 hrly. Max: 80 mg/day.
Non ulcer dyspepsia 10 mg 3-4 times daily. Max: 20 mg 3-4 times daily. Last dose to be taken at bedtime.
Migraine 20 mg 4 hrly. Max: 4 doses/24 hr.
Rectal:
Nausea and vomiting 60 mg twice daily.
Elderly: No dosage adjustment needed.
Hepatic impairment: No dosage adjustment needed.
Child Dose
Oral
Children : 0.2 - 0.4 mg/kg every 4 - 8 hours daily.
Rectal
Child: <12 yr >15 kg: 30 mg bid;
>12 yr >35 kg: 60 mg bid.
Renal Dose
Renal impairment: Mild to moderate: No dosage adjustment needed. Severe: Reduce dosing to 1-2 times daily w/ prolonged treatment.
Administration
Should be taken on an empty stomach. Take 15-30 min before meals.
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