BMA Concise Guide to Medicine & Drugs

Domperidone

Brand name Motilium

Used in the following combined preparations None

QUICK REFERENCE

Drug group Anti-emetic drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Domperidone, an anti-emetic drug, was first introduced in the early 1980s. It is particularly effective for treating nausea and vomiting caused by gastroenteritis, chemotherapy or radiotherapy. It is not effective for motion sickness or nausea caused by inner ear disorders such as Ménière’s disease.

The main advantage of domperidone over other anti-emetic drugs is that it does not usually cause drowsiness or other adverse effects such as abnormal movement. Domperidone is not suitable, however, for the long-term treatment of gastrointestinal disorders, for which an alternative drug treatment is often prescribed.

Domperidone is now restricted to use in the relief of nausea and vomiting. It is sometimes used in single doses to manage acute attacks of migraine by enhancing the absorption of other drugs for migraine, such as paracetamol.

INFORMATION FOR USERS

Follow instructions on the label. Call your doctor if symptoms worsen.

How taken/used Tablets, liquid.

Frequency and timing of doses 1–3 x daily.

Adult dosage range Up to a maximum of 30mg daily.

Onset of effect Within 1 hour. The effects of the drug may be delayed if taken after the onset of nausea.

Duration of action Approximately 6 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children. Protect from light.

Missed dose If your next dose is due within 4 hours, take a single dose now and skip the next. Then return to your normal dose schedule.

Stopping the drug Can be stopped when you no longer need it.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause dizziness. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Domperidone rarely causes adverse effects. Occasionally, it may cause breast enlargement or milk secretion, muscle spasms, tremors, reduced libido, and a rash. Consult your doctor if any of these effects occur. Rarely, it may cause an irregular heartbeat or fainting; if either of these occur, stop taking the drug and seek immediate medical attention.

INTERACTIONS

Anticholinergic drugs

These may reduce the beneficial effects of domperidone.

Opioid analgesics

These may reduce the beneficial effects of domperidone.

Bromocriptine and cabergoline

Domperidone may reduce the effects of these drugs in some people.

Ketoconazole

This antifungal drug should not be taken while also taking domperidone as the combination increases the risk of heart rhythm problems.

SPECIAL PRECAUTIONS

Be sure to consult your doctor or pharmacist before taking this drug if:

· You have a long-term kidney problem or liver disease.

· You have thyroid disease.

· You have a pituitary tumour.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding The drug may pass into the breast milk, but at normal doses adverse effects on the baby are unlikely. Discuss with your doctor.

Infants and children Do not use in children under 16 years, except on a doctor’s advice.

Over 60 No special problems.

Driving and hazardous work No special problems.

Alcohol No special problems, but alcohol is best avoided in cases of nausea and vomiting.

PROLONGED USE

Treatment should be reviewed after one week and the need for continued treatment reassessed. In people with heart disease, there is a small increased risk of collapse or sudden death.