Domperidone

Domperidone is a prokinetic and anti-nausea medication. It comes from a class of medicines known as dopamine antagonists. It is mainly used to alleviate symptoms such as nausea, vomiting, pain, and discomfort in the stomach and upper gastrointestinal (GI) tract, often caused by slow-moving stomach and GI tract motion.

Domperidone operates by inhibiting the dopamine receptors located in the gastrointestinal system. This action enhances the contractions of the stomach and intestinal muscles, thereby facilitating the quicker and smoother movement of food through the digestive tract. Additionally, it impacts the chemoreceptor trigger zone in the brain, which plays a role in causing nausea and vomiting. Notably, this brain region is located outside the protective blood-brain barrier. Unlike some other medications that block dopamine, domperidone does not cross the blood-brain barrier, reducing the likelihood of central nervous system side effects.

Regarding its use in boosting breast milk production, domperidone functions by elevating the levels of a hormone known as prolactin, which stimulates the production of breastmilk.

What are the uses of Domperidone?

Many conditions, including the following, are treated with Domperidone:

• To relieve nausea (the feeling of being sick) and vomiting, particularly when migraine headaches are the main cause.
• To stop vomiting and nausea induced by Levodopa and Pergolide, two drugs used to treat Parkinson's disease.
• Help alleviate the discomfort brought by Gastroparesis, a condition where the stomach moves slowly. 
• Dyspepsia (indigestion), being unable to complete a meal, feeling bloated or full after eating, losing appetite, feeling ill, and maybe vomiting or belching without relief are other symptoms alleviated by this medicine.

When and how to take Domperidone?

Your doctor will explain to you how and when to take this medication. Take Domperidone according to the prescription only.


• The pills should be consumed whole, along with some water. Do not chew them or smash them.
• Use the plastic measuring cup that is included if taking the oral suspension.
• While using the oral drops, make sure you use the dropper that comes with it.
• It is not necessary to have water while taking disintegrating pills orally because they dissolve in the mouth.

What are the side effects of Domperidone?

The adverse effects of dopamine can sometimes be severe. Do not continue taking Domperidone and consult a physician or go right immediately to the hospital if you notice the following symptoms:

• You experience a seizure or fit.
• You experience swelling in your hands, ankles, feet, face, lips, or neck, which might make it difficult for you to walk, breathe, or swallow. You could also get an itchy, lumpy rash or nettle rash. This might indicate that you are reacting allergically to the medication.
• You notice any erratic motions. They include odd tongue and eye movements as well as atypical postures such as a twisted neck, shaking, and muscle rigidity. Children have a higher chance of experiencing this. 
• You have an unusually quick or rapid pulse. This could indicate a serious cardiac condition that might be fatal.

The following are uncommon adverse effects of Domperidone:

• Anxiety
• Drowsiness
• Diarrhoea
• Unusual eye movements
• Itchy skin or skin rash
• Painful or tender breasts
• Unusual breast milk production in both men and women
• Reduction in male sexual desire
• Menstrual cycles in women may be erratic or cease altogether.

These side effects are not common and happen very rarely.

What are the precautions for Domperidone?    

• It is important to take the medication before meals, as recommended by your healthcare provider, to ensure optimal effectiveness.
• Do not take it for more than seven days without first talking to your doctor.
• You may feel dizzy and tired as a result. Until you know how it affects you, don't drive or perform any other activities that need concentration.
• Avoid consuming alcohol while taking Domperidone, as it may make you feel too sleepy.
• If you get a fever, prolonged stomach discomfort, or watery diarrhoea, let your doctor know right away.
• It is not advised to use this medication in patients under the age of 12 or who weigh less than 35 kg since its safety and effectiveness have not been scientifically verified.
• Pregnant women shouldn't use this drug without asking the doctor.
• Domperidone use may elevate the risk of heart rhythm irregularities and cardiac arrest, with a higher likelihood in individuals aged 60 or older and those taking doses exceeding 30 mg daily. This risk is further heightened when combined with certain medications. It's important to inform your healthcare provider or pharmacist if you are using drugs to treat infections, whether fungal or bacterial and if you have pre-existing heart conditions or compromised immune systems like in conditions such as HIV/ AIDS.
• For adults and adolescents aged 12 and older with a body weight of 35 kg or more, domperidone should be administered at the lowest effective dose.
• While using this medication, it's essential to get in touch with your doctor if you encounter heart rhythm issues, such as palpitations, breathing difficulties, or loss of consciousness. In such cases, the use of domperidone should be discontinued.

Interactions with other medicines

Domperidone should not be taken if you are also taking medication to treat:

• Fungal Infection or Bacterial Infection
• High Blood Pressure
• Depression
• Gastrointestinal disorders 
• Malaria 
• Cancer
• AIDS/HIV (protease inhibitors)

What to do if I miss a dose of Domperidone?

If you have forgotten to take this medication then take it as soon as you remember. On the other hand, avoid the missed dosage and resume your usual dosing plan if it is almost time for your next dose. Never combine two dosages into one to avoid overdose.

What to do in the case of an overdose of Domperidone?

It might be harmful to take too much Domperidone. A rapid or irregular heartbeat might result from taking more medication than was intended. In the case of an overdose of Domperidone, seek immediate medical help.

What are the storage conditions for Domperidone?

• The medicine needs to be stored in a tight container at room temperature, away from heat, humidity, and strong light.
• Medicine that is no longer needed or that is obsolete should not be kept.
• Store the medication out of reach of children to ensure their safety.

How quickly does Domperidone show results?

Domperidone causes an initial rise in prolactin levels within 60 minutes of treatment. Usually, the effect starts to show in 30-40 minutes.

Domperidone vs Metoclopramide

FAQs

1. What is the difference between Domperidone with Metoclopramide? 

Based on the mechanism of action and usage, differences between Domperidone and Metoclopramide are:

• Mechanism of Action: Domperidone and Metoclopramide are both medications that can help relieve digestive issues, but they work differently. Domperidone works by blocking dopamine receptors in the gut, enhancing the movement of stomach and intestinal muscles, and reducing nausea. Metoclopramide, on the other hand, acts on dopamine receptors in the stomach and upper intestines to enhance muscle contractions and increase the movement of food through the digestive tract. It also affects the chemoreceptor trigger zone in the brain, reducing nausea and vomiting.
• Usage: Both medications are used to treat similar conditions, such as nausea, vomiting, and certain digestive disorders, but the healthcare provider may prescribe either domperidone, metoclopramide, or any other similar medication based on your overall health condition. 

2. Is domperidone tablet used for acidity?

Yes, domperidone can be used to relieve symptoms associated with acidity, such as nausea and heartburn, especially when these symptoms are related to delayed gastric emptying.

3. When should domperidone be taken?

Domperidone is typically taken before meals, as it helps in promoting the movement of food through the digestive tract. The exact dosing instructions should be provided by a healthcare professional based on your specific condition.

4. What side effects might domperidone cause?

Common side effects of domperidone can include stomach cramps, diarrhea, and headache. In some cases, it may cause more serious side effects, such as irregular heartbeats, which can be a concern, especially at higher doses. It's important to use this medication as directed by a healthcare provider and report any unusual or severe side effects promptly.

5. Can DOMPERIDONE result in dry mouth?

Yes, dry mouth can be a side effect of domperidone. It's important to stay well-hydrated and report this or any other side effects to your healthcare provider if they become bothersome or severe. Adjustments to the medication or dosing may be considered if necessary.

References:

https://www.drugs.com/domperidone.html https://www.mayoclinic.org/drugs-supplements/domperidone-oral-route/description/drg-20063481
https://www.nhs.uk/medicines/domperidone/#:~:text=Taking%20too%20much%20domperidone%20can,a%20fast%20or%20irregular%20heartbeat.

Disclaimer: The information provided here is not meant to substitute an advice from a healthcare professional. The information is not intended to cover all the possible uses, side-effects, precautions, and drug interactions. This information is not intended to suggest that using a specific drug is suitable, safe, or efficient for you or anyone else. The absence of any information or warning regarding the drug should not be interpreted as an implicit guarantee from the organisation. We strongly advise you to consult a doctor if you have any concerns about the drug and never use the medication without a doctor’s prescription.