Domperidone Tablet Uses

Are you looking for relief from nausea, vomiting, or digestive discomfort? Domperidone is a widely used medication that can help improve digestion and alleviate these symptoms.

In this guide, we’ll explore everything you need to know about Domperidone, including its uses, contraindications, side effects, and drug interactions.

Whether you're considering this medication or want to know more about its safety, this article is your one-stop source for all the essential details.

Keep reading to discover how Domperidone works, who should avoid it, and why understanding its interactions with other medications is crucial.

List of Contents

• What is Domperidone?

• Mode of Action of Domperidone

• Dosage for Domperidone

• Different forms in Which Domperidone is available

• Side Effects of Domperidone

• Contraindications for Domperidone

• Frequently Asked Questions (FAQs) About Domperidone

What is Domperidone?

Domperidone is a medication that helps treat nausea, vomiting, and certain stomach problems, like bloating or feeling too full. It works by improving the movement of food through your stomach and intestines, making digestion smoother. Domperidone also helps prevent the feeling of sickness caused by some medications or health conditions.

It belongs to a group of medicines called dopamine antagonists, which means it blocks a natural substance in the body (dopamine) that can slow down digestion or cause nausea.

Chemical Information:

Chemical Name: 5-chloro-1-{1-[3-(2-oxo-2,3-dihydro-1H-benzimidazol-1-yl)propyl]-4-piperidinyl}-1,3-dihydro-2H-benzimidazol-2-one

Chemical Formula: C22H24ClN5O2

Mode of Action of Domperidone

Domperidone primarily works by blocking dopamine D2 receptors in the gastrointestinal tract and the chemoreceptor trigger zone (CTZ) in the brain. Here's how it provides relief:

Blocking Dopamine Receptors in the Gut:

Dopamine naturally inhibits the movement (motility) of the stomach and intestines. By blocking dopamine D2 receptors in the gastrointestinal tract, domperidone promotes the coordinated movement of food through the stomach and intestines. This helps alleviate symptoms like bloating, fullness, and delayed gastric emptying.

Acting on the Chemoreceptor Trigger Zone (CTZ):

The CTZ is an area in the brain responsible for triggering nausea and vomiting. Domperidone blocks dopamine receptors in this zone, reducing the feeling of nausea and preventing vomiting. Importantly, since it does not cross the blood-brain barrier easily, it has fewer central nervous system side effects compared to some other dopamine antagonists.

Prokinetic Effect:

By increasing the motility of the upper gastrointestinal tract, domperidone ensures quicker passage of food from the stomach to the intestines, relieving symptoms like indigestion and discomfort.

How It Relieves Symptoms

Nausea and Vomiting: Domperidone stops the signals that trigger nausea and vomiting by blocking dopamine receptors in the CTZ.

Bloating and Fullness: Enhances the movement of food through the stomach, reducing the feeling of being too full or bloated.

Improved Digestion: Facilitates gastric emptying, especially in conditions like gastroparesis (delayed stomach emptying), ensuring smoother digestion.

Uses of Domperidone

Domperidone is widely used to manage various conditions related to gastrointestinal discomfort and nausea. Below is a detailed explanation of its uses

Treatment of Nausea and Vomiting

Effective for nausea and vomiting caused by various factors, including:

o Gastrointestinal disorders (e.g., gastritis, food poisoning)

o Medications like chemotherapy drugs, opioids, or NSAIDs

o Motion sickness (though less commonly used for this)

How it Helps: Blocks dopamine receptors in the chemoreceptor trigger zone (CTZ) of the brain, reducing the vomiting reflex.

Relief of Dyspepsia (Indigestion)

Used in patients with symptoms of indigestion, including bloating, early satiety (feeling full quickly), or upper abdominal discomfort.

How it Helps: Enhances the motility of the stomach and improves the passage of food into the intestines, reducing discomfort.

Treatment of Gastroparesis

Effective in managing delayed gastric emptying, often seen in conditions like:

o Diabetic gastroparesis

o Idiopathic gastroparesis (when no specific cause is identified)

How it Helps: Stimulates stomach contractions and promotes the faster movement of food through the digestive tract.

Management of Reflux Disorders (GERD)

Used as an adjunctive treatment in gastroesophageal reflux disease (GERD) when conventional therapies like proton pump inhibitors (PPIs) are insufficient.

How it Helps: By improving gastric motility, domperidone reduces the backward flow of stomach contents into the esophagus, alleviating symptoms like heartburn.

Preventing Nausea Associated with Parkinson’s Disease

Helps counteract nausea caused by dopamine agonists and levodopa, which are commonly used in Parkinson’s treatment.

How it Helps: Blocks peripheral dopamine receptors without crossing the blood-brain barrier, ensuring it does not interfere with Parkinson’s medications.

6. Post-Surgical Gastric Symptoms

Used after certain abdominal surgeries to reduce nausea, vomiting, and sluggish gastric motility.

How it Helps: Enhances the movement of the digestive tract, aiding recovery and preventing discomfort.

Lactation Support (Off-label Use)

Sometimes prescribed to increase milk production in breastfeeding mothers with low supply.

How it Helps: Domperidone indirectly increases prolactin levels (a hormone essential for milk production) by blocking dopamine receptors in the pituitary gland.

Irritable Bowel Syndrome (IBS)

May help alleviate symptoms of bloating and discomfort in IBS patients.

How it Helps: By improving gastric motility, domperidone can relieve symptoms of delayed gastric emptying or functional dyspepsia often associated with IBS.

Key Notes:

Domperidone is generally considered safe but should be used under a doctor’s supervision, especially in individuals with underlying heart conditions due to a potential risk of arrhythmias.

It is available in various forms, including tablets, suspensions, and suppositories, making it versatile for different patient needs.

Dosage for Domperidone

The dosage of Domperidone depends on the condition being treated, the patient's age, and the severity of symptoms. Below is a detailed breakdown:

1. General Dosage Guidelines for Adults

Nausea and Vomiting:

o Typical Dose: 10 mg taken 3 times a day.

o Maximum Daily Dose: 30 mg.

o Duration: Short-term use, generally not exceeding one week unless otherwise advised by a doctor.

Chronic Dyspepsia (Indigestion) and Gastroparesis:

o Initial Dose: 10 mg taken 3 times a day, 15–30 minutes before meals.

o Maximum Daily Dose: 30 mg.

o Duration: Can be extended under medical supervision for long-term management.

Reflux Disorders (GERD):

o Dose: 10 mg taken 3 times a day before meals.

o Duration: As prescribed, usually in combination with antacids or proton pump inhibitors.

2. Pediatric Dosage (For Children Under 12 Years or Below 35 kg)

Dosage Based on Weight:

o Typical Dose: 0.25–0.5 mg/kg body weight per dose.

o Frequency: 3 times a day, 15–30 minutes before meals.

o Maximum Daily Dose: Should not exceed 2.4 mg/kg or 35 mg per day, whichever is lower.

Forms: Often administered as a liquid suspension for easier dosing in children.

3. Special Uses

Nausea from Chemotherapy or Parkinson’s Medications:

o Adults: 10 mg taken 3–4 times a day.

o Duration: As long as nausea persists, under strict medical supervision.

Lactation Support (Off-Label Use):

o Initial Dose: 10 mg taken 3 times a day.

o Escalated Dose (if needed): Can be increased to 20 mg taken 3 times a day.

o Duration: Typically 2–4 weeks, reassessed periodically by a healthcare provider.

4. Special Populations

Elderly:

o Start with the lowest effective dose to reduce the risk of cardiac side effects.

o Monitor for QT prolongation or arrhythmias.

Patients with Kidney Impairment:

o Mild to Moderate Impairment: Reduce frequency to 1–2 times a day.

o Severe Impairment: Use with caution; dosage adjustment is necessary.

Patients with Liver Impairment:

o Domperidone is not recommended for patients with moderate to severe liver impairment.

5. Administration Tips

Timing: Always take domperidone 15–30 minutes before meals for optimal effectiveness.

Forms Available: Tablets, suspensions, and suppositories. Use liquid forms for children or patients with swallowing difficulties.

Maximum Doses to Avoid

For Adults: Do not exceed 30 mg/day (e.g., 10 mg three times daily).

For Children: Maximum dose depends on body weight but should not exceed 35 mg/day.

Precautions with Dosage

Avoid Overdose: Higher doses increase the risk of serious side effects, especially cardiac arrhythmias (QT prolongation).

Duration of Use: Domperidone is typically used for short-term treatment, unless a doctor advises otherwise.

Drug Interactions: Avoid combining with other medications that prolong the QT interval (e.g., certain antibiotics, antifungals, or antidepressants).

When to Consult a Doctor

• If symptoms persist beyond the prescribed treatment period.

• If side effects like dizziness, irregular heartbeat, or severe abdominal pain occur.

• For adjustments in cases of kidney, liver, or heart conditions.

Different forms in Which Domperidome is available

Domperidone is available in various forms to suit different patient needs and preferences. Here's an overview of the common forms:

Tablets

• Strengths Available: 10 mg and 20 mg (depending on region and manufacturer).

• Use: Commonly prescribed for adults to manage nausea, vomiting, and gastric motility disorders.

• How to Take: Swallowed whole with water, usually 15–30 minutes before meals.

Oral Suspension (Liquid Form)

• Strengths Available: Typically 1 mg/mL or 5 mg/mL.

• Use: Preferred for children, elderly patients, or those who have difficulty swallowing tablets.

• Administration: Measured using a dosing spoon or syringe to ensure accuracy.

Suppositories

• Strengths Available: Often 30 mg per suppository.

• Use: For patients who are vomiting and cannot take oral medication.

• Administration: Inserted rectally; used in situations like severe nausea or post-surgery.

Orodispersible Tablets (ODT)

• Strengths Available: Usually 10 mg.

• Use: Convenient for patients who have difficulty swallowing or when water is unavailable.

• How to Take: Placed on the tongue to dissolve, swallowed with or without water.

Injectable Form

• Strengths Available: Rarely used, typically available as a hospital-only preparation.

• Use: Administered intravenously or intramuscularly for acute conditions.

• Notes: This form is uncommon due to potential risks of cardiac side effects.

Powder for Suspension

• Strengths Available: Comes in sachets or bottles with powder to be mixed with water.

• Use: Similar to oral suspension, used for patients who prefer liquid medications.

• Preparation: Mixed with the recommended amount of water before use.

Combination Preparations

• Domperidone is occasionally combined with other drugs, such as:

o Pantoprazole or Esomeprazole: For GERD or acid-related disorders.

o Paracetamol: For nausea associated with mild pain or fever.

How to Choose the Right Form

• Tablets or Orodispersible Tablets: Suitable for most adults.

• Oral Suspension: Best for children or elderly individuals with swallowing issues.

• Suppositories: Ideal when vomiting prevents oral intake.

• Injectable Form: Reserved for hospital use in emergencies.

Each form is designed to provide flexibility and effectiveness depending on the patient's condition and preferences. Always follow your healthcare provider's recommendation for the appropriate form and dosage.

Side Effects of Domperidone

Domperidone is generally well-tolerated, but like any medication, it can cause side effects in some individuals. These range from common and mild to rare and more serious. Below is a detailed breakdown:

Common Side Effects

These are usually mild and temporary:

• Dry Mouth: A common effect that may cause discomfort or increased thirst.

• Abdominal Cramps or Discomfort: Can occur due to increased gastric motility.

• Drowsiness or Fatigue: Rare but possible in some users.

• Headache: Mild headaches may occur, often improving with continued use.

• Diarrhea: May result from increased gastrointestinal movement.

Uncommon Side Effects

These may require medical advice if they persist:

• Skin Reactions: Rash, itching, or redness (allergic reactions).

• Increased Prolactin Levels: Domperidone can increase prolactin (a hormone) levels, leading to:

o Breast tenderness or swelling (in both men and women).

o Galactorrhea (unexpected breast milk production).

o Menstrual irregularities in women.

o Gynecomastia (breast enlargement in men).

• Dizziness or Lightheadedness: Especially when standing up quickly, due to mild changes in blood pressure.

Rare but Serious Side Effects

These side effects are less common but require immediate medical attention:

• Cardiac Effects:

o Prolonged QT interval on an ECG (a measure of heart rhythm).

o Arrhythmias (irregular heartbeat) or palpitations.

o Increased risk of sudden cardiac death, especially in:

*Patients over 60 years of age.

*Those taking high doses (>30 mg/day).

*Those with pre-existing heart conditions.

Caution: Avoid combining with drugs that also prolong the QT interval (e.g., certain antibiotics or antifungals).

• Severe Allergic Reactions:

o Symptoms may include swelling of the face, lips, tongue, or throat, difficulty breathing, or hives.

o Immediate medical intervention is necessary.

• Neurological Effects:

o Extrapyramidal symptoms (involuntary muscle movements or tremors), particularly in children.

o Restlessness or agitation (very rare).

Side Effects in Special Populations

• Children:

o More prone to extrapyramidal symptoms, especially with higher doses.

o Monitor for abnormal movements or muscle stiffness.

Elderly:

o Increased risk of cardiac side effects, especially with pre-existing heart disease or when combined with other medications.

Pregnant or Breastfeeding Women:

o Not usually recommended during pregnancy unless deemed necessary.

o Can increase prolactin levels, which may affect lactation.

Risk Factors for Side Effects

• High Doses: Doses exceeding 30 mg/day are more likely to cause cardiac or neurological side effects.

• Drug Interactions: Combining domperidone with certain medications (e.g., antifungals, macrolide antibiotics, or antidepressants) can increase the risk of QT prolongation.

• Pre-existing Conditions: Patients with heart disease, electrolyte imbalances, or kidney or liver dysfunction are at higher risk for complications.

When to Seek Medical Attention

• For Mild Side Effects: If symptoms like dry mouth or headache persist or worsen.

• For Severe Reactions:

o Signs of cardiac problems (e.g., chest pain, dizziness, fainting).

o Allergic reactions (e.g., swelling, difficulty breathing).

o Uncontrolled muscle movements or tremors.

Minimizing Side Effects of Domperidome

• Follow the Prescribed Dose: Avoid exceeding 30 mg/day unless advised by a doctor.

• Avoid Drug Interactions: Inform your doctor of all medications you are taking.

• Regular Monitoring: For long-term use, monitor cardiac health and prolactin levels.

• Adjust for Special Populations: Lower doses may be needed for children, elderly patients, or those with kidney or liver issues.

By understanding the potential side effects and risk factors, patients and healthcare providers can ensure the safe and effective use of domperidone.

Contraindications for Domperidone

Domperidone should not be used in certain situations due to the risk of serious side effects or ineffectiveness. Below is a detailed list of contraindications:

1.Absolute Contraindications

These are conditions where domperidone should never be used:

1.1. Cardiac Disorders

• Prolonged QT Interval: Patients with a known or suspected prolonged QT interval (a heart rhythm condition seen on an ECG).

• Severe Heart Disease: Including congestive heart failure or significant arrhythmias.

• History of Sudden Cardiac Death: A family or personal history of heart rhythm abnormalities or cardiac arrest.

• Bradycardia (Slow Heart Rate): Defined as less than 60 beats per minute, which may increase the risk of arrhythmias.

• Electrolyte Imbalance: Conditions such as:

o Hypokalemia (low potassium levels).

o Hypomagnesemia (low magnesium levels).

o Hyperkalemia (high potassium levels).

1.2. Severe Liver Disease

• Domperidone is extensively metabolized in the liver. Patients with moderate to severe hepatic impairment (e.g., cirrhosis) are at higher risk for toxicity.

1.3. Gastrointestinal Obstruction or Perforation

• Conditions like:

o Intestinal obstruction.

o Gastric perforation.

o Gastrointestinal hemorrhage.

• These conditions require different management, and domperidone can worsen symptoms.

1.4. Prolactin-Releasing Tumors

• Prolactinomas: Domperidone increases prolactin levels, which may exacerbate symptoms in patients with prolactin-secreting pituitary tumors.

1.5. Hypersensitivity or Allergy to Domperidone

• Known allergy to domperidone or any of its excipients (inactive ingredients).

2. Relative Contraindications

Domperidone may be used cautiously under close medical supervision in these cases:

2.1. Renal Impairment

• In severe kidney disease, domperidone clearance is reduced, leading to drug accumulation and an increased risk of side effects.

• Dose Adjustment: Reduced frequency (e.g., once or twice daily instead of three times) is recommended.

2.2. Elderly Patients

• Elderly individuals, especially those with pre-existing heart conditions, are at increased risk for cardiac side effects (e.g., arrhythmias, QT prolongation).

2.3. Pregnancy and Breastfeeding

• Pregnancy: Domperidone is not typically recommended unless the benefits outweigh the risks, as there is limited safety data in pregnant women.

• Breastfeeding: Small amounts of domperidone are excreted in breast milk. It should only be used if essential, and infant monitoring is advised.

2.4. Concurrent Use of QT-Prolonging Drugs

o Macrolide antibiotics (e.g., erythromycin, clarithromycin).

o Antifungals (e.g., ketoconazole, itraconazole).

o Antidepressants (e.g., citalopram, fluoxetine).

• These combinations increase the risk of arrhythmias and cardiac events.

3. Drug Interactions Leading to Contraindications

Certain medications should not be used with domperidone due to increased risks:

• Potent CYP3A4 Inhibitors: Drugs that inhibit the enzyme responsible for metabolizing domperidone, such as:

o Ketoconazole.

o Itraconazole.

o Ritonavir (used in HIV therapy).

o Verapamil and diltiazem (calcium channel blockers).

• Other QT-Prolonging Drugs: As listed above.

4. Special Populations Contraindications

• Neonates and Infants: Domperidone should not be used in neonates due to an immature blood-brain barrier and increased risk of extrapyramidal symptoms (e.g., muscle stiffness, tremors).

• Children Under 12 or Below 35 kg: Only used if the benefit outweighs the risk and with weight-based dosing.

When to Avoid Domperidone

Always consult a healthcare professional if you have any pre-existing medical conditions or are taking other medications. Close monitoring or alternative treatments may be required in certain cases.

Important Tips for Taking Domperidone

To ensure the safe and effective use of domperidone, follow these essential tips:

Take Domperidone as Prescribed

• Dosage: Always follow the dosage and timing prescribed by your healthcare provider. Avoid self-adjusting the dose.

• Duration: Do not exceed the recommended treatment period (usually 7–14 days) unless advised by a doctor.

• Frequency: Most commonly taken 3 times a day before meals.

Timing of Dose

• Before Meals: Take domperidone 15–30 minutes before meals for optimal effectiveness.

• Nighttime Dosing: If prescribed for nighttime symptoms (e.g., GERD), take it before bed.

Avoid Certain Medications

• Inform your doctor about all other medications you are taking, especially:

o QT-Prolonging Drugs: Such as some antibiotics, antifungals, and antidepressants.

o CYP3A4 Inhibitors: Drugs like ketoconazole or ritonavir, which can increase domperidone levels and risks.

Monitor for Side Effects

• Common Effects: Dry mouth, headache, or mild abdominal discomfort may occur but are usually temporary.

• Serious Effects: Watch for irregular heartbeats, fainting, or severe dizziness. Seek medical attention immediately if these occur.

Special Populations

• Children: Use weight-based dosing; measure liquid suspension carefully.

• Elderly: Start with the lowest effective dose to minimize the risk of heart-related side effects.

• Pregnant or Breastfeeding Women: Use only if prescribed, and inform your doctor if you are pregnant, planning to conceive, or breastfeeding.

Avoid Overdose

• Do not take more than the maximum daily dose (30 mg/day for adults) to reduce the risk of side effects like arrhythmias or QT prolongation.

Be Cautious with Underlying Conditions

• Heart Conditions: Avoid if you have a history of arrhythmias, prolonged QT interval, or heart disease.

• Liver or Kidney Issues: Domperidone clearance may be reduced; discuss dose adjustments with your doctor

Avoid Grapefruit and Alcohol

• Grapefruit Juice: May interact with domperidone and increase side effects by interfering with its metabolism.

• Alcohol: Can exacerbate dizziness or other side effects.

Store Properly

• Tablets: Keep in a cool, dry place away from direct sunlight.

• Liquid Suspension: Shake well before use and store according to the label (e.g., some require refrigeration).

Follow Up with Your Doctor

• If symptoms persist or worsen despite taking domperidone, consult your doctor.

• Regularly monitor your heart health if domperidone is used for an extended period or if you have risk factors for cardiac side effects.

Key Safety Reminders

• Do not use domperidone if you have a history of severe liver disease, gastrointestinal obstruction, or known hypersensitivity to the drug.

• Stop taking the medication and seek medical help if you experience allergic reactions, severe abdominal pain, or chest discomfort.

By following these tips, you can use domperidone safely and effectively while minimizing the risk of side effects.

Frequently Asked Questions (FAQs) About Domperidone

1. What is Domperidone used for?

Domperidone is commonly used to treat nausea, vomiting, indigestion, and bloating. It helps improve the movement of food through the stomach and intestines.

2. What forms of Domperidone are available?

Domperidone is available in various forms, including:

Tablets

Oral suspension (liquid)

Dispersible tablets

Capsules

Suppositories

Oral drops

3. Can I buy Domperidone without a prescription?

In many countries, Domperidone is a prescription-only medication. Always consult a doctor before using Domperidone to ensure safe and appropriate use.

4. What are the common brand names of Domperidone?

Some popular brand names include:

Domstal (Torrent Pharmaceuticals)

Motilium (Johnson & Johnson)

Dompro (Adley Formulations)

Domiron (Acron Pharmaceuticals)

5. What is the typical dosage for Domperidone?

The usual adult dosage is one 10 mg tablet taken 2-3 times daily before meals. However, the dosage may vary based on the individual’s condition. Always follow your doctor’s instructions.

6. Are there any side effects of Domperidone?

Yes, some common side effects include:

Dry mouth

Stomach cramps

Drowsiness

Rare but serious side effects, like irregular heartbeat, require immediate medical attention.

7. Can children use Domperidone?

Yes, Domperidone is available in liquid or drop form for children. However, it should only be given under the supervision of a doctor.

8. Can pregnant or breastfeeding women take Domperidone?

Pregnant or breastfeeding women should consult their doctor before taking Domperidone, as its safety in these conditions is not fully established.

9. How much does Domperidone cost?

The price of Domperidone varies by brand and location. For example:

Domstal (Torrent Pharmaceuticals) costs approximately ₹50-₹100 per strip.

Motilium (Johnson & Johnson) is slightly more expensive.

Check with your local pharmacy for accurate pricing.

10. Who should not take Domperidone?

Domperidone is not suitable for individuals with:

A history of heart conditions

Allergies to its ingredients

Severe liver issues

Always inform your doctor about your medical history before taking Domperidone.

11. Can I take Domperidone with other medications?

Domperidone may interact with certain medications, such as:

Antifungals (e.g., Ketoconazole)

Antibiotics (e.g., Erythromycin)

Inform your doctor about all medications you are taking to avoid interactions.

12. How should Domperidone be stored?

Keep Domperidone in a cool, dry place away from direct sunlight.

Store it out of reach of children.

Do not use it after the expiration date mentioned on the packaging.

If you have further questions about Domperidone, consult your doctor or pharmacist for personalized advice.

References

1. Brunton, L., Hilal-Dandan, R., & Knollmann, B. (2018). Goodman & Gilman's: The Pharmacological Basis of Therapeutics (13th ed.). This authoritative resource explains the mechanisms of dopamine antagonists, including domperidone.

2. Sharma, S., & Gupta, P. (2016). Prokinetics and Their Role in Gastrointestinal Disorders. World Journal of Gastroenterology, 22(33), 7547–7560. This article discusses the prokinetic effects and clinical uses of drugs like domperidone.

3. Domperidone: Mechanism of Action and Uses in Gastroparesis. (2020). MedlinePlus Drug Information. Available at MedlinePlus.gov.