1. Dyspeptic symptom complex: Often associated with delayed gastric emptying, gastroesophageal reflux and esophagitis. epigastric sense of fullness, feeling of abdominal distension, upper abdominal pain, eructation, early satiety, heartburn with or without regurgitations of gastric contents in the mouth, diabetic gastroparesis, non ulcer dyspepsia. 2. Nausea & vomiting: Acute nausea & vomiting of functional, organic, infectious, dietetic origin or induced by radiotherapy or drug therapy or induced in migraine. 3. Parkinson’s disease: In dopamine-agonist induced nausea and vomiting. 4. Radiological studies: Speading barium transit in follow through radiological studies.
Domperidone is a dopamine antagonist that principally blocks the dopamine receptors located in the ChemoreceptorTrigger Zone (CTZ) and stomach. Its gastroprokinetic action is based on its blocking effect of dopamine receptors that have an influence on the motility of the gastrointestinal tract. Due to its weak penetration across the blood-brain barrier, Domperidone has almost no effect on the dopaminergic receptors in the brain, therefore, excluding psychotropic and neurologic side effects. Domperidone restores normal motility and tone of the upper gastrointestinal tract, facilitates gastric emptying, enhances antral and duodenal peristalsis and regulates contraction of the pylorus. Domperidone also increases esophageal peristalsis and lower esophageal sphincter pressure, and thus prevents regurgitation of gastric content.
1-2 tablet or 10-20 ml suspension every 6-8 hours daily before meals. Children: 2 ml-4 ml suspension/10 kg or 0.4 ml-0.8 ml Paed. drops/ 10 kg 6-8 hours daily.
Concomitant administration of anticholinergic drugs may antagonise the antidyspeptic effect of domperidone: Antacids and antisecretory drugs should not be given simultaneously with domperidone as they lower its oral bioavailability. The main metabolic pathway of domperidone is through CYP3A4. In vitro data suggest that the concomitant use of drugs that significantly inhibit this enzyme may result in increased plasma levels of domperidone. Examples of CYP3A4 inhibitors include: azole antifungals, macrolide antibiotics. HIV protease inhibitors, nefazodone, etc. Theoretically, since domperidone has gastro-kinetic effects it could influence the absorption of concomitantly orally administered drugs, particularly those with sustained release or enteric coated formulations. However, in patients already stabilised on digoxin or paracetamol, concomitant administration of domperidone did not influence the blood levels of these drugs.
neuroleptics, the action of which it does not potentiate,
dopaminergic agonists (bromocriptine, L-dopa), whose unwanted peripheral effects such as digestive disorders, nausea and vomiting it suppresses without counteracting their central properties.
Known hypersensitivity, gastro-intestinal stimulation, gastro-intestinal hemorrhage, mechanical obstruction or perforation, prolactinoma, increased risk of extra-pyramidal reactions, should be used with caution in patient with hepatic impairment.
Hyperprolactinemia, galactorrhea, breast enlargement, & soreness & reduced libido. Dry mouth, thirst, headache, nervousness, drowsiness, diarrhea, skin rash & itching.
Not recommended during pregnancy. It is secreted in breast milk but in very small quantities insufficient to be considered harmful.
Symptoms of overdosage may include drowsiness, disorientation and extrapyramidal reactions, especially in children. In case of overdosage, the administration of activated charcoal, and close observation of the patients are recommended. Anticholinergic, antiparkinson drugs or antihistamines with anticholinergic properties may be helpful in controlling the extrapyramidal reactions.
Store below 30°C, Protected from light & moisture. Keep out of children's reach.
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