Domperidone: Dosage, Side Effects, Brands & Clinical Use | MedexInfo

Domperidone

Rx

Generic NameDomperidone

Therapeutic ClassDopamine D₂ Receptor Antagonist

Max / 24h80 mg

Common Dose10 mg

PregnancyUse if Benefit Outweighs Risk

Indications ▼

Nausea and vomiting

Gastroparesis (diabetic or functional)

Gastroesophageal reflux symptoms

Functional dyspepsia

Adjunct therapy with proton pump inhibitors

Mechanism & Pharmacokinetics ▼

Mechanism: Domperidone selectively blocks peripheral dopamine D₂ receptors in the gastrointestinal tract. This enhances gastric motility, increases lower esophageal sphincter tone, and accelerates gastric emptying. It also acts on the chemoreceptor trigger zone outside the blood–brain barrier, producing antiemetic effects.

Pharmacokinetics: Oral bioavailability is low (~15%) due to first-pass metabolism. Peak plasma concentration occurs within 30–60 minutes. Highly protein bound. Metabolized mainly in the liver via CYP3A4. Elimination half-life is approximately 7–9 hours. Excreted primarily in feces and urine.

Dosage & Administration ▼

Patient Group	Recommended Dose	Frequency
Adults	10 mg	3 times daily before meals
Maximum Dose	30 mg/day	Do not exceed
Children	As prescribed by physician	Weight based

Side Effects ▼

Dry mouth

Abdominal cramps

Headache

Diarrhea

Hyperprolactinemia (galactorrhea, gynecomastia)

Rare: QT prolongation, cardiac arrhythmia

Contraindications ▼

Known cardiac conduction disorders

Prolonged QT interval

Moderate to severe hepatic impairment

Concomitant use with QT-prolonging drugs

Hypersensitivity to domperidone

Drug Interaction ▼

Ketoconazole, erythromycin: increase plasma domperidone level

Strong CYP3A4 inhibitors increase cardiac risk

Anticholinergics may reduce prokinetic effect

QT-prolonging agents increase arrhythmia risk

Pregnancy & Lactation ▼

Use only if potential benefit justifies risk

Small amounts excreted in breast milk

Breastfeeding use requires medical supervision

Clinical / Research Summary ▼

Therapeutic Role: Domperidone is a peripheral dopamine D2 receptor antagonist used primarily as a prokinetic and antiemetic agent to enhance gastrointestinal motility.

Mechanism-Based Evidence: By blocking dopamine receptors in the gastrointestinal tract, domperidone increases esophageal peristalsis, improves gastric emptying, and enhances lower esophageal sphincter tone.

Clinical Effectiveness: Clinical trials demonstrate benefit in functional dyspepsia, gastroparesis, reflux-related nausea, and medication-induced nausea and vomiting.

Central Nervous System Safety: Unlike metoclopramide, domperidone poorly crosses the blood–brain barrier, resulting in a lower incidence of extrapyramidal side effects.

Cardiac Safety Findings: Research has identified dose-related QT interval prolongation and increased risk of ventricular arrhythmia, particularly at doses above 30 mg/day.

Regulatory Considerations: Several regulatory agencies recommend using the lowest effective dose for the shortest duration, especially in elderly patients.

Use in Combination Therapy: Frequently prescribed with proton pump inhibitors to improve gastric emptying and reduce reflux symptoms.

Current Research Direction: Ongoing studies are evaluating safer dosing strategies and patient selection to minimize cardiovascular risk.

Patient Counseling Points ▼

Take domperidone 15–30 minutes before meals for best effect on gastric motility.

Do not exceed the prescribed dose or duration without medical advice.

Avoid using together with medicines that affect heart rhythm unless advised by a physician.

Inform your doctor if you have a history of heart disease, irregular heartbeat, or electrolyte imbalance.

Stop the medicine and seek medical attention if you feel palpitations, dizziness, fainting, or chest discomfort.

Do not use long term without follow-up, especially in elderly patients.

May increase prolactin levels; report breast tenderness, milk discharge, or menstrual irregularities.

Keep dose spacing if taken with antacids or PPIs as advised by your healthcare provider.

Storage & Handling ▼

Store below 30°C

Protect from moisture and light

Keep out of reach of children

Brand Names (Bangladesh & Global) ▼

Bangladesh (Local Brands):

Motilium Domperid Domidon Domperone Domstal

Global / International Brands:

Motilium Domperix Peridys Domperone

Medical Disclaimer: This information is intended for educational purposes only and must not replace professional medical advice.

Reference Hubs:

• Drug Class: Prokinetic Agents • Conditions: Nausea & Vomiting • Pathway: Dopamine D₂ Blockade