Product Description

Domperidone Tablets IP 10 mg is an oral dopamine D2 receptor antagonist used as an antiemetic and prokinetic agent to treat nausea, vomiting, and gastrointestinal motility disorders. It primarily acts peripherally (limited blood-brain barrier penetration), blocking dopamine receptors in the chemoreceptor trigger zone (CTZ) of the medulla and the upper GI tract.

This relieves nausea/vomiting and enhances gastric emptying without significant central nervous system effects. Domperidone is indicated for short-term use in conditions like gastroparesis (delayed stomach emptying) and functional dyspepsia. It is not a cure but provides symptomatic relief; prolonged use is discouraged due to cardiac risks (e.g., QT prolongation).

Uses

• Relief of acute nausea and vomiting from various causes (e.g., chemotherapy, radiotherapy, post-operative, or viral gastroenteritis)

• Treatment of gastroparesis (delayed gastric emptying) in adults and children >12 years

• Management of functional dyspepsia (indigestion with bloating, fullness, or epigastric pain)

• Adjunctive therapy for reflux esophagitis or medication-induced nausea (e.g., from NSAIDs or levodopa)

• Not indicated for motion sickness (antihistamines preferred), chronic use, or in patients with mechanical GI obstruction
  

How it works

Domperidone acts as a selective peripheral dopamine D2 receptor antagonist:

• Antiemetic effect: Blocks D2 receptors in the CTZ (area postrema in the brain), preventing dopamine-mediated activation of the vomiting center. This inhibits emetic signals from the GI tract or vestibular system.

• Prokinetic effect: Antagonizes inhibitory D2 receptors on cholinergic neurons in the upper GI tract, increasing acetylcholine release. This enhances gastric motility, accelerates emptying, and strengthens lower esophageal sphincter tone, reducing reflux and bloating.

• Unlike metoclopramide, it has minimal central penetration, reducing extrapyramidal side effects. Onset: 15–30 minutes orally; duration: 4–6 hours.

Hyperprolactinemia (elevated prolactin) occurs as a side effect due to D2 blockade in the pituitary but is not part of the therapeutic mechanism.

Benefits

• Rapidly relieves nausea/vomiting, improving comfort and reducing dehydration risk in acute settings.

• Enhances GI motility in gastroparesis/dyspepsia, alleviating symptoms like bloating, early satiety, and postprandial discomfort.

• Improves quality of life in patients with delayed gastric emptying (e.g., diabetic gastroparesis) by promoting faster food transit and better nutrient absorption.

• Short-term use (≤7 days) minimizes risks while providing effective symptom control without sedation (unlike some antiemetics).

• Useful in specific populations (e.g., Parkinson's patients on levodopa) where nausea limits therapy adherence.

How to use

Domperidone tablets should be swallowed whole with water, ideally 15 to 30 minutes before a meal, as this improves absorption. For adults and adolescents 12 years and older (weighing 35 kg or more): The usual dose is one 10 mg tablet, taken up to three times per day. To use Domperidone 10 mg tablets safely and effectively, follow your doctor's instructions carefully.

Side Effects

Common side effects (usually mild and dose-related):

• Gastrointestinal: Dry mouth, diarrhea, abdominal cramps

• Neurological: Headache, dizziness, anxiety

Less common but notable (due to hyperprolactinemia):

• In women: Galactorrhea (milk discharge), menstrual irregularities, breast tenderness

• In men: Gynecomastia (breast enlargement), reduced libido

Safety Advice

• Use the lowest effective dose for the shortest duration (typically ≤7 days) to minimize QT prolongation and sudden cardiac death risk (black box warning in some regions).

• Contraindicated in: Known QT prolongation, ventricular arrhythmias, severe cardiac disease (e.g., heart failure), GI hemorrhage/perforation/obstruction, prolactinoma, or hypersensitivity. Avoid in moderate-severe hepatic impairment (Child-Pugh B/C).

• Caution in: Elderly (>60 years), renal impairment (reduce dose), hypokalemia/magnesemia, or concurrent use with QT-prolonging drugs. Not recommended in pregnancy (Category B—use if benefits outweigh risks) or breastfeeding (passes into milk; avoid).

• Interactions: Potentiates QT risk with CYP3A4 inhibitors (e.g., ketoconazole, erythromycin—contraindicated), antifungals, antidepressants (e.g., SSRIs), or antiarrhythmics. Avoid with apomorphine or levodopa (enhanced effects). Inform the doctor of all medications.

• Lifestyle: Avoid alcohol (may worsen dizziness); monitor for dehydration if vomiting persists. Not for self-medication—requires prescription due to cardiac concerns. Regular ECG monitoring in long-term/at-risk patients.

Storage Conditions

Store at a temperature below 86°F (30 °C). Protect from light and moisture.

FAQs

When should Domperidone be taken?

For most gastrointestinal conditions, it is best to take Domperidone 15–30 minutes before a meal to maximize its effect on digestion. It is typically taken up to three times a day, with doses spaced at least 8 hours apart.

Is Domperidone safe for children?

Domperidone tablets are generally not recommended for children under 12 years of age or weighing less than 35 kg. This is due to a lack of efficacy and safety data in this population. Specialist doctors might occasionally prescribe it for younger children off-label for specific conditions, but with careful monitoring.

How is Domperidone different from Metoclopramide?

Both are antiemetic (anti-nausea) and prokinetic drugs, but they work differently and have different side-effect profiles.

Domperidone has minimal penetration of the blood-brain barrier, resulting in a lower risk of central nervous system (CNS) side effects like drowsiness or involuntary muscle movements.

Metoclopramide crosses the blood-brain barrier more easily and is associated with a higher incidence of CNS side effects.

Can Domperidone be used for acid reflux?

Yes, Domperidone can help relieve symptoms associated with acid reflux, such as heartburn, especially when related to delayed gastric emptying. In some cases, it is used in combination with antacids like proton pump inhibitors for more comprehensive relief.

Can Domperidone be taken long-term?

It is recommended to use the lowest effective dose for the shortest possible duration, typically not exceeding seven days for nausea and vomiting. Long-term use or high doses of domperidone are associated with an increased risk of serious heart rhythm abnormalities.

Is it safe to consume alcohol with Domperidone?

No, it is not recommended to drink alcohol while taking Domperidone. Alcohol can increase the risk of side effects such as dizziness and drowsiness and may also increase stomach acid production, counteracting the drug's effects.

What are the storage conditions for Domperidone?

Domperidone tablets should be stored in a tightly sealed container at room temperature. They should be kept away from excessive heat, moisture, and direct sunlight, and stored out of the reach of children.