View source for Domperidone

<p><strong>Domperidone</strong> (trade names <strong>Motilium</strong>, <strong>Motillium,</strong> <strong>Motinorm</strong> and <strong>Costi</strong>) is an antidopaminergic drug, developed by Janssen Pharmaceutica, and used orally, rectally or intravenously, generally to suppress nausea and vomiting. It has also been used to stimulate lactation.</p>
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<h2><span class="mw-headline">Uses</span></h2>
<p>&nbsp;</p>
<h3><span class="mw-headline">Gastrointestinal problems</span></h3>
<p>There is some evidence that domperidone has antiemetic activity.<sup id="cite_ref-pmid519355_1-0" class="reference"><font size="2"><span>[</span>2<span>]</span></font></sup> Domperidone is used, together with metoclopramide, cyclizine, and 5HT<sub><font size="2">3</font></sub> receptor antagonists (such as granisetron) in the treatment of nausea and vomiting.</p>
<p>Domperidone is a first choice anti-emetic in most countries,<sup style="WHITE-SPACE: nowrap" class="noprint Template-Fact" title="This claim needs references to reliable sources from November 2008"><font size="2">[<em>citation needed</em>]</font></sup>. However, it is not approved for prescription in the US. Although it has never been officially approved for use in the United States, domperidone is sometimes purchased from pharmacies in other countries for this purpose.</p>
<p>It can be used in patients with Parkinson's disease<sup id="cite_ref-pmid6529536_2-0" class="reference"><font size="2"><span>[</span>3<span>]</span></font></sup> because, unlike metoclopramide<sup id="cite_ref-Rossi_3-0" class="reference"><font size="2"><span>[</span>4<span>]</span></font></sup>, domperidone does not cross the blood-brain barrier.</p>
<p>Domperidone has also been found effective in the treatment of gastroparesis,<sup id="cite_ref-pmid9663360_4-0" class="reference"><font size="2"><span>[</span>5<span>]</span></font></sup> a stomach motility condition, and for paediatric Gastroesophageal reflux (infant vomiting).</p>
<p>&nbsp;</p>
<h3><span class="mw-headline">Lactation</span></h3>
<p>The hormone prolactin stimulates lactation in humans, and its release is inhibited by the dopamine secreted by the hypothalamus. Domperidone, by acting as an anti-dopaminergic, results in increased prolactin secretion, and thus promotes lactation.</p>
<p>Since, according to the American FDA, domperidone is not approved for enhanced lactation in any country,<sup id="cite_ref-5" class="reference"><font size="2"><span>[</span>6<span>]</span></font></sup> it is sometimes self-prescribed from original research or prescribed &quot;off-label&quot; for this use in countries around the world.<sup id="cite_ref-fda-warn_6-0" class="reference"><font size="2"><span>[</span>7<span>]</span></font></sup></p>
<p><font size="2"></font></p>
<h2><span class="mw-headline">Controversy</span></h2>
<p>Janssen Pharmaceutical has brought domperidone before the FDA several times in the last two decades, with the most recent effort in the 1990s. Numerous U.S. clinical drug trials have demonstrated its safety and efficacy in dealing with gastroparesis symptoms, but the FDA turned down Janssen's application for domperidone, even though the FDA's division of gastrointestinal drugs had approved domperidone.<sup id="cite_ref-7" class="reference"><font size="2"><span>[</span>8<span>]</span></font></sup></p>
<p>In June 2004, the United States' main regulation agency, the Food and Drug Administration (FDA), issued a letter warning women not to take domperidone, citing unknown risks to parents and infants, and warned pharmacies that domestic sale was illegal, and that import shipments from other countries would be searched and seized. Domperidone is excreted in breast milk, and no studies on its effects on breastfeeding infants have been reported in the literature. Individual incidents of problems with the drug include cardiac arrest and arrhythmia, complications with other medications, as well as complications with improper intravenous use<sup id="cite_ref-fda-warn_6-1" class="reference"><font size="2"><span>[</span>7<span>]</span></font></sup>. A recent paper suggests there may be increased risk of seizures to neonates of mothers taking oral domperidone<sup id="cite_ref-8" class="reference"><font size="2"><span>[</span>9<span>]</span></font></sup>.</p>
<p>Some doctors and pharmacists do not fully accept the FDA's reasoning and still favor domperidone's use in increasing milk supply. Such doctors and pharmacists claim the drug is safe in the doses given for this purpose but have no evidential data or studies to base their claim.<sup id="cite_ref-9" class="reference"><font size="2"><span>[</span>10<span>]</span></font></sup> The American Academy of Pediatrics considers domperidone &quot;usually compatible with breastfeeding&quot;.<sup id="cite_ref-10" class="reference"><font size="2"><span>[</span>11<span>]</span></font></sup></p>
<p>There is a new controversy in Britain regarding lethal levels of sodium found in children who are administered this drug. It is now subject to a medical review following a number of criminal trials where parents were charged with child abuse by salt poisoning based on hypernatremia in the affected children.<sup id="cite_ref-11" class="reference"><font size="2"><span>[</span>12<span>]</span></font></sup> Recent studies also cite increased QT intervals in neonates taking Domperidone. <sup id="cite_ref-pmid18589449_12-0" class="reference"><font size="2"><span>[</span>13<span>]</span></font></sup>.</p>
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<h2><span class="mw-headline">Pharmacology</span></h2>
<p>Domperidone blocks the action of dopamine. It has strong affinities for the D<sub><font size="2">2</font></sub> and D<sub><font size="2">3</font></sub> dopamine receptors <sup id="cite_ref-13" class="reference"><font size="2"><span>[</span>14<span>]</span></font></sup>, which are found in the chemoreceptor trigger zone, located just outside the blood brain barrier, which - among others - regulates nausea and vomiting (area postrema on the floor of the fourth ventricle and rhomboid fossa).</p>
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<h2><span class="mw-headline">See also</span></h2>
<ul>
    <li>itopride </li>
    <li>metoclopramide </li>
    <li>benzamide </li>
    <li>cisapride </li>
</ul>
<p>&nbsp;</p>
<h2><span class="mw-headline">Brand</span></h2>
<p>Many brand names and combinations of the drug exist. The combination of domperidone and pantoprazole is marketed as Dompan by Medley Pharmaceuticals. Domperidone is sold as Motinorm by GlaxoSmithKline. In India for Paediatric purpose Domperidone is available as Domperi Suspension(Domperidone 1&nbsp;mg/ml, 30 ml Suspension;Ipca Laboratories Ltd, Mumbai)[1]and Domstal(Torrent Pharmaceuticals Ltd.)[2]</p>
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<h2><span class="mw-headline">References</span></h2>
<div style="-moz-column-count: 2; column-count: 2" class="references-small references-column-count references-column-count-2">
<ol class="references">
    <li id="cite_note-0"><strong><a title="" href="#cite_ref-0"><font size="+0">^</font></a></strong> <a class="external text" title="http://www.medsafe.govt.nz/downloads/MCC34Domperidone.doc" rel="nofollow" href="http://www.medsafe.govt.nz/downloads/MCC34Domperidone.doc"><font size="+0">Domperidone</font></a> MedSafe NZ Government </li>
    <li id="cite_note-pmid519355-1"><strong><a title="" href="#cite_ref-pmid519355_1-0"><font size="+0">^</font></a></strong> <cite style="FONT-STYLE: normal" id="CITEREFSwann_IL.2C_Thompson_EN.2C_Qureshi_K1979">Swann IL, Thompson EN, Qureshi K (November 1979). &quot;<a class="external text" title="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&amp;artid=1597274" rel="nofollow" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&amp;artid=1597274"><font size="+0">Domperidone or metoclopramide in preventing chemotherapeutically induced nausea and vomiting</font></a>&quot;. <em>British medical journal</em> <strong>2</strong> (6199): 1188. <a class="external" title="http://www.ncbi.nlm.nih.gov/pubmed/519355" href="http://www.ncbi.nlm.nih.gov/pubmed/519355"><font size="+0">PMID 519355</font></a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Domperidone+or+metoclopramide+in+preventing+chemotherapeutically+induced+nausea+and+vomiting&amp;rft.jtitle=British+medical+journal&amp;rft.aulast=Swann+IL%2C+Thompson+EN%2C+Qureshi+K&amp;rft.au=Swann+IL%2C+Thompson+EN%2C+Qureshi+K&amp;rft.date=November+1979&amp;rft.volume=2&amp;rft.issue=6199&amp;rft.pages=1188&amp;rft_id=info:pmid/519355&amp;rfr_id=info:sid/en.wikipedia.org:Domperidone"><span style="DISPLAY: none">&nbsp;</span></span> </li>
    <li id="cite_note-pmid6529536-2"><strong><a title="" href="#cite_ref-pmid6529536_2-0"><font size="+0">^</font></a></strong> <cite style="FONT-STYLE: normal" id="CITEREFShindler_JS.2C_Finnerty_GT.2C_Towlson_K.2C_Dolan_AL.2C_Davies_CL.2C_Parkes_JD1984">Shindler JS, Finnerty GT, Towlson K, Dolan AL, Davies CL, Parkes JD (December 1984). &quot;<a class="external text" title="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&amp;artid=1463696" rel="nofollow" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&amp;artid=1463696"><font size="+0">Domperidone and levodopa in Parkinson's disease</font></a>&quot;. <em>British journal of clinical pharmacology</em> <strong>18</strong> (6): 959&ndash;62. <a class="external" title="http://www.ncbi.nlm.nih.gov/pubmed/6529536" href="http://www.ncbi.nlm.nih.gov/pubmed/6529536"><font size="+0">PMID 6529536</font></a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Domperidone+and+levodopa+in+Parkinson%27s+disease&amp;rft.jtitle=British+journal+of+clinical+pharmacology&amp;rft.aulast=Shindler+JS%2C+Finnerty+GT%2C+Towlson+K%2C+Dolan+AL%2C+Davies+CL%2C+Parkes+JD&amp;rft.au=Shindler+JS%2C+Finnerty+GT%2C+Towlson+K%2C+Dolan+AL%2C+Davies+CL%2C+Parkes+JD&amp;rft.date=December+1984&amp;rft.volume=18&amp;rft.issue=6&amp;rft.pages=959%E2%80%9362&amp;rft_id=info:pmid/6529536&amp;rfr_id=info:sid/en.wikipedia.org:Domperidone"><span style="DISPLAY: none">&nbsp;</span></span> </li>
    <li id="cite_note-Rossi-3"><strong><a title="" href="#cite_ref-Rossi_3-0"><font size="+0">^</font></a></strong> Rossi S, editor. <a title="Australian Medicines Handbook" href="/wiki/Australian_Medicines_Handbook"><font size="+0">Australian Medicines Handbook</font></a> 2006. Adelaide: Australian Medicines Handbook; 2006. </li>
    <li id="cite_note-pmid9663360-4"><strong><a title="" href="#cite_ref-pmid9663360_4-0"><font size="+0">^</font></a></strong> <cite style="FONT-STYLE: normal" id="CITEREFSilvers_D.2C_Kipnes_M.2C_Broadstone_V.2C_.27.27et_al..27.271998">Silvers D, Kipnes M, Broadstone V, <em>et al.</em> (1998). &quot;Domperidone in the management of symptoms of diabetic gastroparesis: efficacy, tolerability, and quality-of-life outcomes in a multicenter controlled trial. DOM-USA-5 Study Group&quot;. <em>Clinical therapeutics</em> <strong>20</strong> (3): 438&ndash;53. <a title="Digital object identifier" href="/wiki/Digital_object_identifier"><font size="+0">doi</font></a>:<span class="neverexpand"><a class="external text" title="http://dx.doi.org/10.1016%2FS0149-2918%2898%2980054-4" rel="nofollow" href="http://dx.doi.org/10.1016%2FS0149-2918%2898%2980054-4"><font size="+0">10.1016/S0149-2918(98)80054-4</font></a></span>. <a class="external" title="http://www.ncbi.nlm.nih.gov/pubmed/9663360" href="http://www.ncbi.nlm.nih.gov/pubmed/9663360"><font size="+0">PMID 9663360</font></a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Domperidone+in+the+management+of+symptoms+of+diabetic+gastroparesis%3A+efficacy%2C+tolerability%2C+and+quality-of-life+outcomes+in+a+multicenter+controlled+trial.+DOM-USA-5+Study+Group&amp;rft.jtitle=Clinical+therapeutics&amp;rft.aulast=Silvers+D%2C+Kipnes+M%2C+Broadstone+V%2C+%27%27et+al.%27%27&amp;rft.au=Silvers+D%2C+Kipnes+M%2C+Broadstone+V%2C+%27%27et+al.%27%27&amp;rft.date=1998&amp;rft.volume=20&amp;rft.issue=3&amp;rft.pages=438%E2%80%9353&amp;rft_id=info:doi/10.1016%2FS0149-2918%2898%2980054-4&amp;rft_id=info:pmid/9663360&amp;rfr_id=info:sid/en.wikipedia.org:Domperidone"><span style="DISPLAY: none">&nbsp;</span></span> </li>
    <li id="cite_note-5"><strong><a title="" href="#cite_ref-5"><font size="+0">^</font></a></strong> <a class="external text" title="http://www.cmaj.ca/cgi/content/full/171/7/725" rel="nofollow" href="http://www.cmaj.ca/cgi/content/full/171/7/725"><em><font size="+0">Domperidone for lactating women</font></em></a>, Canadian Medical Association Journal, Orlando P. da Silva and David C. Knoppert. 2004 Sep 28;171(7):725-6. </li>
    <li id="cite_note-fda-warn-6">^ <a title="" href="#cite_ref-fda-warn_6-0"><sup><em><strong><font size="2">a</font></strong></em></sup></a> <a title="" href="#cite_ref-fda-warn_6-1"><sup><em><strong><font size="2">b</font></strong></em></sup></a> <a class="external text" title="http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01292.html" rel="nofollow" href="http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01292.html"><font size="+0">FDA Warns Against Women Using Unapproved Drug, Domperidone, to Increase Milk Production</font></a> <a class="mw-redirect" title="Food and Drug Administration" href="/wiki/Food_and_Drug_Administration"><font size="+0">FDA</font></a> </li>
    <li id="cite_note-7"><strong><a title="" href="#cite_ref-7"><font size="+0">^</font></a></strong> <a class="external text" title="http://digestivedistress.com/pdf/letter_to_fda_final.pdf" rel="nofollow" href="http://digestivedistress.com/pdf/letter_to_fda_final.pdf"><font size="+0">Letter to Consumer Safety Office, FDA</font></a> Gastroparesis and Dysmotilities Association </li>
    <li id="cite_note-8"><strong><a title="" href="#cite_ref-8"><font size="+0">^</font></a></strong> <a class="external text" title="http://www.ncbi.nlm.nih.gov/pubmed/18589449?dopt=Abstract" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/pubmed/18589449?dopt=Abstract"><font size="+0">Journal of Pediatrics 2008</font></a> </li>
    <li id="cite_note-9"><strong><a title="" href="#cite_ref-9"><font size="+0">^</font></a></strong> <a class="external text" title="http://www.breastfeedingonline.com/OfficialDomStatements.shtml" rel="nofollow" href="http://www.breastfeedingonline.com/OfficialDomStatements.shtml"><font size="+0">Official Statements From Prominent Physicians</font></a> breastfeedingonline.com </li>
    <li id="cite_note-10"><strong><a title="" href="#cite_ref-10"><font size="+0">^</font></a></strong> <a class="external text" title="http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776/T6" rel="nofollow" href="http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776/T6"><font size="+0">Maternal Medication Usually Compatible With Breastfeeding</font></a> American Academy of Pediatrics </li>
    <li id="cite_note-11"><strong><a title="" href="#cite_ref-11"><font size="+0">^</font></a></strong> <a class="external text" title="http://news.scotsman.com/topics.cfm?tid=875&amp;id=1746852006" rel="nofollow" href="http://news.scotsman.com/topics.cfm?tid=875&amp;id=1746852006"><font size="+0">Current news coverage of latest trial</font></a> The Scotsman </li>
    <li id="cite_note-pmid18589449-12"><strong><a title="" href="#cite_ref-pmid18589449_12-0"><font size="+0">^</font></a></strong> <cite style="FONT-STYLE: normal" id="CITEREFDjeddi_D.2C_Kongolo_G.2C_Lefaix_C.2C_Mounard_J.2C_L.C3.A9k.C3.A9_A.2008">Djeddi D, Kongolo G, Lefaix C, Mounard J, L&eacute;k&eacute; A. (2008). &quot;Effect of domperidone on QT interval in neonates.&quot;. <em>Journal of Pediatrics</em> <strong>153</strong> (5): 596-598. <a class="external" title="http://www.ncbi.nlm.nih.gov/pubmed/18589449" href="http://www.ncbi.nlm.nih.gov/pubmed/18589449"><font size="+0">PMID 18589449</font></a>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Effect+of+domperidone+on+QT+interval+in+neonates.&amp;rft.jtitle=Journal+of+Pediatrics&amp;rft.aulast=Djeddi+D%2C+Kongolo+G%2C+Lefaix+C%2C+Mounard+J%2C+L%C3%A9k%C3%A9+A.&amp;rft.au=Djeddi+D%2C+Kongolo+G%2C+Lefaix+C%2C+Mounard+J%2C+L%C3%A9k%C3%A9+A.&amp;rft.date=2008&amp;rft.volume=153&amp;rft.issue=5&amp;rft.pages=596-598&amp;rft_id=info:pmid/18589449&amp;rfr_id=info:sid/en.wikipedia.org:Domperidone"><span style="DISPLAY: none">&nbsp;</span></span> </li>
    <li id="cite_note-13"><strong><a title="" href="#cite_ref-13"><font size="+0">^</font></a></strong> <cite style="FONT-STYLE: normal" class="web"><a class="external text" title="http://pdsp.med.unc.edu/pdsp.php" rel="nofollow" href="http://pdsp.med.unc.edu/pdsp.php"><font size="+0">&quot;PDSP Ki Database&quot;</font></a><span class="printonly">. <a class="external free" title="http://pdsp.med.unc.edu/pdsp.php" rel="nofollow" href="http://pdsp.med.unc.edu/pdsp.php"><font size="+0">http://pdsp.med.unc.edu/pdsp.php</font></a></span>.</cite><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.btitle=PDSP+Ki+Database&amp;rft.atitle=&amp;rft_id=http%3A%2F%2Fpdsp.med.unc.edu%2Fpdsp.php&amp;rfr_id=info:sid/en.wikipedia.org:Domperidone"><span style="DISPLAY: none">&nbsp;</span></span> </li>
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<p><a id="External_links" name="External_links"></a></p>
<h2><span class="mw-headline">External links</span></h2>
<ul>
    <li><a class="external text" title="http://www.digestivedistress.com/files/pdf/FDA_Letter_to_compliance_final4.pdf" rel="nofollow" href="http://www.digestivedistress.com/files/pdf/FDA_Letter_to_compliance_final4.pdf"><font color="#0066cc">GPDA letter to the FDA</font></a> about domperidone for gastroparesis </li>
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