Last Updated on January 15, 2019
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The active ingredient Domperidone is one of the most important agents for the treatment of vomiting, nausea, bloating and upper abdominal pain, where it accelerates the passage through the stomach, among other things. Since the active substance can not cross the blood-brain barrier, it is very seldom to side effects in the central nervous system. Here you can read everything worth knowing about Domperidone, side effects and use.
How Domperidone works
The messenger which mediates communication between nerve cells and therefore neurotransmitter is called, has a variety of tasks in the central nervous system (brain and spinal cord). It acts inter alia, in controlling the movement with, contributes to a so-called “happiness hormone” to positive feelings, caused at excessively high levels psychosis and delusions and affects the prolactin levels in the blood (prolactin promotes women milk production in the breast).
The drug Domperidone acts as an inhibitor (antagonist) of the docking sites for dopamine. It blocks them, causing dopamine can no longer bind to it. Since the active ingredient, however, the blood-brain barrier – the protective barrier against potentially harmful substances in the blood – can not overcome or not, Domperidone does not act on the central nervous system (CNS). This is an effect on the controlled by dopamine in the brain mobility that would suppress it otherwise, and virtually ruled on the psyche.
A special part of the CNS is the so-called vomiting center. It is located in the brainstem and in the adjacent elongated spinal cord. Here the blood-brain barrier is “riddled”, whereby this part can react very quickly to harmful substances in the blood with nausea and vomiting. Thereby, the body protects itself by further inclusion of these substances. Since the communication of nerve cells is controlled in part by dopamine in this region, can here the drug Domperidone its job. By blocking the docking nausea and vomiting are reduced
Another positive side effect of taking Domperidone, whose conclusion is still unclear, is the accelerated gastric emptying towards the intestine. Thus, the stomach is relieved, which in addition can reduce nausea and bloating.
engulfing and digesting Domperidone
After taking Domperidone is rapidly absorbed in the intestine into the bloodstream and reaches there after half an hour to an hour, the highest drug levels. However, it is degraded to a large extent already in the intestinal mucosa and in the liver, so that only about 15 percent of the active ingredient can reach and affect the circulation. After about seven to nine hours Domperidone is excreted in half -. One-third through the urine, two-thirds over the chair.
This medicine increases movement throughout the digestive tract. It’s used to treat symptoms of gut ailments. It might also be employed to stop nausea and nausea due to certain medications. Because of security concerns, this medicine isn’t to be employed by women to improve production of breast milk.
The drug Domperidone is approved for the treatment of nausea, vomiting, bloating and abdominal pain.
With Domperidone milk production to promote and thereby be able to breastfeed effectively, is a so-called “off-label use”, a use outside the approved indications. Since Domperidone does not pass into the CNS, but also hardly stimulates milk production in the breast milk and effectively and this is quite few side effects, is often used for this purpose by mothers with breastfeeding problems.
Since the treatment is symptom-based, Domperidone should be discontinued if symptoms improve again. The duration of intake should not exceed four weeks, except on special instruction by the attending physician.
Mechanism of action
Typically, the active agent Domperidone in the form of tablets or drops is applied. If these dosage forms can not be applied because of severe vomiting to Domperidone suppositories are very good.
In order to improve absorption in the intestine, it is recommended to take the tablets or drops half an hour to an hour before eating. Depending on the severity of symptoms one to two tablets to ten milligrams Domperidone be taken three to four times a day, which corresponds to a maximum daily dose of 80 milligrams. The duration of intake should not exceed four weeks.
What are the side effects of Domperidone?
In short and low-dose application of the drug Domperidone is relatively few side effects. Each tenth occurs and an increased flow of breast milk.
What should be considered when taking Domperidone?
For the absorption in the intestine Domperidone requires a sufficiently acidic gastric environment. The additional intake of active substances which neutralize stomach acid or inhibit gastric acid production, thus reducing the absorption of Domperidone significantly. Such agents are, for example cimetidine, Ranitidine, Omeprazole and Pantoprazole.
In the body of the drug Domperidone by an enzyme system (CYP 3A4) is degraded, which degrades numerous other agents. If the active ingredients concerned taken in addition, this may lead to a reduced degradation and thus to increased levels of Domperidone in the body. Examples of such drugs include many antibiotics (Erythromycin), medicines for fungal infections (ketoconazole), antidepressants (Amitriptyline, Citalopram), analgesics (tramadol), sedatives (diazepam), anti-high cholesterol (Atorvastatin, Simvastatin) and many more. The combination of Domperidone with others, including non-prescription medicines should therefore be discussed with the doctor or pharmacist.
For the intake of Domperidone during pregnancy and lactation only a few data, which is why they should be taken under medical supervision exist. The same applies for use in children under twelve years old.
In case of severe liver and kidney dysfunction, the intake should not or only at a reduced dose take place.
In deciding to use a medicine be weighed against the good it will do. That is a decision you and your doctor will make. With this medication, the following Ought to Be considered:
Tell your Physician if you have ever had any unusual or allergic Response to some other medications or this medication. Tell your wellbeing care practitioner if you have some other forms of allergies, such as foods, dyes, preservatives, or creatures. For goods that are non-prescription, read the label or package ingredients.
Children–Studies on this medicine have been done only in adult Patients, and there is not any particular information comparing use of domperidone.
Many medicines haven’t been studied specifically in older individuals. For this reason, it might not be known whether they work precisely the exact same way they do in younger adults or if they cause different side effects or problems in older individuals. There’s absolutely no particular information regarding the use of domperidone in the elderly.
There are no studies for determining risk, in girls When using this medication. Before taking this medicine while breastfeeding, weigh the benefits against the risks.
Although certain medicines Shouldn’t Be used together in Other cases two unique medicines may be used together even if an interaction may occur. In such cases, your physician might want to change the dose, or other precautions may be necessary. It’s especially important that your healthcare professional know if you are taking any of the medicines whenever you’re getting this medicine. The interactions are chosen on the basis of their importance and are not.
Using this medication with any of the medications isn’t recommended. Alter some or your physician may choose not to deal with you.
Certain medicines Shouldn’t Be utilized in or around the time of ingestion Eating certain kinds of food because interactions or food might happen. Using tobacco or alcohol with medications may cause interactions to happen. The interactions are chosen on the basis of their importance and are not.
Using this medication with any of these is not May be inevitable sometimes, although recommended. If used together, your physician may change the dose or you use this medication, or provide you specific instructions regarding using tobacco, alcohol, or food.
Additional Medical Issues
The use of the may affect medicine. Ensure you tell your Physician if you have any additional medical Problems
Bleeding in the stomach or other issues involving the intestines
Pituitary (brain) tumor
Medicine sensitivity to domperidone
1974 — Domperidone synthesized at Janssen Pharmaceutica after the study on antipsychotic drugs. Janssen pharmacologists found that a number of antipsychotic drugs had a substantial impact on dopamine receptors at the central chemoreceptor trigger zone that controlled nausea and began looking for a dopamine antagonist which wouldn’t pass the blood–brain barrier, thus being liberated of this extrapyramidal side effects which were correlated with drugs of the kind. This resulted in the discovery of domperidone as a powerful anti-emetic with nominal central consequences.
1978 — About 3 January 1978 Domperidone was patented in the United States under patent US4066772 A. The program has been registered on 17 May 1976. Jan Vandenberk, Ludo E. J. Kennis, Marcel J. M. C. Van der Aa And others.
1979 — Domperidone promoted under domain “Motilium” at Switzerland and (Western) Germany.
1999 — Domperidone premiered in the kinds of orally disintegrating tablets (according to Zydis technology).
Janssen Pharmaceutical has attracted domperidone ahead of the United States Federal Drug Administration (FDA) many times, such as in the 1990s.
2014 — In April 2014 Co-ordination Group for Mutual Recognition and Decentralised Procedures — Individual (CMDh) printed official press-release Suggesting to limit the use of medicines. It Also approved previously published hints from Pharmacovigilance Risk Assessment Committee (PRAC) to use domperidone just for treating nausea and nausea and decrease maximum daily dose to 10 milligrams.
The drug was developed in 1974 and already approved a few years later in many European countries. Initially a Domperidone-injection solution was placed on the market, however, which repeatedly led to serious cardiac arrhythmia. Hence their approval has been withdrawn finally back. In the US, the approval of the active substance Domperidone was never granted (to other dosage forms) for said side effects on the heart.