Last Updated on March 16, 2024
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Domperidone is a medication that is commonly used to treat various digestive disorders, such as nausea and vomiting. In the UK, domperidone is available over the counter from a number of pharmacies, which means that it can be purchased without a prescription from a doctor. This option is particularly useful for those who suffer from occasional digestive problems, as they can purchase the medication as and when it is required.
It is worth noting, however, that while domperidone is available over the counter in the UK, it is only intended for short-term use. Long-term use of the medication can lead to potentially serious side effects, including heart problems. As such, it is important for those who require the medication to speak to a healthcare professional before they make a purchase. This will ensure that they receive the appropriate dosage and guidance on how to take the medication safely.
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What is domperidone?
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 usage.
How does domperidone works?
The messenger that mediates communication between nerve cells, called a neurotransmitter, has a variety of functions in the central nervous system (brain and spinal cord). It acts, inter alia, in controlling movement with, contributes to a so-called “happiness hormone” to positive feelings, at excessive levels caused psychosis and delusions and affects the level of prolactin in the blood (prolactin promotes milk production in women’s breasts).
The drug domperidone acts as an inhibitor (antagonist) of the docking sites for dopamine. It blocks them so that dopamine cannot bind to them. However, because the drug cannot cross the blood-brain barrier – the protective barrier against potentially harmful substances in the blood – domperidone has no effect on the central nervous system (CNS). This is an effect on the mobility controlled by dopamine in the brain, which would otherwise suppress it, and virtually ruled on the psyche.
A special part of the CNS is the so-called vomiting center. It is located in the brain stem and the adjacent elongated spinal cord. Here the blood-brain barrier is “pierced,” and this part can react very quickly to harmful substances in the blood with nausea and vomiting. This is the body’s way of protecting itself by continuing to absorb these substances. Since the communication of nerve cells in this region is partly controlled by dopamine, the drug Domperidone can do its job here. By blocking the docking, nausea and vomiting are reduced.
Another positive side effect of taking domperidone, which is still unclear, is the accelerated emptying of the stomach into the intestines. This relieves the stomach, which can also reduce nausea and bloating.
Pharmacokinetics and metabolism of domperidone
After ingestion, domperidone is rapidly absorbed from the intestine into the bloodstream, reaching peak drug levels within 30 minutes to an hour. However, much of the drug is broken down in the intestinal lining and liver, so only about 15 percent of the active ingredient reaches the bloodstream. After about seven to nine hours, domperidone is excreted in two ways: one-third in the urine and two-thirds in the stool.
Uses
This medicine increases movement throughout the digestive tract. It is used to treat symptoms of intestinal disorders. It may also be used to stop nausea and vomiting caused by certain medications. Because of safety concerns, this medication is not to be used by women to improve breast milk production.
The drug Domperidone is approved for the treatment of nausea, vomiting, bloating, and abdominal pain.
Using domperidone to increase lactation in order to be able to breastfeed effectively is an “off-label use,” a use outside of the approved indications. Since Domperidone does not enter the CNS, but also stimulates milk production in breast milk hardly and effectively and this has 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 when the symptoms improve. The duration of intake should not exceed four weeks, except on special instructions by the attending physician.
What are the side effects of Domperidone?
In short and low-dose application of the drug domperidone is relatively few side effects. Every tenth occurs and an increased flow of breast milk.
What should I watch for while taking Domperidone?
Domperidone requires a sufficiently acidic gastric environment for absorption in the intestine. The additional intake of agents that neutralize gastric acid or inhibit the production of gastric acid, thus significantly reducing the absorption of Domperidone. Such agents are for example cimetidine, ranitidine, omeprazole and pantoprazole.
In the body, Domperidone is broken down by an enzyme system (CYP 3A4) that breaks down many other drugs. The concomitant use of these other drugs may result in decreased metabolism and increased levels of Domperidone in the body. Examples of such drugs include many antibiotics (erythromycin), drugs for fungal infections (ketoconazole), antidepressants (amitriptyline, citalopram), analgesics (tramadol), sedatives (diazepam), anti-high cholesterol drugs (atorvastatin, simvastatin), and many more. The combination of Domperidone with others, including non-prescription drugs, should therefore be discussed with the doctor or pharmacist.
There is little data on the use of Domperidone during pregnancy and lactation, so it should be used under medical supervision. The same is true for use in children under twelve years of age.
In case of severe liver and kidney dysfunction the intake should not take place or only in a reduced dose.
Allergies
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.
Pediatric
Children–Studies on this medicine have been done only in adult Patients, and there is not any particular information comparing use of domperidone.
Geriatric
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.
Breastfeeding
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.
Drug Interactions
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.
Amifampridine
Amisulpride
Bepridil
Abiraterone
Alfuzosin
Alprazolam
Other Interactions
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.
Grapefruit Juice
If you’re taking this medicine, avoid eating or drinking grapefruit unless your doctor or chemist advises it’s okay for you to. The likelihood of this medication’s negative effects might be increased by grapefruit. For further information, speak to your doctor or chemist. If your issue persists or worsens, let your doctor know.
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
- Liver disease
- Medicine sensitivity to domperidone
History
1974 — Domperidone is synthesized at Janssen Pharmaceutica following the study of antipsychotic drugs. Janssen pharmacologists found that a number of antipsychotic drugs had a significant effect on dopamine receptors at the central chemoreceptor trigger zone that controls nausea, and began searching for a dopamine antagonist that wouldn’t cross the blood-brain barrier, thus freeing them from the extrapyramidal side effects associated with such drugs. This led to the discovery of domperidone as a potent antiemetic with nominal central effects.
1978 — On or about January 3, 1978, domperidone was patented in the United States under patent US4066772 A. Jan Vandenberk, Ludo E. J. Kennis, Marcel J. M. C. Van der Aa and others.
1979 — Domperidone promoted under domain “Motilium” in Switzerland and (West) Germany.
1999 — Domperidone premiered in the kinds of orally disintegrating tablets (according to Zydis technology).
Janssen Pharmaceutical has registered domperidone before the United States Federal Drug Administration (FDA) many times, such as in the 1990s.
2014 — In April 2014, the Coordination Group for Mutual Recognition and Decentralized Procedures – Individual (CMDh) printed official press release suggesting to limit the use of medicines. It also approved previously published guidance from the Pharmacovigilance Risk Assessment Committee (PRAC) to use domperidone only for the treatment of nausea and vomiting and to reduce the maximum daily dose to 10 milligrams.
The drug was developed in 1974 and approved in many European countries a few years later. Initially, however, a domperidone injection solution was marketed, which repeatedly led to serious cardiac arrhythmias. As a result, its approval was eventually withdrawn. In the U.S., domperidone has never been approved (for other dosage forms) because of these cardiac side effects.
