Description
Uses and Administration of Domperidone in Kenya
Domperidone is a dopamine antagonist. It is used as an antiemetic for the short-term treatment of nausea and vomiting of various aetiologies. It is not considered suitable for chronic nausea and vomiting, nor for the routine prophylaxis of postoperative vomiting.
Domperidone is also used for its prokinetic actions in dyspepsia and has been tried in diabetic gastroparesis in Kenya. It is given with paracetamol in the symptomatic treatment of migraines.
Domperidone is used as the maleate in tablet preparations and as the base in suppositories and the oral suspension; doses are expressed in terms of the base. Domperidone maleate 12.73 mg is approximately equivalent to 10 mg domperidone. Domperidone has been given parenterally, but this route has been associated with severe adverse effects.
For the treatment of nausea and vomiting domperidone/Motilium/Domperon may be given by mouth in doses of 10 to 20 mg three or four times daily up to a maximum daily dose of 80 mg or it may be given rectally in a dose of 60 mg twice daily. In children, doses of 250 to 500 micrograms/kg may be given by mouth three to four times daily, up to a maximum daily dose of 2.4 mg/kg and should not exceed a total of 80 mg daily. Alternatively, children weighing more than 15 kg may be given a rectal dose of 30 mg twice daily.
For the symptomatic treatment of non-ulcer dyspepsia, adults may be given 10 mg by mouth 3 times daily before meals and at night. Depending on clinical response the dose may be increased to 20 mg if necessary. A course of treatment should not normally exceed 2 weeks. In migraine, a dose of 20 mg by mouth may be taken up to every 4 hours, in combination with paracetamol, as required, up to a maximum of 4 doses in 24 hours.
Uses of Domperidone in Parkinsonism Management.
Domperidone is used to control gastrointestinal effects of dopaminergic drugs given in the management of parkinsonism. It may be of use in those patients who experience peripheral effects with levodopa despite the use of peripheral dopa-decarboxylase inhibitors and for patients using dopamine agonists such as bromocriptine or apomorphine since peripheral dopa-decarboxylase inhibitors are ineffective for preventing the peripheral effects of these drugs. Although domperidone does not readily cross the blood-brain barrier there have been isolated reports of extrapyramidal effects associated with its use. Consequently there has been concern over its potential to produce central effects and some consider that domperidone should only be used in patients with parkinsonism when safer antiemetic measures have failed.1,2 However, this view has been contested both by the manufacturers and other medical workers.3,4 In a subsequent review of the use of domperidone in Parkinson’s disease it was considered5 that domperidone might produce central blockade of the therapeutic effects of levodopa if given at a high oral dosage such as 120 mg daily for prolonged periods but also noted that such high doses were rarely required to control levodopa-induced vomiting.
Adverse Effects and Common Side Effects of Domperidone
Single-ingredient Preparations
The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.
Arg.: Ecuamon; Euciton; Moperidona; Motilium; Austral.: Motilium; Austria: Motilium; Belg.: Motilium; Zilium; Braz.: Domperol¤; Motilium; Peridal¤; Pleiadon¤; Canad.: Motilidone¤; Motilium; Chile: Donegal; Dosin; Idon; Restol; Denm.: Motilium; Fr.: Motilium; Motilyo; Peridys; Ger.: Motilium; Gr.: Cilroton; Hong Kong: Costi; Dompeon; Motilium; Rabugen; Hung.: Motilium; India: Domstal; Nautigo; Irl.: Motilium; Israel: Motilium; Ital.: Digestivo Giuliani; Fobidon; Gastronorm; Mod¤; Motilium; Peridon; Malaysia: Domper; Motilium; Mex.: Biolix; Emiken¤; Motilium; Seronex; Neth.: Gastrocure; Motilium; NZ: Motilium; Port.: Cinet; Mogasinte; Motilium; Nordonil; Remotil; S.Afr.: Motilium; Vomidon; Singapore: Dompel; Dompenyl; Domper; Doridone; Mirax; Motilium; Spain: Motilium; Nauzelin¤; Switz.: Motilium; Thai.: Costi¤; Dany; Dolium; Domerdon; Domidone; Domilium¤; Domper-M; Domperdone; Donum; Mirax; Mocydone; Modomed; Molax; Moticon; Motidom; Motilium; Movelium; Ninlium; Peptomet; Pondperdone; Poselium¤; UK: Evoxin¤; Motilium; Vivadone;
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