domperidone

CLINICAL USE

Anti-emetic:Cancer chemotherapy Postoperative nausea and vomiting (PONV)

DOSE IN NORMAL RENAL FUNCTION

Chemotherapy: IV bolus or infusion: 100 mg —30 minutes before chemotherapyOral: 200 mg 1 hour before —chemotherapy, then 200 mg daily to prevent delayed nausea and vomitingPONV: IV bolus or infusion: 12.5 mg —Oral: 50 mg before induction of —anaesthesia

PHARMACOKINETICS

Molecular weight :420.5

%Protein binding :69–77

%Excreted unchanged in urine : 50–60

Volume of distribution (L/kg) :5–7.9

half-life – normal/ESRD (hrs) :7–9/Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in normal renal function

HD :Unknown dialysability. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnti-arrhythmics: increased risk of ventricular arrhythmias – avoid concomitant useBeta-blockers: increased risk of ventricular arrhythmias with sotalol – avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral, IV bolus,

IV infusion

Rate of Administration

Bolus: over 30 seconds Infusion: over 15 minutes

Comments

Can be added to 50 mL sodium chloride 0.9%, glucose 5% or compound sodium lactate

OTHER INFORMATION

Peak concentrations occur 1 hour after oral and 0.6 hour after IV dosesOral bioavailability of 75% Active metabolite is renally excreted (approximately 30%)In patients with severe renal impairment (creatinine clearance

<10 : mL/min), maximum plasma levels of metabolite are increased 17% or 34%, respectively, after intravenous or oral administration of dolasetron, and systemic exposure is increased approximately 2-fold dolasetron mesilate.

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