domperidone

CLINICAL USE

Acute nausea and vomiting (including that caused by levodopa and bromocriptine)Gastro-oesophageal reflux Dyspepsia

DOSE IN NORMAL RENAL FUNCTION

Nausea and vomiting: Adults

10 to 20 : mg orally 3–4 times daily, maximum 80 mg dailyPR: 60 mg twice daily

PHARMACOKINETICS

Molecular weight :425.9

%Protein binding :>90

%Excreted unchanged in urine : <1

Volume of distribution (L/kg) :5.7

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 :Unlikely to be dialysed. Dose as in normal renal function

HD :Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux :Unlikely to be dialysed. Dose as in normal renal function

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

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntifungals: possibly increased risk of arrhythmias with ketoconazole

ADMINISTRATION

Reconstition

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Route

Oral, PR

Rate of Administration

–

Comments

Treatment of acute nausea and vomiting: maximum period of treatment is 12 weeksTreatment of dyspepsia: administer before food; maximum period of treatment is 12 weeks

OTHER INFORMATION

Domperidone has the advantage over metoclopramide and phenothiazines of being less likely to cause central effects, such as sedation and dystonic reactions, as it does not readily cross the blood brain barrier

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