Domperidone

Domperidone (Motilium®) is an antidopaminergic drug used orally or intravenously, generally to suppress nausea and vomiting. It has also been used to stimulate lactation.

Uses

Gastrointestinal problems

Domperidone is used, together with metoclopramide, cyclizine, and 5HT₃ receptor antagonists (such as granisetron) in the treatment of nausea and vomiting. It is useful in patients with Parkinson's disease because, unlike metoclopramide, domperidone does not cross the blood-brain barrier. Domperidone is also prescribed for the treatment of gastroparesis, a stomach motility condition.

Lactation

The hormone prolactin stimulates lactation in humans, and its release is inhibited by the dopamine secreted by the hypothalamus. Domperidone, by acting as an anti-dopaminergic, results in increased prolactin secretion, and thus promotes lactation.

Although it has never been officially approved for use in the United States, domperidone is widely purchased from pharmacies in other countries for this purpose.

Problems

In June 2004, the United States' main regulation agency, the Food and Drug Administration (FDA) issued a letter warning women not to take domperidone, citing unknown risks to parents and infants, and warned pharmacies that domestic sale was illegal, and that import shipments from other countries would be searched and seized. Individual incidents of problems with the drug include cardiac arrest and arrhythmia, complications with other medications, as well as complications with improper intravenous use.

It has been widely speculated that this action by the FDA is related to increasing drug importation from countries such as Canada. However, organisations such as the American Association of Pediatrics have endorsed the FDA action.

Yet prominent doctors and pharmacists have rejected the FDA's reasoning and still promote domperidone's use in increasing milk supply. Such doctors and pharmacists are confident the drug is safe in the doses given for this purpose. The American Academy of Pediatrics considers domperidone "usually compatible with breastfeeding." [http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776/T6

References

Domperidone for lactating women, Canadian Medical Association Journal, Orlando P. da Silva and David C. Knoppert

External links

Domperidone Issue Brief International Academy of Compounding Pharmacists.

Antiemetics