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Domperidone Maleate: Brands, Price & Uses in Bangladesh
Established Uses Nausea and vomiting of various causes (excluding chemotherapy-induced and postoperative nausea/vomiting, for which other agents are preferred).
About Domperidone Maleate
Indications of Domperidone Maleate
Established Uses
- Nausea and vomiting of various causes (excluding chemotherapy-induced and postoperative nausea/vomiting, for which other agents are preferred).
- Symptoms of delayed gastric emptying and dyspepsia, such as epigastric bloating, early satiety, upper abdominal discomfort, belching, and regurgitation of gastric contents.
Guideline-Supported / Adjunct Use
- Relief of nausea and vomiting associated with dopamine-agonist therapy (e.g., levodopa, bromocriptine) in Parkinson’s disease, where Domperidone Maleate is used as an adjunct because, unlike most anti-dopaminergic antiemetics, it does not readily cross the blood-brain barrier and therefore does not counteract the central effects of dopamine-agonist treatment.
- As an aid during certain radiological (barium) studies to accelerate gastric emptying and small-bowel transit.
Off-Label Use (Not Routinely Recommended)
- Domperidone Maleate has been used off-label to increase milk supply in breastfeeding mothers (a galactagogue effect via prolactin elevation). Because of the recognized cardiac safety signal described under Precautions and Warnings, this use is not officially approved in most countries and should only be considered under close medical supervision when other measures have failed.
Domperidone Maleate is not an antibiotic and has no role in treating infections.
Dosage & Administration of Domperidone Maleate
General Principles
Domperidone Maleate should be used at the lowest effective dose for the shortest duration necessary to control symptoms, reflecting current safety guidance on cardiac risk (see Precautions and Warnings). Treatment courses for acute nausea/vomiting or dyspepsia are generally limited to about one week unless a physician determines that continued use is necessary after reassessing the benefit-risk balance.
| Indication | Adult Dose | Pediatric Dose |
|---|---|---|
| Nausea, vomiting, dyspepsia / delayed gastric emptying | 10 mg orally up to three times daily before meals; maximum 30 mg/day. Some markets and formulations allow up to 20 mg three to four times daily (maximum 80 mg/day) under close medical supervision for short courses — follow the prescribing physician’s instructions and local product labeling. | Children ≥12 years and ≥35 kg: same as adult dose. Children <12 years or <35 kg: approximately 0.25–0.4 mg/kg body weight up to three times daily, not exceeding recommended maximum daily weight-based dose; use only under medical supervision (see Pediatric Uses). |
| Nausea/vomiting with dopaminergic anti-Parkinson’s therapy | 10–20 mg up to three times daily as directed by the treating physician, for the shortest period needed. | Not applicable (Parkinson’s disease is not a pediatric condition). |
Administration
Tablets and orodispersible tablets/meltabs should be taken 15–30 minutes before meals and, if needed, before bedtime; swallow tablets with water, or allow orodispersible forms to dissolve on the tongue. Oral suspension should be measured with the supplied measuring device. Rectal suppositories (where available) are dosed differently and should be used strictly as directed by the prescriber; injectable domperidone has been withdrawn in many markets because of cardiac safety concerns and should not be used.
Renal and Hepatic Adjustment
- Hepatic impairment: Domperidone Maleate is contraindicated in moderate-to-severe hepatic impairment (see Contraindications). Mild hepatic impairment requires caution and physician judgment.
- Renal impairment: Domperidone is extensively metabolized, and only a small fraction is renally excreted; in significant renal insufficiency, reduce dosing frequency to once or twice daily and use the lowest effective dose, since drug accumulation may occur with repeated dosing.
Side Effects of Domperidone Maleate
Most side effects of Domperidone Maleate are uncommon at recommended doses. Reported adverse effects include:
- Common: dry mouth, headache, transient intestinal cramping, diarrhea.
- Hormonal (due to raised prolactin): galactorrhea (unexpected breast milk production), breast tenderness or enlargement (gynecomastia, including in men), menstrual irregularities.
- Cardiac (uncommon but serious): QT-interval prolongation and, rarely, serious ventricular arrhythmia or sudden cardiac death — risk is higher with doses above 30 mg/day, in patients over 60 years of age, and with concurrent use of interacting drugs (see Precautions and Warnings and Interactions).
- Neurological (rare, mainly at high doses or in young children): extrapyramidal symptoms (abnormal muscle movements), drowsiness.
- Allergic: rash, itching, urticaria; rare severe hypersensitivity reactions.
Seek prompt medical attention for palpitations, fainting, irregular heartbeat, or any severe or persistent reaction while taking Domperidone Maleate.
Contraindications of Domperidone Maleate
Domperidone Maleate is contraindicated in the following situations:
- Known hypersensitivity to domperidone or any excipient in the formulation.
- Prolactin-releasing pituitary tumor (prolactinoma).
- Conditions in which stimulation of gastrointestinal motility could be harmful, including gastrointestinal hemorrhage, mechanical obstruction, or perforation.
- Moderate-to-severe hepatic impairment.
- Known pre-existing prolongation of cardiac conduction intervals (notably QTc prolongation), clinically significant electrolyte disturbances (hypokalemia, hyperkalemia, hypomagnesemia), or underlying structural heart disease such as congestive heart failure.
- Concurrent use with medicines known to prolong the QT interval.
- Concurrent use with potent CYP3A4-inhibiting drugs (e.g., certain azole antifungals, macrolide antibiotics, HIV protease inhibitors).
- Neonates (infants in the first four weeks of life).
Frequently Asked Questions about Domperidone Maleate
What is Domperidone Maleate used for?
Domperidone Maleate is used to relieve nausea, vomiting, and symptoms of delayed gastric emptying such as bloating, early fullness, and upper abdominal discomfort. It is also used, under medical supervision, to control nausea caused by dopamine-agonist medicines used in Parkinson’s disease.
How should I take Domperidone Maleate?
Take Domperidone Maleate exactly as prescribed, usually 15–30 minutes before meals and, if directed, before bedtime. Do not exceed the dose or duration recommended by your physician — current safety guidance recommends using the lowest effective dose for the shortest time needed, generally not more than about a week for acute symptoms unless your doctor advises otherwise.
Is Domperidone Maleate safe for the heart?
Domperidone Maleate carries a recognized risk of QT-interval prolongation and, rarely, serious irregular heart rhythms, especially at higher doses, in people over 60, and in those with existing heart disease, electrolyte imbalances, or who take certain interacting medicines. Tell your doctor about any heart problems or other medicines you take before starting Domperidone Maleate, and seek urgent medical care if you develop palpitations, dizziness, or fainting while taking it.
Can Domperidone Maleate be used during pregnancy or breastfeeding?
Data on Domperidone Maleate in human pregnancy are limited, so it should be used in pregnancy only if clearly needed and your doctor believes the benefit outweighs the potential risk to the baby. Small amounts pass into breast milk; because of the cardiac safety signal associated with Domperidone Maleate, it is not routinely recommended simply to increase milk supply, and any use while breastfeeding should be directed by a physician.
Who should not take Domperidone Maleate?
Domperidone Maleate should not be used by people with a known allergy to domperidone, a prolactin-secreting pituitary tumor, gastrointestinal bleeding, obstruction, or perforation, moderate-to-severe liver impairment, significant heart disease or electrolyte disturbances, or by anyone taking QT-prolonging medicines or potent CYP3A4 inhibitors. It is also contraindicated in newborn infants. See the Contraindications section for the full list.
What should I do if I take too much Domperidone Maleate?
If you or someone else may have taken too much Domperidone Maleate, seek immediate medical attention or contact emergency services or a poison control center right away. Do not try to treat a suspected overdose at home, as it can cause drowsiness, abnormal movements, and heart rhythm problems that need medical monitoring.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.