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Disclaimer to the On-line Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

DOMPERIDONE

 

Indication

  • symptomatic management of gastrointestinal (GI) motility disorders and to treat gastroesophageal reflux disease

Pharmacology

  • domperidone is a peripheral dopamine type 2 receptor blocker and does not readily cross the blood brain barrier
  • effects on the GI tract include increased lower esophageal sphincter pressure and increased esophageal peristalsis, increased gastric motility and peristalsis and enhanced gastroduodenal coordination

Side Effects

  • insomnia, irritability, lethargy, dry mouth, gynecomastia, extrapyramidal symptoms (such as agitation, tremor and increased or decreased muscle movement) are rare
  • QTc prolongation at higher doses, especially in patients with other risk factors such as other medications known to prolong QTc (for example chloral hydrate, ciprofloxacin, clarithromycin, dopamine, epinephrine, erythromycin, norepinephrine, salbutamol), hypokalemia or hyperkalemia, congenital long QT syndrome

Contraindications

  • conditions in which stimulation of the GI tract may be dangerous (eg. gastrointestinal hemorrhage, NEC, mechanical obstruction or perforation, Hirschsprung's disease)

Nursing Implications

  • monitor gastric residuals
  • monitor for side effects as above

Dose

  • neonates: 0.25mg/kg/dose po q8h or q6h
  • infants greater than 40 weeks PCA and 28 days of life: 0.3-0.6 mg/kg/dose po TID or QID
  • dilute oral solution with water or feeds just prior to administration

Supplied

  • 1 mg/mL oral suspension

References

  1. Domperidone monograph. Lexicomp online database, accessed online June 22, 2011 at http://online.lexi.com/crlsql/servlet/crlonline.
  2. Dailly E, Drouineau MH, Gournay V, Roze JC, Jolliet P. Population pharmacokinetics of domperidone in preterm neonates. Eur Jn Clin Pharmacol 2008 (64): 1197-1200.
  3. Gunlemez A, Babaoglu A, Arisoy AE, Turker G, Gokalp AS. Effect of domperidone on the QTc interval in premature infants. Journal of Perinatology 2010 (30): 50-53.
  4. Djeddi D, Kongolo G, Lefaix C, Mounard J, Leke A. Effect of Domperidone on QT Interval in Neonates. J Pediatr 2008: 153: 663-6.
Prepared by: Emily Ung, BScPhm  Date: June 22th, 2011
Reviewed by

David C. Knoppert, MScPhm 
Henry Roukema, MD 

Date: June 23, 2011
Date: July 4, 2011

Last Uploaded: May 2011

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