Domperidone

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 As

• 1 mg/mL oral suspension