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Domperidone 5mg drug is effective against nausea and vomiting in adults and children. The drug has no effect on dopamine receptors in the brain, so it is very safe for the nervous and mental systems.
1. What is Domperidone?
Domperidone is a Dopamine antagonist with antiemetic properties.
The drug is packaged as a suspension. Depending on the manufacturer, cans from 20, 30 to 50 ampoules of 5ml type. Available in bottles of 30ml, 60ml and 100ml.
2. Uses of Domperidone 5mg Domperidone is mainly used in the treatment of symptoms of vomiting and nausea in adults. Treatment of hiccups, vomiting, bloating, indigestion, fast satiety in children.
2.1. Mechanism of action of the drug Domperidone 5mg Domperidone is difficult to cross the blood-brain barrier. In people taking Domperidone it promotes the release of Prolactin from the pituitary gland. The antiemetic effect may be due to a combination of antagonism of Dopamine receptors in the chemoreceptor trigger zone, located outside the blood-brain barrier in the area of the pyloric sphincter, and peripheral gastric effects.) . Animal studies, in parallel with low concentrations in the brain, have shown that the effects of Domperidone are primarily peripheral to dopamine receptors. In humans, studies have shown that oral domperidone increases esophageal pressure, accelerates gastric emptying, and improves duodenal motility. But no effect on gastric secretion.
Thuốc Domperidon 5mg có tác dụng chống nôn ói, buồn nôn ở người lớn và trẻ em
2.2. Absorption of Domperidone 5mg About 1 hour after dosing, Domperidone is rapidly absorbed in plasma with peak concentrations. The AUC and Cmax values of domperidone increased proportionally over the dose range of 10 mg to 20 mg/day. Observations have shown that the accumulation of Domperidone AUC is 2 to 3 times higher when administered for 4 consecutive days with doses administered every 5 hours.
Due to extensive metabolism in the intestinal wall and liver, the absolute bioavailability of domperidone administered orally is low (approximately 15%). The effect of Domperidone is enhanced when taken after meals in normal people, but for patients with gastrointestinal problems, it is recommended to take Domperidone 15-30 minutes before meals. Reducing stomach acid also reduces the absorption of Domperidone. The effect of oral drugs is also reduced with previous concomitant use of sodium bicarbonate and cimetidine. Time to peak absorption is slowed and AUC is somewhat increased when the drug is taken after a meal.
2.3. Metabolism of Domperidone 5mg Domperidone undergoes extensive and rapid hepatic metabolism by N-dealkylation, hydroxylation. In vitro metabolism experiments with a diagnostic inhibitor showed that CYP3A4 is the major form of cytochrome P-450 involved in the N-dealkylation of domperidone, while CYP3A4, CYP1A2, and CYP2E1 participate in hydroxylation. Aromatic Domperidone.
3. How to use Domperidone 5mg
Domeperidone should be used at the lowest dose to achieve the short-term effect needed to control nausea and vomiting.
Domperidone should be taken before meals. If taken at the time after a meal, the absorption of the drug is somewhat delayed.
Patients should try to take each dose at a fixed time. If a dose is missed, skip the missed dose and continue taking it as directed. Never double up to make up for a missed dose.
Usually, doctors will appoint a maximum treatment time of no more than one week.
3.1. Dosage of the drug Domperidon 5mg Adults and adolescents (aged from 12 years old and weighing 35kg or more):
Take 10ml each time, 3 times a day and with a maximum dose of 30ml (only recommended). use the measuring cup provided in the medicine bottle). Infants, children and adolescents weighing less than 35 kg:
The recommended dose is 0.25 mg/kg. May be used up to 3 times a day but not more than 0.75 mg/kg per day. For example, for a child weighing 12 kg, the dose is 3 mg (equivalent to 3 ml), which can be administered twice daily up to a maximum dose of 6 mg/day (6 ml) (using a measuring cup with available in medicine bottles). For patients with hepatic impairment:
Domperidone is contraindicated in patients with moderate or severe hepatic impairment. But for patients with mild hepatic impairment, no dose adjustment is required. For patients with renal impairment:
Because the half-life of Domperidone is prolonged in patients with severe renal impairment, when repeated use, the frequency of Domperidone should be reduced depending on the degree of renal failure, which should be reduced to 1-3 times per day or effective. adjusted according to the condition. Patients on long-term treatment should be examined regularly.
Thuốc Domeperidone nên được sử dụng ở liều thấp nhất để đạt được hiệu quả trong thời gian ngắn
3.2. Contraindications of the drug Domperidone 5mg Domperidone is contraindicated in the following cases:
In patients with moderate or severe hepatic impairment; In patients with conditions such as longer current intracardiac conduction times, especially QTc, typically patients with congestive heart failure or significant electrolyte disturbances; Concomitant use with QT-prolonging drugs, except Apomorphine; Concomitant use with strong CYP3A4 inhibitors; Hypersensitivity to Domperidone or any of the excipients in the composition of the drug; Patients with prolactin-releasing pituitary tumors (prolactinoma.); Patients with drug intolerance, stomach bleeding, gastrointestinal perforation...; Do not use for infants under 1 year old; Do not use to treat symptoms of vomiting after surgery; Use with caution in pregnant and lactating women. 3.3. Adverse effects of Domperidone 5mg Domperidone have been associated with prolongation of the QT interval on the electrocardiogram and an increased risk of serious ventricular arrhythmias or sudden cardiac death. A higher risk was observed in patients over 60 years of age, taking daily doses above 30 mg and concomitantly with CYP3A4 inhibitors, QT prolongation.
Domperidone treatment should be discontinued if signs or symptoms possibly related to arrhythmia occur and the patient should consult a physician.
3.4. Drug Interactions Domperidone 5mg List of some drugs that should not be taken with Domperidone because they prolong the QT interval:
Class IA antiarrhythmic drugs (eg, Hydroquinidine, Disopyramide, Quinidine); Class III antiarrhythmic drugs (eg, Dofetilide, Dronedarone, Amiodarone, Ibutilide, Sotalol); Antipsychotics (eg, pimozide, Haloperidol, Sertindole); Antidepressants (eg, Citalopram, Escitalopram); Antibiotics (eg, Erythromycin, Levofloxacin, Moxifloxacin, Apiramycin); Antifungal drugs (eg, Pentamidine); Antimalarial drugs (especially Halofantrine, Lumefantrine); Gastrointestinal drugs (eg: Cisapride, Dolasetron, Prucalopride); Antihistamines (eg, Mequitazine, Mizolastine); Cancer drugs (eg, Tamoxifen, Vandetanib, Vincamine); Certain other medicines (eg, Bepridil, Diphemanil, Methadone). Strong CYP3A4 inhibitors (independent of their QT prolongation effects), eg:
Protease inhibitors; Systemic antifungal agents of the Azol group; Some macrolide drugs (Erythromycin, Carithromycin and Telithromycin). Concomitant administration of the following drugs is not recommended:
Moderate CYP3A4 inhibitors, e.g. diltiazem, verapamil and some macrolides. Use with caution when coadministered with the following drugs:
Drugs that slow the heart rate, hypokalemic drugs and some Macrolides that contribute to prolongation of the QT interval: Azithromycin, Oxithromycin (Contraindicated Clarithromycin because it is an inhibitory drug). strong CYP3A4. Domperidone can be used together with anxiolytics. Anticholinergics may inhibit the effects of domperidone. If these drugs must be used in combination, atropine can be given after domperidone has been given. If used together with antacids or inhibitors of acid secretion, domperidone must be taken before meals, and antacids or inhibitors of acid secretion should be taken after meals. Domperidone is a medication commonly prescribed by doctors to treat nausea. During the use of the drug, some unwanted side effects may occur. Therefore, it is necessary to use the drug as prescribed by a specialist to ensure safety and effectiveness.
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