Uses of Hadilium

1 Hadilium tablet contains 12.72mg Domperidone maleate, equivalent to 10mg Domperidone and other excipients. Domperidone maleate is a dopamine antagonist with properties similar to Metoclopramide hydrochloride. The drug has almost no effect on the dopamine receptors in the brain, so it does not affect the mind and nerves.
Domperidone stimulates peristalsis of the gastrointestinal tract, helps to increase the cardiac sphincter tone, increases the expansion amplitude of the pyloric sphincter after meals but does not affect gastric secretion. It is indicated for the symptomatic treatment of acute nausea and vomiting, including nausea and vomiting, associated with the use of bromocriptine or levodopa in patients with Parkinson's disease.
Indications for the use of Hadilium:
Treatment of symptoms of vomiting, nausea, anorexia, dyspepsia, heartburn, bloating, belching in the following conditions: Adults: Chronic gastritis, gastroesophageal reflux management, gastric prolapse, symptoms after gastrectomy, taking anticancer drugs or L-dopa; Children: Periodic vomiting, taking anti-cancer drugs, upper respiratory tract infections. Contraindications to using Hadilium:
Patients with vomiting after surgery; Patients with gastrointestinal bleeding; Patients with mechanical intestinal obstruction; Children under 1 year old; People who are using Domperidone regularly or long-term; People with moderate and severe liver failure; Patients with prolonged conduction time of cardiac impulses (especially QT interval), patients with marked electrolyte disturbances or patients with cardiovascular disease such as congestive heart failure; Concomitant use with drugs that prolong the QT interval; Concomitant use with CYP3A4 inhibitors does not depend on the prolongation of the QT interval.

Usage: Orally. Patients should take Hadilium before meals. If the drug is taken after a meal, the drug may be absorbed slowly. The patient should also take the medicine at the same time each day to avoid forgetting the medicine.
Dosage: Hadilium should only be used at the lowest effective dose for the shortest time to control vomiting and nausea. The maximum duration of treatment does not exceed 1 week. Specific dosage is as follows:
Adults and adolescents (over 12 years old and weighing over 35kg): Take 1 tablet/time x 1-3 times/day, the maximum dose is 30mg/day; Infants, young children under 12 years old and adolescents under 35kg: Due to the need for accurate dosage, tablets, suppositories and effervescent tablets should not be used for this group of people; Patients with hepatic impairment: No dose adjustment of Hadilium is required for patients with mild hepatic impairment. Do not use the drug if the patient has moderate and severe liver failure; Patients with renal impairment: Due to the prolonged half-life of Domperidone in patients with severe renal impairment, if repeated use, the number of doses should be reduced to 1-2 times/day, adjust the dose according to the degree of impairment. kidney. Overdose: In the event of an overdose of Hadilium, immediate symptomatic measures should be taken. The treatment of acute poisoning and overdose includes: osmotic diuresis, gastric lavage and symptomatic treatment. EKG monitoring of the patient is recommended, because of the potential for prolongation of the QT interval.
Missed dose: If you forget to take a dose of Hadilium, skip the missed dose and continue on your regular dosing schedule. Do not double the dose to make up for the missed dose.

When using Hadilium, patients may experience some unwanted side effects such as:
Extrapyramidal disorders and somnolence (occurs at a very low rate), often due to disturbances in the permeability of the barrier. cerebral hemorrhage (in premature infants, damage to the meninges) or drug overdose; Lactation, breast enlargement, breast tenderness, menstrual disturbances, amenorrhea due to increased serum prolactin (seen in patients taking high doses of Hadilium for a long time); Cardiovascular disorders include ventricular arrhythmias, torsades de pointes, prolongation of the QT interval, and sudden cardiac death. The risk of serious ventricular arrhythmias or sudden cardiovascular death was higher in patients receiving daily doses of Hadilium above 30 mg and in patients over 60 years of age. When experiencing side effects from Hadilium, patients should inform their doctor and stop taking the drug until appropriate advice is received.

Some notes patients need to remember before and while using Hadilium are:
Domperidone should only be used for no more than 12 weeks for Parkinson's patients. Patients may experience adverse CNS side effects. Care should be taken to only use Domperidone in Parkinson's patients if safer antiemetic measures have not been effective; Should reduce the dose of Hadilium by about 30 - 50% in patients with renal failure, for patients to take the drug several times a day; The half-life of Domperidone is prolonged in patients with severe renal impairment. In case of repeated administration, the frequency of domperidone should be reduced to 1-2 times/day depending on the degree of renal impairment. Dosage adjustments can be made if necessary; Domperidone prolongs the QT interval on the electrocardiogram and increases the risk of serious ventricular arrhythmias or even cardiovascular death. This risk is higher in patients over 60 years of age, in patients receiving daily doses greater than 30 mg, and in patients receiving concomitant CYP3A4 inhibitors or drugs that prolong the QT interval. Therefore, patients need to be careful with this risk; Domperidone should be used at the lowest effective dose in both adults and children; Domperidone is contraindicated in patients with prolonged cardiac impulse conduction time (especially QT interval), bradycardia, marked electrolyte disturbances (hyperkalemia, hypokalemia, hypomagnesaemia) ), is suffering from congestive heart failure,. .. due to the risk of causing ventricular arrhythmias. Electrolyte disturbances or bradycardia are factors that increase the risk of arrhythmias; Patients should stop taking Domperidone and tell their doctor immediately if they have any symptoms related to arrhythmia or other cardiovascular symptoms; Although Domperidone is not teratogenic, to ensure safety, it is advisable to avoid using Hadilium for pregnant women; Domperidone may be excreted in human milk, causing adverse cardiovascular effects. The benefits and risks should be weighed in order to decide whether to avoid treatment with Domperidone or to discontinue breastfeeding.

Some drug interactions of Hadilium include:
Domperidone can be used concurrently with anti-anxiety drugs; Anticholinergics may inhibit the action of domperidone. If these drugs must be combined, the patient should take atropine after taking Domperidone; If domperidone is taken with antacids or acid-suppressing drugs after meals, there may be an increased risk of QT prolongation; Concomitant use of Domperidone with the following drugs: Drugs that prolong the QT interval (class IA antiarrhythmics, class III antiarrhythmics, some antipsychotics, some antidepressants) some antibiotics, some antifungals, antimalarial drugs, gastrointestinal drugs, antihistamines, some cancer drugs) and strong CYP3A4 inhibitors (protease inhibitors, anti-inflammatory drugs). systemic fungi of the azole group, some drugs of the macrolide group); Co-administration of Domperidone with moderate CYP3A4 inhibitors such as verapamil, diltiazem,... is not recommended; Caution should be exercised when domperidone is used concomitantly with bradycardia drugs, drugs that reduce blood potassium, some macrolides that prolong the QT interval (roxithromycin, azithromycin). Hadilium is an effective anti-nausea and vomiting drug. When taking the drug, the patient should strictly follow the instructions of the doctor, do not arbitrarily change the dose of the drug to ensure the effectiveness of treatment.
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