Generic name: domperidone
Brand names: Motilium, Nauzelin, Domstal, Euciton, Moperidona, Vometa, Zilium and more
Dosage form: oral tablet, oral suspension, oral drops, orally disintegrating tablet, suppository
What is domperidone?
Domperidone is an antiemetic (anti-sickness) and prokinetic drug. It belongs to a group of drugs called dopamine antagonists. It is used to treat stomach-related issues, such as nausea and vomiting, as well as stomach pain and discomfort caused by decreased movement of the stomach and upper gastrointestinal (GI) tract. It is also used to boost breastmilk supply.
Domperidone works by blocking dopamine receptors in the gut. It increases the movement or contractions of the muscles in your stomach and intestines, increasing how quickly and easily food moves through your digestive tract. It also acts on the chemoreceptor trigger zone in your brain, which is involved in nausea and vomiting. This area of your brain is outside the blood-brain barrier. Unlike other dopamine antagonists, domperidone does not cross the blood-brain barrier, which minimizes central nervous system (CNS) side effects.
Domperidone works to boost breastmilk supply by increasing the level of a hormone called prolactin, which stimulates the production of breastmilk.
Domperidone is available on prescription and in some places as an over-the-counter (OTC) medicine. It is available in many places around the world, including the UK, Europe, Canada and New Zealand. Approved uses of the drug vary from country to country. It is also used for off-label or unapproved conditions, including boosting breastmilk supply. Domperidone is not approved for use in the US, but some patients with severe gastrointestinal motility disorders can still access it through an expanded access investigation new drug (IND) application.
Domperidone first became available in the late 1970s.
What is domperidone used for?
Domperidone is used for a range of conditions including:
- To treat nausea (feeling sick) and vomiting (being sick), including when it is caused by migraine headaches
- To prevent nausea and vomiting caused by certain medicines used to treat Parkinson's disease, including levodopa and pergolide
- To relieve discomfort caused by a slow moving stomach known as gastroparesis. Symptoms include indigestion (dyspepsia), not being able to finish a meal, feeling too full or bloated after a meal, a loss of appetite, feeling sick and maybe vomiting, or belching without relief
- To increase breastmilk supply
Domperidone may cause an increased risk of heart rhythm disorder and cardiac arrest. This risk may be more likely in those over 60 years old or taking doses higher than 30 mg per day. The risk also increases when it is given together with some drugs. Tell your doctor or pharmacist if you are taking drugs to treat infection (fungal infections or bacterial infection) and/or if you have heart problems or AIDS/HIV.
Domperidone should be used at the lowest effective dose in adults and adolescents 12 years of age and older and a body weight of 35kg or more.
While taking this medicine, contact your doctor if you experience heart rhythm disorders such as palpitations, trouble breathing, loss of consciousness. Treatment with domperidone should be stopped.
Who should not take domperidone?
Do not take domperidone tablets if:
- You are allergic to domperidone or any of the other ingredients in it. Signs of an allergic reaction include:
- Swallowing or breathing problems
- Swelling of your lips, face, throat or tongue
- You have a tumor of the pituitary gland (prolactinoma)
- You have a blockage or tear in your intestines
- You have black, tarry bowel motions (stools) or notice blood in your bowel motions. This could be a sign of bleeding in the stomach or intestines.
- You have a moderate or severe liver disease
- Your ECG (electrocardiogram) shows a heart problem called “prolonged QT corrected interval”
- You have or had a problem where your heart cannot pump the blood round your body as well as it should (condition called heart failure)
- You have a problem that gives you a low level of potassium or magnesium, or a high level of potassium in your blood
- You are taking certain medicines (see Interactions below)
Do not take domperidone if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking this medicine.
What should I tell my doctor before taking domperidone?
Before you take domperidone, tell your healthcare provider about all of your medical conditions, including if you:
- You suffer from liver problems (liver function impairment or failure)
- You suffer from kidney problems (kidney function impairment or failure). It is advisable to ask your doctor for advice in case of prolonged treatment as you may need to take a lower dose or take this medicine less often, and your doctor may want to examine you regularly.
How should I take domperidone?
- Always take this medicine exactly as your doctor or pharmacist tells you to. You should check with them if you are not sure.
- Your doctor will decide how long you will need to take this medicine. Gastric symptoms usually resolve within 3-4 days of using this medicine. Do not take for more than 7 days without talking to your doctor.
- Oral forms of domperidone - oral tablet, oral suspension, oral drops and orally disintegrating tablet
- Take this medicine by mouth.
- It is recommended to take oral domperidone 15 to 30 minutes before meals, as when taken after meals the absorption of the medicine is slightly delayed.
- Swallow the tablets whole with a drink of water. Do not crush or chew them.
- Orally disintegrating tablets (orodispersible tablets) dissolve in the mouth and do not need to be taken with water.
- If taking the oral suspension, use the plastic measuring cup that comes with it.
- If taking the oral drops, use the dropper that comes with it.
- Suppositories containing domperidone
- To insert a suppository into your rectum (back passage) take the following steps:
- First wash your hands.
- The suppository should be moistened and then inserted into the bottom as far as possible.
- Once this has been done tense your muscles to prevent the suppository coming out.
- Food and drink does not affect the absorption of domperidone suppositories.
- To insert a suppository into your rectum (back passage) take the following steps:
What happens if I miss a dose?
If you miss a dose of domperidone, take it as soon as you remember. However if it is almost time for the next dose, wait until that is due and then continue as normal. Do not take a double dose to make up for a missed dose.
What happens if I overdose?
If you take too much domperidone, seek medical attention straight away. In the event of overdose, symptomatic treatment can be implemented. An ECG monitoring may be undertaken, because of the possibility of a heart problem called prolonged QT interval.
The signs of taking more than you should include feeling sleepy, confused, uncontrolled movements which include unusual eye movements, unusual movements of the tongue or abnormal posture (such as a twisted neck).
Adults and adolescents 12 years of age and older and with a body weight of 35 kg or more:
- Tablet. The usual dose is one 10mg tablet taken up to three times per day, if possible before meals. It is usually recommended not to take more than three tablets (30 mg) per day, but in some cases your doctor may recommend taking up to 4 tablets (40 mg) per day.
- Oral suspension. The usual dose is 10 ml taken up to three times per day, if possible before meals. Do not take more than 30 ml per day.
- Suppositories. The usual dose is one 30 mg suppository two times a day. Do not use more than two suppositories per day.
See full prescribing information for more details about domperidone dosing.
What are the side effects of domperidone?
Domperidone can cause serious side effects. Stop taking domperidone and see your doctor or go to a hospital straightaway if:
- You get swelling of the hands, feet, ankles, face, lips or throat which may cause difficulty in swallowing or breathing. You may also notice an itchy, lumpy rash (hives) or nettle rash (urticaria). This may mean you are having an allergic reaction to this medicine.
- You notice any uncontrolled movements. These include irregular eye movements, unusual movements of the tongue, and abnormal posture such as a twisted neck, trembling and muscle stiffness. This is more likely to happen in children. These symptoms should stop once you stop taking this medicine.
- You have a very fast or unusual heartbeat. This could be a sign of a life-threatening heart problem.
- You have a fit (seizure).
Common side effects of domperidone include:
- Dry mouth
Uncommon side effects of domperidone include:
- Lowering of sexual drive (libido) in men
- Feeling anxious
- Feeling drowsy
- Itchy skin. You may also have a rash
- Unusual production of breast milk in men and women
- Painful or tender breasts
- A general feeling of weakness
Other side effects (frequency unknown) of domperidone include:
- Disorders of the cardiovascular system: heart rhythm disorders (rapid or irregular heart beat) have been reported; if this happens, you should stop the treatment immediately. Domperidone may be associated with an increased risk of heart rhythm disorder and cardiac arrest. This risk may be more likely in those over 60 years old or taking doses higher than 30 mg per day.
- Feeling agitated or irritable
- Feeling more nervous than usual
- Abnormal eye movements
- Inability to urinate
- Breast enlargement in men
- In women, menstrual periods may be irregular or stop
- A blood test shows changes in the way your liver is working
Some patients who have used this medicine for conditions and dosages requiring longer term medical supervision have experienced the following unwanted effects: Restlessness; swollen or enlarged breasts, unusual discharge from breasts, irregular menstrual periods in women, difficulty breastfeeding, depression, hypersensitivity.
Side effects such as feeling drowsy, nervous, agitated or irritable or having a fit are more likely to happen in children.
These are not all of the possible side effects of domperidone.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Do not take domperidone if you are taking medicine to treat:
- Fungal infections such as azole anti-fungals, specifically oral ketoconazole, fluconazole or voriconazole.
- Bacterial infections, specifically erythromycin, clarithromycin, telithromycin, moxifloxacin, pentamidine (these are antibiotics)
- Heart problems or high blood pressure (amiodarone, dronedarone, quinidine, disopyramide, dofetilide, sotalol, diltiazem, verapamil)
- Psychoses (haloperidol, pimozide, sertindole)
- Depression (citalopram, escitalopram)
- Gastro-intestinal disorders (cisapride, dolasetron, prucalopride)
- Allergy (mequitazine, mizolastine)
- Malaria (in particular halofantrine)
- AIDS/HIV (protease inhibitors)
- Cancer (toremifene, vandetanib, vincamine)
Tell your doctor or pharmacist if you are taking drugs to treat infection, heart problems or AIDS/HIV.
Talk to your doctor if you need to take domperidone and apomorphine. Before you use these two medicines together your doctor will ensure that you can tolerate both when used simultaneously. Ask your doctor or specialist for advice.
It is important to ask your doctor or pharmacist if domperidone is safe for you when you are taking any other medicines, including medicines obtained without prescription.
Pregnancy and breastfeeding
Tell your doctor if you are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed.
Domperidone is not usually recommended in pregnancy. There is limited information available about the use of this medicine in pregnant people. Domperidone should only be used during pregnancy when justified by the anticipated therapeutic benefit. Ask your doctor for advice before taking this medicine.
Domperidone is not usually recommended if you are breastfeeding. Small amounts of this medicine have been detected in breastmilk. It may cause unwanted side effects affecting the heart in a breastfed baby. Domperidone should be used during breastfeeding only if your doctor considers this clearly necessary. Ask your doctor for advice before taking this medicine.
- Stored at room temperature between 68-77°F (20-25°C) or as directed
- Protect from light
- Do not refrigerate or freeze domerpidone suppositories. Do no store above 77°F (25°C)
- Keep out of sight and reach of children
What are the ingredients in domperidone?
Active ingredient: domperidone
Motilium tablets: lactose maize starch, microcrystalline cellulose, pregelatinized potato starch, povidone, magnesium stearate, hydrogenated cottonseed oil, sodium lauryl sulfate, hypromellose.
Zentiva oral solution: sorbitol, microcrystalline cellulose and carmellose sodium, methyl-p-hydroxybenzoate, propylhydroxybenzoate, sodium saccharin, polysorbate 20, sodium hydroxide and water.
Motilium suppositories: tartaric acid, macrogol 4000, macrogol 1000, macrogol 400, butyl hydroxyanisol.
Inactive ingredients may vary depending on the brand or generic version of domperidone you take. Check the product label of the version you take for a full list of ingredients.
The Motilium brand of domperidone is manufactured by Janssen, Janssen-Cilag, Zentiva Pharma and others. Other companies also make generic versions of this medicine.
- Health Products Regulatory Authority (HPRA). Motilium Suppositories Package Leaflet
- Food and Drug Administration (FDA). How to Request Domperidone for Expanded Access Use. February 2, 2021
- Health Navigator New Zealand. Domperidone. May 16, 2020
- UK Electronic Medicines Compendium (EMC). Domperidone Oral Suspension Patient Information Leaflet
- MedSafe - New Zealand Medicines and Medical Devices Safety Authority. Motilium Tablets Datasheet
- NHS. Domperidone. January 3, 2020
- Practo. Domstal Baby Drops. September 21, 2021
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.