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Common uses
This medicine contains the active ingredient domperidone, which is a type of medicine called a dopamine antagonist. It is an anti-emetic medicine, meaning it is used to treat nausea and vomiting. It can also be used to treat abdominal bloating, fullness and discomfort in adults.
Domperidone works primarily by blocking dopamine receptors found in an area of the brain known as the chemoreceptor trigger zone (CTZ). The CTZ is activated by nerve messages from the stomach when an irritant is present. It is also activated directly by agents circulating in the blood, for example anti-cancer medicines. Once activated, it sends messages to another area of the brain, the vomiting centre, which in turn sends messages to the gut, causing the vomiting reflex.
Before using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For domperidone the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to domperidone.
Pregnancy—domperidone has not been studied in pregnant women. However, domperidone has not been shown to cause birth defects or other problems in animal studies.
Breast-feeding—Domperidone passes into the breast milk, but it is not known if domperidone will cause unwanted effects in the newborn. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.
Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of domperidone in children with use in other age groups.
Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing the use of domperidone in the elderly with use in other age groups.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your doctor or pharmacist if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine, especially:
• Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegilene [e.g., Eldepryl], tranylcypromine [e.g., Parnate])
Other medical problems—The presence of other medical problems may affect the use of domperidone. Make sure you tell your doctor if you have any other medical problems, especially:
• Bleeding from the stomach or other problems involving the bowels
• Pituitary (brain) tumor
• Liver disease
• Medicine sensitivity to domperidone
Directions
The usual adult dose of domperidone is 10 mg three to four times a day, taken 15 to 30 minutes before meals and at bedtime if required. The dose sometimes needs to be increased to 20 mg four times a day. When treating the nausea and vomiting associated with medications used to treat Parkinson's disease, the usual adult dosage is 20 mg three or four times a day.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.
It is very important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not double doses.
Cautions
This medicine is not recommended for long term use.
Motilium tablets contain lactose and may be unsuitable for people with lactose intolerance, glucose/galactose malabsorption or a genetic disorder leading to accumulation of galactose in the blood (galactosaemia). Motilium suspension contains sorbitol and may be unsuitable for people with sorbitol intolerance.
Possible side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
• Diarrhoea
• Abnormal enlargement of breasts in men (gynaecomastia)
• Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects)
• Breast pain
• High blood prolactin (milk producing hormone) level (hyperprolactinaemia). Sometimes this can lead to symptoms such as breast enlargement, production of milk and stopping of menstrual periods.
• Stomach cramps
• Decreased sex drive
• Itchy rash (urticaria)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
If you take too much
Symptoms of overdosage may include drowsiness, disorientation and extrapyramidal reactions especially in children.
Anticholinergic, anti-Parkinson medicines or antihistamines with anticholinergic properties may be helpful in controlling the extrapyramidal reactions. There is no specific antidote to domperidone but in the event of overdosage, gastric lavage as well as the administration of activated charcoal may be useful. Symptomatic and supportive measures are recommended.
Additional information
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
• The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
• This medicine passes into breast milk in small amounts. Seek medical advice from your doctor before breastfeeding.
Drug interactions
The following medications may affect how domperidone works or increase the risk of side effects:
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, miconazole)
• erythromycin antibiotics (e.g., clarithromycin)
• HIV protease inhibitors (e.g., indinavir)
• MAO inhibitors (e.g., phenelzine)
• nefazodone
If you are taking any of these medications, speak with your doctor or pharmacist.
Depending on your specific circumstances, your doctor may want you to:
• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.
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