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Domperidone

Brand name: Motilium®
German: Domperidon

1 Definition

Domperidone is a prokinetic antiemetic from the group of dopamine antagonists.

2 Mechanism of action

Domperidone blocks the D1 and the D2 dopamine receptors in the area postrema and also increases the motility of the gastrointestinal tract.

3 Effect

Domperidone is effective with nausea, vomiting and gastroparesis. In general, domperidone is not as potent as Metoclopramide, also a dopamine antagonist.

Domperidone being a dopamine antagonist is not effective for kinetosis. Kinetosis is instead treated with H1 antagonists (Diphenhydramine, Dimenhydrinate) or scopolamine.

4 Pharmacokinetics

Only a small fraction of domperidone passes the blood brain barrier. Because of that it has its main effect in the periphery, and a very little effect in the central part. Since the vomiting center is located in the area postrema, belonging to the circumventricular organs, and with that lacks a blood brain barrier, domperidone has a central antiemetic action.

Because of its low presence in the CNS very few side effects on the central nervous system can be observed.

5 Side effects

Domperidone increases the prolactin levels and can lead to hyperprolactinemia. Additionally, domperidone is suspected to give rise to ventricular arrhythmias. Since domperidone, contrary to metoclopramide, can not pass the blood brain barrier, it also has no effect on the extrapyramidal motor system and does not lead to dyskinesia.

Further side effects are:

6 Drug interactions

Domperidone should not be used with substances that elongate the QT interval.

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Specialties: Pharmacology

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