Domperidone is an anti-nausea medication. It is also prescribed to treat stomach pain for people who are receiving end-of-life care. In some countries, doctors prescribe it to breastfeeding mothers to increase milk supply when other measures haven't worked.
Domperidone is available by prescription only. It is sold under the brand name Motilium.
Can I Take Domperidone in the United States?
Domperidone is not yet approved for legal sale or use as a prescription in the United States. The FDA has issued a warning that using domperidone can cause an uneven heartbeat called cardiac arrhythmia. It can also cause cardiac arrest, which is a heart attack, and even sudden death. These serious dangers are related to the amount of domperidone that you take.
Higher levels of domperidone in the blood increase your risk of complications. Using domperidone with other medicines such as erythromycin, a common antibiotic, can increase the level of domperidone in your blood to potentially dangerous levels.
Domperidone has not been approved for regular prescription use in the U.S. However, patients who are over 12 years of age with serious gastrointestinal problems that have not found relief through other treatments may be able to receive it through an investigational new drug application with the FDA.
How Do You Take Domperidone?
You should follow your doctor's instructions for taking domperidone. If your dosage is different, don't change it. These are the average doses, but your situation may be different:
For gastrointestinal motility disorders. This is a problem related to how food moves through your body. Adults take 10 milligrams, 3 to 4 times daily. Some people may need a higher dose of 20 mg, 3 to 4 times daily.
For nausea and vomiting. Adults take 20 milligrams, 3 to 4 times daily.
For increasing milk supply. The usual starting dose is 10 milligrams, every 8 hours. The dose may change depending on the response.
Missed dose. If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and return to your regular schedule. Don't take a double dose.
How Does Domperidone Work?
Domperidone blocks the messages that pass between your digestive system and your brain. It makes you less likely to be sick by making the muscles at the entrance of your stomach tighten and the muscles at the exit of your stomach relax. It also blocks messages in your brain that cause you to feel sick.
Domperidone helps increase your milk supply by stimulating the release of prolactin. This hormone stimulates breast milk production.
Who Shouldn't Take Domperidone?
Domperidone is usually prescribed for adults and children over 12, but it is not for everyone. You should talk to your doctor if you have any of the following issues:
- Allergy to domperidone or other medication
- Bleeding from your stomach
- Recent abdominal surgery
- Pituitary gland tumor
- Liver or kidney problems
- Heart problems or irregular heartbeat
- Weight below 77 pounds
- Bowel obstruction, Crohn's disease, or diverticulitis
Domperidone may interact with some other medicines. Tell your doctor if you are taking any of the following:
- Antipsychotics or antidepressants
- Antibiotics or antifungal medicines
- HIV medicines
- Malaria medicines
- Medicines for high blood pressure or heart problems
- Medicines or treatments for cancer
What Are the Side Effects of Domperidone?
Not all of these side effects may occur, and they can also result from an overdose. If you experience any of the following, you may need medical attention:
- Irregular heartbeat
- Loss of muscle control or balance
- Difficulty speaking
If you have any of the following symptoms, check with your doctor immediately:
- Swelling of the mouth
- Loss of muscle control or balance
- Swelling of hands, face, lower legs, or feet
- Fast, pounding, irregular, or racing heartbeat
Some side effects may improve as you adjust to treatment. They may not require medical attention. Check with your healthcare provider if you find any of these bothersome:
- Dry mouth
- Swelling of the breast in men
- Hot flashes
- Itchy skin
- Eye itchiness, pain, swelling, or redness
- Breast milk draining from nipples
- Breast pain
- Menstrual irregularities
Other Ways to Increase Milk Production
Domperidone has not been approved for use in increasing milk supply. That doesn't mean it can't be prescribed for that reason. It just means that the manufacturer hasn't approved it for that reason. In the United States, it can't be prescribed for any reason.
Domperidone should never be the first method used to increase breast milk production. It should only be used after you've tried all other methods of increasing your milk supply. Before trying domperidone, you should do these things:
- Make sure your baby is latching correctly.
- Use breast compression to increase the amount of milk your baby is drinking.
- Pump after your baby eats to increase milk supply.
- Don't use any artificial nipples such as pacifiers.
Other ways to naturally increase your breast milk supply include:
- Breastfeed every time your baby is hungry.
- Offer both breasts at each feeding. Let your baby finish on one side and then offer the other.
- Get plenty of sleep and eat a healthy diet.
- Pump frequently between feedings.
- Relax and massage your breasts to encourage your milk to flow before feeding your baby.