Domiren
Generic Name
Domperidone
Manufacturer
Square Pharmaceuticals PLC.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| domiren 5 mg suspension | ৳ 35.00 | N/A |
Description
Overview of the medicine
Domiren 5 mg suspension contains Domperidone, which is used to treat nausea and vomiting, and to relieve symptoms of gastric motility disorders like dyspepsia and gastric stasis. It works by blocking dopamine receptors in the brain and gut.
Uses & Indications
Dosage
Adults
Adults and adolescents ≥12 years weighing ≥35 kg: 10 ml (10 mg) up to 3 times daily, maximum 30 mg/day. Should be taken before meals.
Elderly
Use with caution. Dosage similar to adults, but monitor for cardiac adverse effects. Maximum 30 mg/day.
Renal_impairment
In severe renal impairment (creatinine clearance <30 ml/min), frequency should be reduced to once or twice daily depending on severity. Total daily dose should not exceed 10 mg.
How to Take
Take orally, preferably 15-30 minutes before meals. Do not exceed the prescribed dose or duration of treatment.
Mechanism of Action
Domperidone is a peripheral dopamine D2-receptor antagonist. It blocks dopamine receptors in the chemoreceptor trigger zone (CTZ) in the brain, thereby preventing nausea and vomiting. Peripherally, it increases lower esophageal sphincter pressure, gastric motility, and accelerates gastric emptying without affecting gastric secretion.
Pharmacokinetics
Onset
30-60 minutes for antiemetic effects.
Excretion
About 66% excreted in feces and 33% in urine, largely as metabolites. Only a small percentage is excreted unchanged.
Half life
Approximately 7-9 hours in healthy subjects; prolonged in severe renal impairment.
Absorption
Rapidly absorbed after oral administration, but has low oral bioavailability (13-17%) due to extensive first-pass metabolism in the gut wall and liver. Peak plasma concentrations are reached within 30-60 minutes.
Metabolism
Extensively metabolized in the liver by hydroxylation and N-dealkylation, primarily by CYP3A4. Conjugation also occurs.
Side Effects
Contraindications
- Hypersensitivity to Domperidone or any component of the formulation
- Prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment
- Known existing prolongation of cardiac QTc interval, significant cardiac disease (e.g., congestive heart failure)
- Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Drug Interactions
Antacids or H2-receptor antagonists
May reduce the oral bioavailability of domperidone. Should be taken after domperidone (e.g., 30 minutes apart).
Potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Significantly increase domperidone plasma levels, leading to an increased risk of QTc prolongation and other cardiac adverse events. Concomitant use is contraindicated.
QTc-prolonging drugs (e.g., class IA and III antiarrhythmics, some antipsychotics, some antibiotics)
May have an additive effect on QTc prolongation. Concomitant use is generally contraindicated.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, disorientation, and extrapyramidal reactions (e.g., abnormal muscle movements). Treatment is symptomatic and supportive, including gastric lavage and administration of activated charcoal. Anticholinergic drugs may be useful for extrapyramidal reactions.
Pregnancy & Lactation
Use in pregnancy only if clearly needed and if the potential benefits outweigh the potential risks to the fetus. Domperidone is excreted in breast milk; therefore, it should be avoided during lactation unless the expected benefits to the mother outweigh the potential risks to the infant.
Side Effects
Contraindications
- Hypersensitivity to Domperidone or any component of the formulation
- Prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment
- Known existing prolongation of cardiac QTc interval, significant cardiac disease (e.g., congestive heart failure)
- Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Drug Interactions
Antacids or H2-receptor antagonists
May reduce the oral bioavailability of domperidone. Should be taken after domperidone (e.g., 30 minutes apart).
Potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Significantly increase domperidone plasma levels, leading to an increased risk of QTc prolongation and other cardiac adverse events. Concomitant use is contraindicated.
QTc-prolonging drugs (e.g., class IA and III antiarrhythmics, some antipsychotics, some antibiotics)
May have an additive effect on QTc prolongation. Concomitant use is generally contraindicated.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, disorientation, and extrapyramidal reactions (e.g., abnormal muscle movements). Treatment is symptomatic and supportive, including gastric lavage and administration of activated charcoal. Anticholinergic drugs may be useful for extrapyramidal reactions.
Pregnancy & Lactation
Use in pregnancy only if clearly needed and if the potential benefits outweigh the potential risks to the fetus. Domperidone is excreted in breast milk; therefore, it should be avoided during lactation unless the expected benefits to the mother outweigh the potential risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Check the expiration date on the packaging.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by national regulatory authorities
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Ongoing clinical trials focus on evaluating the safety profile, particularly cardiac risks, and efficacy in specific populations. Data has led to revised dosing guidelines in many regions.
Lab Monitoring
- ECG monitoring (especially in patients with pre-existing cardiac conditions or risk factors for QTc prolongation)
- Prolactin levels (if hyperprolactinemia symptoms occur)
Doctor Notes
- Strictly adhere to dosing guidelines and contraindications, especially in patients with cardiac risk factors or hepatic/renal impairment.
- Inform patients about potential cardiac and extrapyramidal side effects and advise them to seek immediate medical attention if these occur.
- Review concomitant medications for potential drug interactions, particularly CYP3A4 inhibitors and QTc-prolonging drugs.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not exceed the recommended dose or duration of treatment.
- Report any symptoms like palpitations, dizziness, or fainting to your doctor immediately.
- Avoid alcohol during treatment as it may worsen symptoms or side effects.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Domperidone may cause dizziness or drowsiness in some individuals. Exercise caution when driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy diet to support digestion.
- Avoid overeating and spicy foods if they trigger dyspepsia.
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