Domixon
Generic Name
Domperidone
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| domixon 10 mg tablet | ৳ 3.50 | ৳ 35.00 |
Description
Overview of the medicine
Domperidone is a dopamine antagonist that helps relieve nausea, vomiting, and certain gastrointestinal symptoms by increasing stomach and bowel movements. It is also used to treat symptoms of dyspepsia.
Uses & Indications
Dosage
Adults
10 mg three to four times daily, 15-30 minutes before meals and at bedtime. Max 30 mg/day for chronic use. Max 80 mg/day for acute nausea/vomiting, for shortest duration possible.
Elderly
Similar to adult dosage, but caution advised due to potential for cardiac effects. Start with lowest effective dose.
Renal_impairment
Dose frequency should be reduced to once or twice daily depending on the severity of impairment. e.g., 10 mg once or twice daily.
How to Take
Orally, preferably 15-30 minutes before meals. Do not crush or chew extended-release tablets.
Mechanism of Action
Domperidone selectively blocks dopamine D2 receptors located in the chemoreceptor trigger zone (CTZ) and in the stomach wall. This action increases gastrointestinal motility and tone, facilitating gastric emptying and reducing esophageal reflux. By blocking D2 receptors in the CTZ, it prevents nausea and vomiting.
Pharmacokinetics
Onset
30-60 minutes
Excretion
Around 66% excreted in feces (primarily as metabolites), 33% in urine (also as metabolites).
Half life
Approximately 7-9 hours, may be prolonged in severe renal impairment.
Absorption
Rapidly absorbed after oral administration, but bioavailability is low (around 15%) due to extensive first-pass metabolism in the gut and liver. Food decreases the rate and extent of absorption.
Metabolism
Extensively metabolized in the liver by cytochrome P450 enzymes, primarily CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to domperidone or any component
- Prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment
- Known existing prolongation of cardiac conduction intervals (e.g., QTc), particularly in patients with significant electrolyte disturbances or underlying cardiac diseases
- Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
- Conditions where gastrointestinal stimulation might be dangerous (e.g., gastrointestinal hemorrhage, mechanical obstruction, perforation)
Drug Interactions
Dopamine agonists (e.g., bromocriptine, cabergoline)
Domperidone may antagonize their effects.
Antacids and antisecretory agents (e.g., proton pump inhibitors)
Reduce bioavailability of domperidone. Should be taken after domperidone.
QTc prolonging drugs (e.g., certain antiarrhythmics, antipsychotics, antidepressants)
Increased risk of QTc prolongation and cardiac arrhythmias. Concomitant use should be avoided or used with extreme caution.
Potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin, ritonavir)
Significantly increase domperidone plasma levels, increasing risk of QTc prolongation. Concomitant use is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Drowsiness, disorientation, extrapyramidal reactions (especially in children), cardiac arrhythmias. Management: Symptomatic and supportive treatment. Gastric lavage and activated charcoal may be considered within an hour of ingestion. ECG monitoring is recommended due to potential for QTc prolongation.
Pregnancy & Lactation
Pregnancy: Use only if clearly needed and the potential benefits outweigh the potential risks to the fetus. Limited data available. Lactation: Domperidone is excreted in breast milk in small amounts. Weigh the benefits of breastfeeding against the potential risk to the infant. Consider alternative treatments if possible.
Side Effects
Contraindications
- Hypersensitivity to domperidone or any component
- Prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment
- Known existing prolongation of cardiac conduction intervals (e.g., QTc), particularly in patients with significant electrolyte disturbances or underlying cardiac diseases
- Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
- Conditions where gastrointestinal stimulation might be dangerous (e.g., gastrointestinal hemorrhage, mechanical obstruction, perforation)
Drug Interactions
Dopamine agonists (e.g., bromocriptine, cabergoline)
Domperidone may antagonize their effects.
Antacids and antisecretory agents (e.g., proton pump inhibitors)
Reduce bioavailability of domperidone. Should be taken after domperidone.
QTc prolonging drugs (e.g., certain antiarrhythmics, antipsychotics, antidepressants)
Increased risk of QTc prolongation and cardiac arrhythmias. Concomitant use should be avoided or used with extreme caution.
Potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin, ritonavir)
Significantly increase domperidone plasma levels, increasing risk of QTc prolongation. Concomitant use is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Drowsiness, disorientation, extrapyramidal reactions (especially in children), cardiac arrhythmias. Management: Symptomatic and supportive treatment. Gastric lavage and activated charcoal may be considered within an hour of ingestion. ECG monitoring is recommended due to potential for QTc prolongation.
Pregnancy & Lactation
Pregnancy: Use only if clearly needed and the potential benefits outweigh the potential risks to the fetus. Limited data available. Lactation: Domperidone is excreted in breast milk in small amounts. Weigh the benefits of breastfeeding against the potential risk to the infant. Consider alternative treatments if possible.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture.
Availability
Pharmacies, hospitals, clinics
Approval Status
Generally approved for marketing and use in many countries
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have evaluated domperidone's efficacy in nausea, vomiting, and dyspepsia. Recent trials have also focused on its safety profile, especially cardiac risks, leading to dose limitations and shorter treatment durations in many guidelines.
Lab Monitoring
- ECG monitoring (especially in patients with pre-existing cardiac conditions or those on QTc prolonging drugs)
- Electrolyte levels (potassium, magnesium) if risk factors for cardiac arrhythmias are present
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration.
- Assess patient's cardiac risk factors (including electrolyte imbalance and concomitant QTc prolonging drugs) before initiating and during treatment.
- Avoid in patients with moderate to severe hepatic impairment.
- Advise patients to report any cardiac symptoms immediately.
Patient Guidelines
- Take Domixon 15-30 minutes before meals.
- Do not exceed the recommended dose, especially if you have heart problems.
- Inform your doctor about all other medications you are taking.
- Report any unusual heart symptoms (palpitations, dizziness, fainting) immediately.
- Avoid grapefruit juice while taking this medication.
Missed Dose Advice
Take the missed dose as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Domperidone may cause dizziness or drowsiness. Patients should be warned not to drive or operate machinery if they experience these effects.
Lifestyle Advice
- Maintain a healthy diet to support digestive health.
- Avoid foods that trigger indigestion or nausea.
- Stay hydrated.
- Manage stress, as it can worsen gastrointestinal symptoms.
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