Dorel
Generic Name
Dorel
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dorel 75 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Dorel is a drug used to treat nausea and vomiting, and to promote gastric motility.
Uses & Indications
Dosage
Adults
10 mg three to four times daily, before meals and at bedtime if necessary. Max 30 mg/day.
Elderly
No specific dose adjustment for elderly patients with normal renal function, but caution is advised. Lower doses or reduced frequency may be considered.
Renal_impairment
Dose frequency should be reduced to once or twice daily depending on severity. Avoid in severe renal impairment (CrCl < 30 mL/min).
How to Take
Take orally 15-30 minutes before meals. For suspension, shake well before use.
Mechanism of Action
Dorel acts as a peripheral dopamine D2 receptor antagonist, primarily in the chemoreceptor trigger zone (CTZ) and the gut. This blocks dopamine's inhibitory effect on gastric motility, enhancing upper GI tract peristalsis and sphincter tone. Its antiemetic effect is due to D2 receptor antagonism in the CTZ.
Pharmacokinetics
Onset
15-30 minutes for gastroprokinetic effects.
Excretion
Excreted primarily via feces (66%) and urine (33%) as metabolites.
Half life
Approximately 7-9 hours (prolonged in severe renal impairment).
Absorption
Rapidly absorbed from the gastrointestinal tract, but undergoes extensive first-pass metabolism.
Metabolism
Extensively metabolized in the liver by hydroxylation and N-dealkylation, mainly by CYP3A4.
Side Effects
Contraindications
- Known hypersensitivity to Dorel or any component
- Prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment
- Conditions where gastric stimulation is dangerous (e.g., gastrointestinal hemorrhage, mechanical obstruction, perforation)
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
- Patients with known prolonged cardiac conduction intervals, particularly QTc, or underlying cardiac disease
Drug Interactions
Anticholinergics
May antagonize the prokinetic effect of Dorel.
Dopaminergic agonists (e.g., bromocriptine, L-dopa)
Dorel may increase their bioavailability. Concurrent use requires caution.
QTc prolonging drugs (e.g., certain antipsychotics, antiarrhythmics)
Increased risk of QTc prolongation. Avoid concomitant use.
Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin)
Increased plasma levels of Dorel, increased risk of QTc prolongation. Concomitant use is contraindicated.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, disorientation, extrapyramidal reactions, and potential cardiac events. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal. ECG monitoring is recommended.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Dorel is excreted in breast milk in small amounts; caution is advised, and breastfeeding mothers should consult a doctor.
Side Effects
Contraindications
- Known hypersensitivity to Dorel or any component
- Prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment
- Conditions where gastric stimulation is dangerous (e.g., gastrointestinal hemorrhage, mechanical obstruction, perforation)
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
- Patients with known prolonged cardiac conduction intervals, particularly QTc, or underlying cardiac disease
Drug Interactions
Anticholinergics
May antagonize the prokinetic effect of Dorel.
Dopaminergic agonists (e.g., bromocriptine, L-dopa)
Dorel may increase their bioavailability. Concurrent use requires caution.
QTc prolonging drugs (e.g., certain antipsychotics, antiarrhythmics)
Increased risk of QTc prolongation. Avoid concomitant use.
Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin)
Increased plasma levels of Dorel, increased risk of QTc prolongation. Concomitant use is contraindicated.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, disorientation, extrapyramidal reactions, and potential cardiac events. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal. ECG monitoring is recommended.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Dorel is excreted in breast milk in small amounts; caution is advised, and breastfeeding mothers should consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established Dorel's efficacy and safety in treating dyspepsia, nausea, and vomiting. Recent studies have focused on cardiac safety, especially with higher doses and prolonged use.
Lab Monitoring
- Regular ECG monitoring in patients at risk of cardiac events or on high doses.
- Prolactin levels if symptoms of hyperprolactinemia occur.
Doctor Notes
- Advise patients about the cardiac risks, especially in elderly and those with pre-existing cardiac conditions. Prescribe the lowest effective dose for the shortest duration. Avoid concomitant use with QTc-prolonging drugs and strong CYP3A4 inhibitors.
- Consider alternative antiemetics if cardiac risks are high.
Patient Guidelines
- Do not exceed the prescribed dose.
- Inform your doctor about all other medications you are taking.
- Report any unusual heart symptoms (e.g., palpitations, fainting) immediately.
- Avoid grapefruit juice.
Missed Dose Advice
Take the missed dose as soon as you remember, unless it's almost time for your next dose. Do not double dose.
Driving Precautions
May cause drowsiness or dizziness. Avoid driving or operating machinery if affected.
Lifestyle Advice
- Maintain a healthy diet to manage dyspepsia.
- Avoid fatty foods that can worsen gastric emptying.
- Quit smoking and reduce alcohol intake to improve digestive health.
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