Adults

Adults and adolescents (12 years and above, weighing >35 kg): 10 ml (10 mg) up to 3 times daily, 15-30 minutes before meals. Max daily dose: 30 ml (30 mg). For children (1 to 12 years and weighing ≤35 kg): 0.25 ml/kg body weight, up to 3 times daily. Max daily dose: 0.75 ml/kg body weight. For example, a 10 kg child would take 2.5 ml per dose, 3 times a day. Always follow doctor's prescription.

Elderly

Dose reduction may be necessary, especially with impaired renal function, and monitoring for cardiac risks is advised.

Renal_impairment

In moderate to severe renal impairment (creatinine clearance <30 ml/min), dosing frequency should be reduced to 1-2 times daily depending on severity. Avoid in severe impairment.

Onset

Within 30-60 minutes.

Excretion

Excreted primarily via feces (66%) and urine (33%) as metabolites.

Half life

Approximately 7-9 hours (can be prolonged in severe renal impairment).

Absorption

Rapidly absorbed after oral administration; peak plasma concentrations reached in about 1 hour. Bioavailability is low (15%) due to extensive first-pass metabolism.

Metabolism

Extensively metabolized in the liver by N-dealkylation and oxidative hydroxylation, primarily via CYP3A4.

Anticholinergics

May antagonize the prokinetic effect of domperidone.

QT prolonging drugs

Concomitant use with other drugs known to prolong the QT interval (e.g., some antiarrhythmics, antipsychotics, antidepressants, macrolides) increases the risk of cardiac arrhythmias.

Potent CYP3A4 inhibitors

Co-administration with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin, ritonavir) is contraindicated as it significantly increases domperidone plasma levels, increasing the risk of QT prolongation and cardiac arrhythmias.

Antacids and antisecretory agents

May reduce the bioavailability of domperidone; it is generally recommended to take domperidone before meals and antacids after meals.