MHRA limits use of domperidone

The MHRA has issued new advice for domperidone which states that it should no longer be used to relieve symptoms of heartburn, bloating or stomach discomfort and should be avoided in people with serious underlying heart conditions.

Domperidone is a dopamine antagonist with anti-emetic properties | SCIENCE PHOTO LIBRARY
Domperidone is a dopamine antagonist with anti-emetic properties | SCIENCE PHOTO LIBRARY
The advice was issued after a European Medicines Agency (EMA) review of the safety and efficacy of domperidone concluded that there is a small increased risk of serious cardiac adverse drug reactions related to its use, including QT prolongation, torsade de pointes, serious ventricular arrhythmia and sudden cardiac death.

The EMA review concluded that when used to relieve nausea and vomiting the benefits of domperidone outweigh the risks. The drug should be used at the lowest effective dose for the shortest possible duration (not usually exceeding one week) with a recommended dose in adults (and children ≥35kg where licensed) of 10mg orally up to three times daily or 30mg rectally twice daily.

Domperidone products are contraindicated in patients with severe hepatic impairment, conditions where cardiac conduction is or could be impaired, or where there is underlying cardiac disease. Co-administration with drugs that prolong QT interval or potent CYP3A4 inhibitors is also contraindicated.

View domperidone drug records

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