Editing Domperidone (section)

==Medical uses==

=== Nausea and vomiting ===
There is some evidence that domperidone has [[antiemetic]] activity.<ref name="mechanismforantiemetic"/> It is recommended by the Canadian Headache Society for treatment of nausea associated with acute [[migraine]].<ref>{{cite journal | vauthors = Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ | title = Canadian Headache Society Guideline: acute drug therapy for migraine headache | journal = The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques | volume = 40 | issue = 5 Suppl 3 | pages = S1–S80 | date = September 2013 | pmid = 23968886 | doi = 10.1017/S0317167100118943 | doi-access = free }}</ref>

===Gastroparesis===
[[Gastroparesis]] is a medical condition characterised by delayed emptying of the stomach when there is <u>no</u> mechanical [[gastric outlet obstruction]]. Its cause is most commonly [[idiopathic]], a [[diabetes|diabetic]] complication or a result of abdominal surgery. The condition causes nausea, vomiting, [[postprandial|fullness after eating]], early satiety (feeling full before the meal is finished), abdominal pain, and bloating. Domperidone can be used to increase the transit of food through the stomach by increasing [[gastrointestinal]] [[peristalsis]] and hence to treat gastroparesis.<ref name="mechanismforantiemetic"/><ref name="pmid10332535" /> It may be useful in idiopathic and diabetic gastroparesis.<ref>{{cite journal | vauthors = Stevens JE, Jones KL, Rayner CK, Horowitz M | title = Pathophysiology and pharmacotherapy of gastroparesis: current and future perspectives | journal = Expert Opinion on Pharmacotherapy | volume = 14 | issue = 9 | pages = 1171–1186 | date = June 2013 | pmid = 23663133 | doi = 10.1517/14656566.2013.795948 | s2cid = 23526883 }}</ref><ref name="pmid9663360">{{cite journal | vauthors = Silvers D, Kipnes M, Broadstone V, Patterson D, Quigley EM, McCallum R, Leidy NK, Farup C, Liu Y, Joslyn A | title = Domperidone in the management of symptoms of diabetic gastroparesis: efficacy, tolerability, and quality-of-life outcomes in a multicenter controlled trial. DOM-USA-5 Study Group | journal = Clinical Therapeutics | volume = 20 | issue = 3 | pages = 438–453 | year = 1998 | pmid = 9663360 | doi = 10.1016/S0149-2918(98)80054-4 }}</ref> However, increased rate of gastric emptying induced by drugs like domperidone does not always correlate well with relief of symptoms.<ref>{{cite journal | vauthors = Janssen P, Harris MS, Jones M, Masaoka T, Farré R, Törnblom H, Van Oudenhove L, Simrén M, Tack J | title = The relation between symptom improvement and gastric emptying in the treatment of diabetic and idiopathic gastroparesis | journal = The American Journal of Gastroenterology | volume = 108 | issue = 9 | pages = 1382–1391 | date = September 2013 | pmid = 24005344 | doi = 10.1038/ajg.2013.118 | s2cid = 32835351 }}</ref>

===Lactation===
Domperidone is used [[Off-label use|off-label]] in some countries to stimulate [[lactation]] or enhance breast milk production, but, as of December 2023, it is not approved for that purpose in any country, and is not approved for use in humans in the United States.<ref name="FDA 20231212" /><ref name="FDADomperidone">{{cite web |title=Information about Domperidone |website=U.S. [[Food and Drug Administration]] (FDA) |date=12 December 2023 |url=https://www.fda.gov/drugs/information-drug-class/information-about-domperidone |archive-url=https://web.archive.org/web/20231213162326/https://www.fda.gov/drugs/information-drug-class/information-about-domperidone |url-status=dead |archive-date=13 December 2023 |access-date=8 June 2024}} {{PD-notice}}</ref> Domperidone acts as a peripheral [[dopamine]] antagonist and is hypothesized to stimulate [[prolactin]] secretion, with a 2003 study supporting that hypothesis.<ref name="pmid15451832">{{cite journal | vauthors = da Silva OP, Knoppert DC | title = Domperidone for lactating women | journal = CMAJ | volume = 171 | issue = 7 | pages = 725–726 | date = September 2004 | pmid = 15451832 | pmc = 517853 | doi = 10.1503/cmaj.1041054 }}</ref>

A 2018 meta-analysis of five randomized controlled trials found that domperidone resulted in a moderate increase of in breast milk volume for mothers of preterm infants with insufficient milk supply. The analysis also indicated that domperidone was well tolerated with no significant difference in maternal adverse events compared to placebo.<ref name="t992">{{cite journal | vauthors = Grzeskowiak LE, Smithers LG, Amir LH, Grivell RM | title = Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis | journal = BJOG | volume = 125 | issue = 11 | pages = 1371–1378 | date = October 2018 | pmid = 29469929 | doi = 10.1111/1471-0528.15177 | publisher = Wiley | hdl = 2440/114203 | hdl-access = free }}</ref> Domperidone has no officially established dosage for increasing milk supply, but most published studies have used 10&nbsp;mg three times daily for 4 to 10 days (30&nbsp;mg per day).<ref name="NIH">{{cite journal |journal=Drugs and Lactation Database |title=Domperidone |publisher=Bethesda (MD): National Institute of Child Health and Human Development |orig-date=2006 |date=15 May 2024 |pmid=30000430 |url=https://www.ncbi.nlm.nih.gov/books/NBK501371/}}</ref>

The US [[Food and Drug Administration]] (FDA) has expressed concerns about serious adverse side effects and concerns about its effectiveness.<ref name="FDADomperidone"/> The FDA identified serious cardiac adverse events associated with domperidone use in lactating individuals, including arrhythmias, cardiac arrest, and sudden death. Additionally, discontinuation or tapering of domperidone has been linked to severe neuropsychiatric adverse events such as agitation, anxiety, and suicidal ideation. Because of these risks, the FDA strongly cautions against the use of domperidone to enhance lactation.<ref name="FDADomperidone"/>

A review by [[Health Canada]] also found a link between the sudden discontinuation or tapering of domperidone when used off-label for lactation, and psychiatric withdrawal events, particularly daily doses greater than the maximum recommended dose of 30&nbsp;mg per day.<ref name="HealthCanada">{{cite web |title=Assessing the Potential Risk of Psychiatric Withdrawal Events when Used for Lactation Stimulation |website=Drug and Health Products Portal |date=8 June 2024 |url=https://dhpp.hpfb-dgpsa.ca/review-documents/resource/SSR1691692252806 |access-date=8 June 2024}}</ref> A 2021 study found that postpartum usage of domperidone increased across five Canadian provinces from 2004 and 2017 with usage plateauing in 2011 and a drop in usage after a 2012 Health Canada advisory warning about domperidone.<ref name="e088">{{cite journal | vauthors = Moriello C, Paterson JM, Reynier P, Dahl M, Aibibula W, Fisher A, Gamble JM, Kuo IF, Ronksley PE, Winquist B, Filion KB | title = Off-label postpartum use of domperidone in Canada: a multidatabase cohort study | journal = CMAJ Open | volume = 9 | issue = 2 | pages = E500–E509 | year = 2021 | pmid = 33990364 | doi = 10.9778/cmajo.20200084 | publisher = CMA Joule Inc. | pmc = 8157989 }}</ref>

===Other uses===

====Parkinson's disease====
[[Parkinson's disease]] is a [[neurodegenerative disease|degenerative neurological condition]] where a decrease in [[dopamine]] in the [[brain]] leads to [[muscle rigidity|rigidity]] (stiffness of movement), [[tremor]], and other symptoms and signs. Poor [[gastrointestinal]] function, [[nausea]], and [[vomiting]] are major problems for people with Parkinson's disease because most medications used to treat Parkinson's disease are given [[oral administration|by mouth]]. These [[medication]]s, such as [[levodopa]], can also cause nausea as a [[side effect]]. Furthermore, [[antiemetic|anti-nausea drugs]], such as [[metoclopramide]], which do cross the [[blood–brain barrier]], may worsen the [[extrapyramidal symptom]]s of Parkinson's disease. Domperidone can be used to relieve nausea and gastrointestinal symptoms in Parkinson's disease; it blocks peripheral D<sub>2</sub> receptors but minimally crosses the blood-brain barrier in normal doses, so has no effect on the extrapyramidal symptoms of the disease.<ref name="pmid30361854">{{cite journal | vauthors = Ramprasad C, Douglas JY, Moshiree B | title = Parkinson's Disease and Current Treatments for Its Gastrointestinal Neurogastromotility Effects | journal = Current Treatment Options in Gastroenterology | volume = 16 | issue = 4 | pages = 489–510 | date = December 2018 | pmid = 30361854 | doi = 10.1007/s11938-018-0201-3 | s2cid = 53104650 }}</ref><ref name="pmid18281732">{{cite journal | vauthors = Lertxundi U, Peral J, Mora O, Domingo-Echaburu S, Martínez-Bengoechea MJ, García-Moncó JC | title = Antidopaminergic therapy for managing comorbidities in patients with Parkinson's disease | journal = American Journal of Health-System Pharmacy | volume = 65 | issue = 5 | pages = 414–419 | date = March 2008 | pmid = 18281732 | doi = 10.2146/ajhp060624 }}</ref><ref name="pmid9108986">{{cite journal | vauthors = Jost WH | title = Gastrointestinal motility problems in patients with Parkinson's disease. Effects of antiparkinsonian treatment and guidelines for management | journal = Drugs & Aging | volume = 10 | issue = 4 | pages = 249–258 | date = April 1997 | pmid = 9108986 | doi = 10.2165/00002512-199710040-00002 | s2cid = 38114001 }}</ref> In addition, domperidone may be useful in the treatment of [[orthostatic hypotension]] caused by [[dopaminergic]] therapy in people with Parkinson's disease.<ref name="BacchiChimKramer2017">{{cite journal | vauthors = Bacchi S, Chim I, Kramer P, Postuma RB | title = Domperidone for Hypotension in Parkinson's Disease: A Systematic Review | journal = J Parkinsons Dis | volume = 7 | issue = 4 | pages = 603–617 | date = 2017 | pmid = 29103053 | doi = 10.3233/JPD-171209 | url = }}</ref><ref name="LiWuCui2023">{{cite journal | vauthors = Papakonstantinou T, Nikolakopoulou A, Higgins JP, Egger M, Salanti G | title = CINeMA: Software for semiautomated assessment of the confidence in the results of network meta-analysis | journal = Campbell Systematic Reviews | volume = 16 | issue = 1 | pages = e1080 | date = March 2020 | pmc = 10056828 | doi = 10.1002/14651858.CD014883 | pmid = 37131978 }}</ref><ref name="Lang2001">{{cite journal | vauthors = Lang AE | title = Acute orthostatic hypotension when starting dopamine agonist therapy in parkinson disease: the role of domperidone therapy | journal = Arch Neurol | volume = 58 | issue = 5 | pages = 835 | date = May 2001 | pmid = 11346387 | doi = 10.1001/archneur.58.5.835 | doi-broken-date = 11 November 2024 | url = }}</ref><ref name="LuchsingerGrilliVelasco1998">{{cite journal | vauthors = Luchsinger A, Grilli M, Velasco M | title = Metoclopramide and domperidone block the antihypertensive effect of bromocriptine in hypertensive patients | journal = Am J Ther | volume = 5 | issue = 2 | pages = 81–88 | date = March 1998 | pmid = 10099042 | doi = 10.1097/00045391-199803000-00005 | url = }}</ref><ref name="SchofferHendersonOMaley2007">{{cite journal | vauthors = Schoffer KL, Henderson RD, O'Maley K, O'Sullivan JD | title = Nonpharmacological treatment, fludrocortisone, and domperidone for orthostatic hypotension in Parkinson's disease | journal = Mov Disord | volume = 22 | issue = 11 | pages = 1543–1549 | date = August 2007 | pmid = 17557339 | doi = 10.1002/mds.21428 | url = }}</ref>

====Other gastrointestinal uses====
Domperidone may be used in [[functional dyspepsia]] in both adults and children.<ref>{{cite journal | vauthors = Xiao M, Qiu X, Yue D, Cai Y, Mo Q | title = Influence of hippophae rhamnoides on two appetite factors, gastric emptying and metabolic parameters, in children with functional dyspepsia | journal = Hellenic Journal of Nuclear Medicine | volume = 16 | issue = 1 | pages = 38–43 | year = 2013 | pmid = 23529392 | doi = <!-- not 10.1967/s002449910070 --> | url=https://www.nuclmed.gr/wp/wp-content/uploads/2017/03/42-4.pdf }}</ref><ref>{{cite journal | vauthors = Huang X, Lv B, Zhang S, Fan YH, Meng LN | title = Itopride therapy for functional dyspepsia: a meta-analysis | journal = World Journal of Gastroenterology | volume = 18 | issue = 48 | pages = 7371–7377 | date = December 2012 | pmid = 23326147 | pmc = 3544044 | doi = 10.3748/wjg.v18.i48.7371 | doi-access = free }}</ref> It has also been found effective in the treatment of [[gastroesophageal reflux disease|reflux]] in children.<ref>{{cite book| vauthors = Kapoor AK, Raju SM |year=2013|title=Illustrated Medical Pharmacology|chapter=7.2 Gastrointestinal Drugs|chapter-url=https://books.google.com/books?id=Le28AQAAQBAJ&pg=PA677|publisher=JP Medical Ltd|page=677|isbn=978-9350906552|access-date=31 October 2014}} (Google Books)</ref> However some specialists consider its risks prohibitory of the treatment of infantile reflux.<ref>{{Cite news|url=https://www.telegraph.co.uk/health/healthnews/11005559/Fear-that-reflux-treatment-for-babies-will-be-denied-under-new-Nice-guidance.html |title=Fear that reflux treatment for babies will be denied under new Nice guidance | vauthors = Smith R |date=1 August 2014 |publisher=[[The Daily Telegraph]] |access-date=31 October 2014 |archive-url=https://web.archive.org/web/20141005121124/http://www.telegraph.co.uk/health/healthnews/11005559/Fear-that-reflux-treatment-for-babies-will-be-denied-under-new-Nice-guidance.html |archive-date=5 October 2014 |url-status=dead  }}</ref>

===Available forms===
Domperidone is available for use by [[oral administration]] in the form of [[tablet (pharmacy)|tablet]]s, [[orally disintegrating tablet]]s (ODTs) and [[suspension (chemistry)|suspension]], and by [[rectal administration]] in the form of [[suppository|suppositories]].<ref name="ema" /><ref name="mhra"/> The oral tablets are available in the strength of 10{{nbsp}}mg.<ref name="mechanismforantiemetic"/> Domperidone has been studied for use by [[intramuscular injection]] and an [[intravenous injection|intravenous]] formulation was previously available, but the medication is now only available in forms for oral and rectal administration.<ref name="mechanismforantiemetic"/>