Editing Domperidone (section)

===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>