From the Research
Domperidone is not typically associated with causing hypotension as a common side effect, and in fact, it may even increase blood pressure in certain situations, as evidenced by a study published in 2001 1. The primary concern with domperidone is its potential to cause QT interval prolongation, which can lead to cardiac arrhythmias, rather than hypotension. When considering the use of domperidone, it is essential to weigh the benefits against the potential risks, particularly in patients with pre-existing cardiovascular conditions or those taking other medications that might interact with domperidone. Some studies have suggested that domperidone may be beneficial in treating orthostatic hypotension in patients with Parkinson's disease, especially when used in conjunction with apomorphine, as reported in a systematic review published in 2017 2. However, the most recent and highest quality study, a meta-analysis published in 2018 3, found that domperidone treatment may not be associated with an overall cardiovascular event risk increase at doses ≤30 mg/day and does not result in QT prolongation. Key points to consider when prescribing domperidone include:
- Monitoring for potential cardiovascular side effects, particularly in patients with pre-existing heart conditions
- Being aware of the potential for drug interactions with other medications
- Considering the benefits of domperidone in treating nausea, vomiting, and certain gastrointestinal disorders, as well as its potential use in managing orthostatic hypotension in patients with Parkinson's disease. It is crucial to prioritize the patient's overall health and well-being, taking into account their individual medical history and current health status, when making decisions about domperidone use.