Domperidone Dosing for a 5-Year-Old Child Weighing 14.9kg
The recommended dose of domperidone for a 5-year-old child weighing 14.9kg is 0.2-0.4 mg/kg/dose given 3-4 times daily, which calculates to approximately 3-6 mg per dose.
Dosing Calculation
For pediatric patients, domperidone dosing should be weight-based:
- Standard pediatric dosing range: 0.2-0.4 mg/kg/dose
- For a 14.9kg child:
- Minimum dose: 14.9kg × 0.2 mg/kg = 2.98 mg (round to 3 mg)
- Maximum dose: 14.9kg × 0.4 mg/kg = 5.96 mg (round to 6 mg)
- Frequency: 3-4 times daily before meals and at bedtime
Important Safety Considerations
Cardiac Risk
Domperidone has been associated with QT interval prolongation and increased risk of sudden cardiac death, particularly at doses ≥30 mg/day in adults 1, 2. Therefore:
- Always use the lowest effective dose
- Consider baseline ECG to assess QTc interval before initiating therapy
- Avoid in patients with:
- Pre-existing cardiac conditions
- Family history of cardiac arrhythmias
- Concomitant medications that prolong QT interval
Administration Guidelines
- Give 15-30 minutes before meals and at bedtime
- Oral suspension is preferred for accurate dosing in children
- Duration of treatment should be limited to the shortest period necessary for symptom control
Clinical Indications
Domperidone is used as:
- An antiemetic for nausea and vomiting
- A prokinetic agent for upper gastrointestinal motility disorders 3, 4
Monitoring
- Monitor for extrapyramidal side effects, although these are less common with domperidone than with metoclopramide due to minimal blood-brain barrier penetration 4
- Watch for gastrointestinal side effects (abdominal cramps, diarrhea)
- If treatment extends beyond short-term use, consider periodic cardiac evaluation
Advantages Over Other Antiemetics
Domperidone has minimal central nervous system penetration compared to metoclopramide, resulting in fewer neurological side effects 3, 4. This makes it potentially safer for pediatric use when an antiemetic is necessary.
Limitations
Despite its use in many countries, domperidone is not FDA-approved in the United States due to safety concerns 5. Its use should be carefully considered, especially in pediatric populations where long-term safety data are limited.