From the Guidelines
The recommended dosage of Domperidone (Motilium) is 10 mg 3 times a day.
Key Considerations
- The dosage can be escalated to 20 mg 4 times a day, but this is not recommended due to cardiovascular safety considerations 1.
- Cardiac side effects, such as QT prolongation and ventricular tachycardia, are risks associated with Domperidone, and 7% of patients may need to stop the medication due to these side effects 1.
- Domperidone has modest efficacy in improving symptoms of gastroparesis, with 68% of patients showing improvement in symptom scores 1.
- The medication is not readily available in the United States, and can only be obtained through an FDA investigational drug application 1.
From the Research
Recommended Dosage of Domperidone
The recommended dosage of Domperidone (Motilium) varies depending on the condition being treated.
- For treating gastrointestinal symptoms in patients with Parkinson's disease, doses above 30 mg/daily should only be considered with special caution due to potential cardiotoxic effects 2.
- For diabetic gastropathy, oral domperidone 40 to 80 mg/day is effective in managing symptoms, and doses up to 120 mg/day may be used 3.
- For treating symptoms of gastroparesis, domperidone 10 mg QID or TID may be prescribed, with an average dose of 36 ± 13 mg/day 4.
- A study on the effect of chronic domperidone use on QT interval found that domperidone at doses of 30 to 80 mg/d was associated with QTc prolongation in only 6% of patients, suggesting that it can be safely prescribed at these doses for the treatment of gastroparesis 5.
- However, another study suggested that the defined daily dose of domperidone (30 mg/day) has limited gastrointestinal benefits and is associated with an increased risk of sudden cardiac death, particularly at doses above 30 mg/day 6.
Key Considerations
- The dosage of domperidone should be carefully considered due to the potential risk of cardiotoxicity, particularly in patients over 60 years old or those taking high doses 2.
- The benefits and risks of domperidone should be weighed carefully, especially in patients with a history of cardiac conditions or those taking other medications that may interact with domperidone 5, 6.
- Patients should be monitored closely for signs of cardiotoxicity, such as QTc prolongation, and the dosage of domperidone should be adjusted accordingly 5.