Domperidone Dosing for an 11kg Pediatric Patient with Vomiting
For an 11kg pediatric patient with vomiting, the recommended dose of domperidone is 0.5-0.7 mg/kg/dose given 3-4 times daily, which equals approximately 5.5-7.7 mg per dose (maximum 30 mg/day). 1
Dosing Guidelines
- The optimal dose of domperidone for antiemetic purposes in pediatric patients is 0.7 mg/kg per dose 1
- For an 11kg child, this would calculate to approximately 7.7 mg per dose
- Typically administered 3-4 times daily before meals and at bedtime 2
- Total daily dose should not exceed 30 mg for pediatric patients 3
Administration Considerations
- Domperidone is available as oral suspension and tablets 2
- For young children, the suspension formulation is preferred for accurate dosing 2
- Duration of treatment should be limited to the shortest time necessary to control vomiting 2
Efficacy and Alternatives
- Domperidone has shown effectiveness for vomiting control in pediatric patients, with reasonable to good control in most cases 1
- However, ondansetron (0.15 mg/kg/dose) has demonstrated superior efficacy compared to domperidone (0.5 mg/kg/dose) for acute gastroenteritis-related vomiting 4, 5
- In a multicenter trial, ondansetron reduced the need for IV rehydration by over 50% compared to domperidone 5
Safety Considerations and Monitoring
- Extrapyramidal side effects are rare (1/10,000) but more common in infants and young children due to immature blood-brain barrier 3
- Monitor for signs of oromandibular dystonia, which can occur even at recommended doses 3
- Dystonic reactions are reversible upon discontinuation of the medication 3
- Use caution with prolonged treatment due to potential cardiac effects (QT prolongation) 2
- Domperidone should be used at the lowest effective dose for the shortest duration possible 2
Clinical Pearls
- Domperidone does not readily cross the blood-brain barrier in older children, making it less likely to cause central nervous system side effects compared to metoclopramide 2
- For persistent vomiting not responding to domperidone, consider switching to ondansetron which has shown superior efficacy in comparative studies 4, 5
- If using for gastroenteritis, ensure appropriate oral rehydration therapy is also administered 5
- Judicious use is advised due to potential side effects, even though they are uncommon 3