From the Guidelines
I strongly advise against giving domperidone to a child without specific medical guidance from a healthcare provider, as its safety profile in pediatric populations is not well established, except for adolescents aged 12-17 years who can use it for nausea under strict medical supervision. According to the study published in Nature Reviews Neurology in 2021 1, domperidone can be used for nausea in adolescents aged 12–17 years, although oral administration is unlikely to prevent vomiting. However, for younger children, the evidence base for medication therapy is confounded by a high placebo response in clinical trials, and the apparent therapeutic gain is low.
- Key considerations for using domperidone in children include:
- Age: only adolescents aged 12-17 years can use domperidone for nausea
- Dosing: weight-based and varies by age and condition
- Potential side effects: cardiac rhythm disturbances, neurological reactions, and other serious complications
- Alternative treatments: safer alternatives available for children with similar symptoms, such as ibuprofen for migraine, which is recommended as first-line medication at a dose appropriate for body weight 1.
- If your child is experiencing nausea, vomiting, or gastrointestinal issues, it is essential to consult with a pediatrician who can recommend appropriate treatments based on your child's specific condition, age, weight, and medical history.
From the FDA Drug Label
HUMAN WARNINGS Not for use in humans. For oral use in animals only. Keep this and all drugs out of the reach of children. The FDA drug label does not answer the question.
From the Research
Domperidone for Children
- Domperidone is a peripheral dopamine-2 receptor antagonist with prokinetic and antiemetic properties, mainly used in the upper gastrointestinal (GI) tract 2.
- Its use is restricted to relief of nausea and vomiting in children older than 12 years for a short period of time, but it is also used off-label for treatment of symptoms associated with gastro-esophageal reflux disease, dyspepsia, and gastroparesis 2.
Efficacy and Safety
- A study comparing the efficacy of ondansetron with domperidone in cessation of vomiting in pediatric acute gastroenteritis found that ondansetron was more efficacious than domperidone at 24 hours 3.
- Another study comparing oral ondansetron, metoclopramide, and domperidone for managing vomiting in children with acute gastroenteritis found that ondansetron exhibited superior efficacy in managing AGE-related vomiting in children within 24 hours compared to metoclopramide and domperidone 4.
- A review of domperidone's efficacy in the treatment of GI disorders in infants and children found that little is known about its efficacy in the treatment of GI motility disorders in children and controversial data have emerged in the pediatric literature 2.
Prescribing Patterns
- A study on domperidone prescribing patterns in pediatric patients before and after a safety warning in South Korea found that the probability of receiving at least one prescription in 2016 has been reduced by 30% compared to 2011, and the number of prescriptions containing a maximum daily dosage of over 30 mg was significantly lower in 2016 5.
- A study on prokinetics prescribing in pediatrics found that prescriptions of domperidone increased 10-fold, mainly following the withdrawal of cisapride in 2000, and despite the increase in prescriptions of domperidone, no new safety signals were identified 6.