Domperidone Dosing for 2-Year-Old Children
For a 2-year-old child, domperidone should be dosed at 0.3 mg/kg per dose, given three times daily before meals, using the 5mg/ml concentration. 1
Specific Dosing Calculation
- Standard dose: 0.3 mg/kg per dose, administered three times daily (t.d.s.) before meals 1
- With 5mg/ml concentration: Calculate the child's weight in kg, multiply by 0.3 mg, then divide by 5 mg/ml to determine the volume in ml per dose
- Example: For a 12 kg child: (12 kg × 0.3 mg/kg) = 3.6 mg per dose = 0.72 ml per dose of the 5mg/ml suspension
Evidence Supporting This Dosing
The 0.3 mg/kg dose three times daily was established in a double-blind controlled trial of 47 infants and children with chronic vomiting or regurgitation, where domperidone at this dose was significantly more effective than both placebo and metoclopramide. 1 This dosing regimen has been validated specifically for the pediatric population in this age range.
Alternative Dosing for Specific Indications
For chemotherapy-induced nausea and vomiting, a higher dose of 0.7 mg/kg per dose may be considered, as this was found to be the optimum dose in pediatric oncology patients. 2 However, this higher dose should be reserved for more severe antiemetic needs rather than routine gastrointestinal symptoms.
Administration Considerations
- Administer before meals to maximize prokinetic effects in the upper gastrointestinal tract 1
- If given intravenously (not typical for outpatient use), ensure adequate dilution to prevent pain at the injection site 2
- The medication is primarily used off-label in children under 12 years for gastrointestinal motility disorders 3
Important Safety Caveats
- Current authorization restricts domperidone use to children older than 12 years for short-term relief of nausea and vomiting 3
- Use in 2-year-olds represents off-label prescribing, though supported by clinical evidence 3, 1
- Monitor for cardiac effects, as domperidone is a dopamine-2 receptor antagonist with potential cardiovascular considerations 3
- Treatment duration should be limited to short-term use when possible 3