From the Guidelines
The combination of Paracetamol 325 mg and Domperidone Maleate 10 mg is used to treat pain or fever that is accompanied by nausea and vomiting, particularly in conditions like migraine headaches, viral illnesses with fever and nausea, or post-operative pain with nausea. Paracetamol works as an analgesic and antipyretic, relieving pain and reducing fever by inhibiting prostaglandin synthesis in the central nervous system 1. Domperidone acts as an antiemetic and prokinetic agent, helping to relieve nausea and vomiting by blocking dopamine receptors in the chemoreceptor trigger zone and enhancing gastric emptying 1.
Key Points to Consider
- The standard dosage is typically one tablet taken up to three times daily as needed, with at least 4 hours between doses.
- Patients should not exceed the maximum daily dose of paracetamol (4000 mg) to avoid liver damage, as highlighted by the FDA's recommendation to limit the amount of acetaminophen per tablet, capsule, or other dosage unit in prescription products to 325 mg 1.
- Domperidone may cause side effects such as dry mouth or headache, and its use should be cautious in patients with cardiac conditions due to the risk of QT prolongation and ventricular tachycardia 1.
- This combination should be used with caution in patients with liver disease or those taking medications that might interact with either component.
Clinical Considerations
- For patients with migraine headaches, the combination can be particularly useful, as metoclopramide is sometimes recommended as a single agent in the treatment of migraine pain, mainly for treating accompanying nausea and improving gastric motility 1.
- In cases of viral illnesses with fever and nausea, or post-operative pain with nausea, the combination of paracetamol and domperidone can provide relief from both pain and nausea symptoms.
- It is essential to monitor patients for any adverse effects and adjust the dosage or discontinue use as necessary to prioritize morbidity, mortality, and quality of life outcomes.
From the Research
Different Uses of the Combination Drug
The combination of paracetamol 325 mg and domperidone maleate IP 10 mg is used for various purposes, including:
- Relief from migraine symptoms, such as headache and nausea 2, 3
- Treatment of pain, although the evidence suggests that it may not be more effective than other available options 4, 5
- Prevention of post-operative nausea and vomiting, with domperidone being the active ingredient providing antiemetic effects 6
Mechanism of Action
The combination of paracetamol and domperidone works by:
- Paracetamol providing analgesic and antipyretic effects
- Domperidone providing antiemetic effects, which helps in reducing nausea and vomiting associated with migraine and other conditions
Efficacy and Safety
Studies have shown that the combination of paracetamol and domperidone is effective in reducing the duration of migraine attacks and alleviating symptoms such as headache and nausea 2, 3. The combination is also well-tolerated, with no serious adverse effects reported in clinical trials 2, 3. However, the evidence also suggests that the combination may not be more effective than other available options for pain relief 4, 5.