From the Research
Domperidone (Motilium) is generally considered safe for patients with Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency, as it does not have oxidative properties that would put these patients at risk of hemolytic anemia 1. The standard dosing for adults is typically 10 mg up to three or four times daily before meals, with a maximum daily dose of 30-40 mg.
Key Points to Consider
- Domperidone works as a dopamine antagonist that increases upper gastrointestinal motility and has antiemetic properties, making it useful for treating nausea, vomiting, and certain gastrointestinal disorders.
- It does not enter the central nervous system significantly, which reduces the risk of extrapyramidal side effects compared to other antiemetics.
- However, patients should be aware that domperidone can cause QT interval prolongation, so caution is advised in patients with cardiac conditions or those taking other medications that affect heart rhythm 2.
- Always consult with a healthcare provider before starting any medication, especially if you have G6PD deficiency or other medical conditions.
Safety in G6PD Deficiency
According to a review of medications and G6PD deficiency, domperidone is not listed as a medication that should be avoided in individuals with G6PD deficiency 1. In fact, the review found no evidence to contravene the use of domperidone in normal therapeutic doses to G6PD-deficient patients.
Recent Guidelines and Studies
Recent studies and reviews have highlighted the importance of considering G6PD deficiency in patients who experience acute hemolysis after exposure to known oxidative medications, infection, or ingestion of fava beans 3, 4, 2. However, domperidone is not considered an oxidative medication and is therefore not a concern for patients with G6PD deficiency.
Clinical Implications
In clinical practice, it is essential to be aware of the potential risks and benefits of medications in patients with G6PD deficiency. While domperidone is considered safe, other medications such as rasburicase, primaquine, dapsone, pegloticase, and methylene blue should be avoided in patients with G6PD deficiency until a diagnostic test has been performed 2.