NationMaster - Encyclopedia: Domperidone

Domperidone (trade name Motilium or Motillium) is an antidopaminergic drug, developed by Janssen Pharmaceutica, and used orally, rectally or intravenously, generally to suppress nausea and vomiting. It has also been used to stimulate lactation. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. ... This page is a candidate to be moved to Wiktionary. ... This article does not cite any references or sources. ... Johnson & Johnson NYSE: JNJ is an international pharmaceutical, medical devices and consumer packaged goods manufacturer founded in 1885. ... The posterior aspect of the rectum exposed by removing the lower part of the sacrum and the coccyx. ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... For other uses, see Nausea (disambiguation). ... Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... Kittens nursing Lactation describes the secretion of milk from the mammary glands, the process of providing that milk to the young, and the period of time that a mother lactates to feed her young. ...

Uses

Gastrointestinal problems

Domperidone is used, together with metoclopramide, cyclizine, and 5HT₃ receptor antagonists (such as granisetron) in the treatment of nausea and vomiting. It is useful in patients with Parkinson's disease because, unlike metoclopramide, domperidone does not cross the blood-brain barrier. Metoclopramide (INN) (IPA: ) is a potent dopamine receptor antagonist used for its antiemetic and prokinetic properties. ... Cyclizine is an antihistamine drug used to treat nausea, vomiting and dizziness associated with motion sickness, vertigo and post-operative following administration of general anaesthesia and opioids. ... Skeletal formula of ondansetron, the prototypical 5-HT3 antagonist The 5-HT3 antagonists are a class of medications which act as receptor antagonists at the 5-hydroxytryptamine-3 receptor (5-HT3 receptor), a subtype of serotonin receptor found in terminals of the vagus nerve and certain areas of the brain. ... Granisetron is used to prevent nausea and vomiting caused by cancer chemotherapy and radiation therapy. ... Metoclopramide (INN) (IPA: ) is a potent dopamine receptor antagonist used for its antiemetic and prokinetic properties. ... The blood-brain barrier (BBB) is a membranic structure that acts primarily to protect the brain from chemicals in the blood, while still allowing essential metabolic function. ...

Domperidone has also been found effective in the treatment of gastroparesis,^[2] a stomach motility condition, and for paediatric Gastroesophageal reflux (infant vomiting). Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. ... Pediatrics (also spelled paediatrics or pædiatrics) is the branch of medicine that deals with the medical care of infants and children. ... Gastroesophageal Reflux Disease (GERD, or GORD when -oesophageal, the BE form, is substituted) is injury to the esophagus that develops from chronic exposure of the esophagus to acid coming up from the stomach (reflux). ...

Lactation

The hormone prolactin stimulates lactation in humans, and its release is inhibited by the dopamine secreted by the hypothalamus. Domperidone, by acting as an anti-dopaminergic, results in increased prolactin secretion, and thus promotes lactation. Prolactin (PRL) is a peptide hormone primarily associated with lactation. ... Dopamine is a phenethylamine naturally produced by the human body. ... The hypothalamus links the nervous system to the endocrine system via the pituitary gland (hypophysis). ... Prolactin (PRL) is a peptide hormone primarily associated with lactation. ...

Although it has never been officially approved for use in the United States, domperidone is widely purchased from pharmacies in other countries for this purpose. Since, according to the FDA, domperidone is not approved for enhanced lactation in any country,^[3] it is still prescribed "off-label" for this use in countries besides the United States.^[4] For other uses, see Pharmacy (disambiguation). ... Off-label use is the practice of prescribing drugs for a purpose outside the scope of the drugs approved label, most often concerning the drugs indication. ...

Controversy

Janssen Pharmaceutical has brought Domperidone before the FDA several times in the last two decades, with the most recent effort in the 1990s. Numerous U.S. clinical drug trials have demonstrated its safety and efficacy in dealing with gastroparesis symptoms, but the FDA turned down Janssen's application for Domperidone, even though the FDA's division of gastrointestinal drugs had approved Domperidone.^[5]

In June 2004, the United States' main regulation agency, the Food and Drug Administration (FDA), issued a letter warning women not to take domperidone, citing unknown risks to parents and infants, and warned pharmacies that domestic sale was illegal, and that import shipments from other countries would be searched and seized. Domperidone is excreted in breast milk, and no studies on its effects on breastfeeding infants have been reported in the literature. Individual incidents of problems with the drug include cardiac arrest and arrhythmia, complications with other medications, as well as complications with improper intravenous use^[4] hi â€œFDAâ€ redirects here. ... A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ...

It has been widely speculated that this action by the FDA is related to increasing drug importation from countries such as Canada.^{[citation needed]}

Yet prominent doctors and pharmacists have rejected the FDA's reasoning and still promote domperidone's use in increasing milk supply. Such doctors and pharmacists are confident the drug is safe in the doses given for this purpose.^[6] The American Academy of Pediatrics considers domperidone "usually compatible with breastfeeding".^[7]

There is a new controversy in Britain regarding lethal levels of sodium found in children who are administered this drug. It is now subject to a medical review following a number of criminal trials.^[8]

Brand

Domperidone is marketed in India by Ion healthcare under the brand name MELDOM-DT.

References

External links

Categories: All articles with unsourced statements | Articles with unsourced statements since February 2007 | Antiemetics | Motility stimulants | Piperidines A division of the Anatomical Therapeutic Chemical Classification System A Alimentary tract and metabolism A03A Drugs for functional bowel disorders A03AA Synthetic anticholinergics, esters with tertiary amino group A03AA01 Oxyphencyclimine A03AA03 Camylofin A03AA04 Mebeverine A03AA05 Trimebutine A03AA06 Rociverine A03AA07 Dicycloverine A03AA08 Dihexyverine A03AA09 Difemerine A03AA30 Piperidolate A03AB Synthetic anticholinergics, quaternary... An anticholinergic agent is a member of a class of pharmaceutical compounds which serve to reduce the effects mediated by acetylcholine in the central nervous system and peripheral nervous system. ... A muscarinic receptor antagonist is an agent that reduces the activity of the muscarinic acetylcholine receptor. ... Mebeverine HCI is a musculotropic antispasmodic drug without atropic side-effects whose major therapeutic role is in the treatment of irritable bowel syndrome. ... Dicyclomine is an anticholinergic that blocks muscarinic receptors. ... Propantheline bromide is a type of medical agent called an antimuscarinic. ... Papaverine is an opium alkaloid used primarily in the treatment of visceral spasm, vasospasm (especially those involving the heart and the brain), and occasionally in the treatment of erectile dysfunction. ... Drotaverine (INN, also known as drotaverin) is an antispasmodic drug, structurally related to papaverine. ... Moxaverine is a drug used to treat functional gastrointestinal disorders. ... In the field of neurochemistry, 5-HT receptors are receptors for the neurotransmitter and peripheral signal mediator serotonin, also known as 5-hydroxytryptamine or 5-HT. 5-HT receptors are located on the cell membrane of nerve cells and other cell types in animals and mediate the effects of serotonin... Alosetron is a 5-HT3 antagonist used for the management of severe diarrhoea-predominant irritable bowel syndrome (IBS) in women only. ... Tegaserod is a 5-HT4 agonist used for the management of constipation-predominant irritable bowel syndrome (IBS). ... Cilansetron (Pronounced Sil-an-set-ron) is a drug that is a 5HT-3 antagonist currently under trial phase in the EU and US it is manufactured by Solvay Pharmacuticals INC. 5HT-3 receptors are responsible for causing many things from nausea to excess bowel movements. ... Diisopromine or disoprominum, usually as the hydrochloride salt, is a synthetic spasmolytic which neutralizes spastic conditions of the biliary tract and of the sphincter of Oddi. ... Isometheptene (usually as isometheptene mucate) is a sympathomimetic amine sometimes used in the treatment of migraines due to its vasoconstricting properties, that is, it causes constriction (narrowing) of blood vessels (arteries and veins). ... Phloroglucinol or benzene-1,3,5-triol is a process chemical widely used in the industrial synthesis of pharmaceuticals and high-energy chemicals (explosives). ... For information on the erotic actress Belladonna see: Belladonna. ... A muscarinic receptor antagonist is an agent that reduces the activity of the muscarinic acetylcholine receptor. ... Atropine is a tropane alkaloid extracted from the deadly nightshade (Atropa belladonna) and other plants of the family Solanaceae. ... Hyoscyamine is a chemical compound, a tropane alkaloid it is the levo-isomer to atropine. ... Butylscopolamine, also known as scopolamine butylbromide and hyoscine butylbromide is an abdominal-specific antispasmodic. ... Methylscopolamine is an anticholinergic used in ophthalmology. ... This article or section does not adequately cite its references or sources. ... A dopamine antagonist is a drug which blocks dopamine receptors (of which there are five types in the human body; they are found in the brain, peripheral nervous system, blood vessels, and the kidney). ... Metoclopramide (INN) (IPA: ) is a potent dopamine receptor antagonist used for its antiemetic and prokinetic properties. ... Bromopride (INN) is a dopamine antagonist with prokinetic properties widely used as an antiemetic, closely related to metoclopramide. ... Alizapride is a dopamine antagonist with prokinetic and antiemetic effects used in the treatment of nausea and vomiting, including postoperative nausea and vomiting. ... Cisapride is a parasympathomimetic which acts as a serotonin 5-HT4 agonist. ... Clebopride is a dopamine antagonist drug with antiemetic and prokinetic properties used to treat functional gastrointestinal disorders. ...

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