Domperidone
Generic Alternative to Motilidone / Motilium
Strength Size FormatProduct Price  
10mg 100 $25.12
10mg 300 $64.26
10mg 500 $103.39
Domperidone (Motilium) is used in the symptomatic management of upper gastrointestinal motility disorders. Domperidone (Motilium) should be swallowed whole half-hour before meals. Domperidone (Motilium) is a drug that has, as a side effect, stimulating or increasing breast milk production, probably by increasing prolactin production by the pituitary gland. Prolactin is the hormone that stimulates the cells in the mother's breast to produce milk. Domperidone (Motilium) increases prolactin secretion indirectly, by interfering with the action of dopamine whose action is to decrease the secretion of prolactin by the pituitary gland. Domperidone (Motilium) is generally used for disorders of the gastrointestinal tract (gut) and has not been released in Canada for use as a stimulant for milk production. This does not mean that Domperidone (Motilium) cannot be prescribed for this reason, but rather that the manufacturer does not back the use of Domperidone (Motilium) for increasing milk production. However, there are several studies that show that Domperidone (Motilium) works to increase milk production and that Domperidone (Motilium) is safe. Domperidone (Motilium) is a drug which has, as a side effect, the increased production of the hormone prolactin. Prolactin is the hormone which stimulates the cells in the mother's breast to produce milk. Domperidone (Motilium) increases prolactin secretion indirectly, by interfering with the action of dopamine. One of the actions of dopamine is that it decreases the secretion of prolactin by the pituitary gland. Domperidone from Canada (Motilium) is generally used for disorders of the gastrointestinal tract (gut) and has not been released in Canada for use as a stimulant for milk production. This does not mean that Domperidone (Motilium) cannot be prescribed for this reason, but rather that the manufacturer does not back the use of Domperidone (Motilium) for increasing milk production. Domperidone (Motilium) has been used, for several years, in small infants who spit up and lose weight, but Domperidone (Motilium) has recently been replaced for this reason by a newer drug called cisapride (Prepulsidô). Domperidone (Motilium) has the ability to increase milk production has been recognized since Domperidone (Motilium) first became available. Another, related, but older medication, metoclopramide (Maxeranô), is also known to increase milk production, but it has frequent side effects which have made its use for many nursing mothers unacceptable (fatigue, irritability, depression). Domperidone (Motilium) has many fewer side effects because Domperidone (Motilium) does not enter the brain tissue in significant amounts (does not pass the blood-brain barrier). When is it appropriate to use Domperidone (Motilium)? Domperidone (Motilium) must never be used as the first approach to correcting breastfeeding difficulties. Domperidone (Motilium) is not a cure for all things. Domperidone (Motilium) must not be used unless all other factors which may result in insufficient milk supply have been dealt with first. These include: 1. correcting the baby's latch so that the baby can obtain as efficiently as possible the milk which the mother has available. Correcting the latch may be all that is necessary to change a situation of "not enough milk" to one of "plenty of milk". 2. using breast compression to increase the intake of milk (handout #15 Breast Compression). 3. using milk expression after feedings to increase the supply. 4. correcting sucking problems, stopping the use of artificial nipples (handout #5, Using a Lactation Aid, and #8, Finger Feeding) and other stratagems. Using Domperidone (Motilium) for increasing milk production Domperidone (Motilium) works particularly well to increase milk production under the following circumstances: it has frequently been noted that a mother who is pumping milk for a sick or premature baby in hospital has a decrease in the amount she pumps around 4 or 5 weeks after the baby is born. The reasons for this are likely many, but domperidone generally brings the amount of milk pumped back to where it was or even to higher levels. When a mother has a decrease in milk supply, often associated with the use of birth control pills (avoid estrogen containing birth control pills while breastfeeding), or on occasion for no obvious reason when the baby is 3 or 4 months old, Domperidone (Motilium) will often bring the supply back to normal. Domperidone (Motilium) still works, but often less dramatically when: the mother is pumping for a sick or premature baby but has not managed to develop a full milk supply, the mother is trying to develop a full milk supply while nursing an adopted baby, the mother is trying to wean the baby from supplements. In addition, Domperidone (Motilium) has been used, for several years, in small infants who spit up and lose weight, but was replaced until a few years ago by cisapride (Prepulsid) (cisapride has since been taken off the market because it can cause serious cardiac problems). Domperidone (Motilium) is not in the same family of medication as cisapride and has never had the cardiac side effects that cisapride does. Another, related, but older medication, metoclopramide (Maxeran), is also known to increase milk production, but it has frequent side effects which have made its use for many nursing mothers unacceptable (fatigue, irritability, depression). Domperidone (Motilium) has many fewer side effects because Domperidone (Motilium) does not enter the brain tissue in significant amounts (does not pass the blood-brain barrier).
Domperidone side effects include allergic reactions, stimulating or increasing milk production, by increasing prolactin production by the pituitary gland, such as rash or urticaria, have been reported. Abdominal cramps have also been reported. Domperidone side effects like Dystonic reactions (extrapyramidal phenomena) may occur.Domperidone side effects like Reversible raised serum prolactin levels have been observed which may lead to galactorrhoea and gynaecomastia.Domperidone side effects like Hypertensive crises in patients with phaeochromocytoma may occur.Where the blood brain barrier is not fully developed (mainly in young babies) or is impaired, the possible occurrence of neurological side-effects cannot be totally excluded. Special precautions Since Motilium (Domperidone) is highly metabolised in the liver, Motilium (Domperidone) should be used with caution in patients with hepatic impairment (and in the elderly). To help maximize the chance that your baby will breastfeed effectively, you should: ï try and breastfeed your baby right after he is born and before he is taken to the nursery if possible ï room in with your baby so that you can breastfeed on demand when your baby is hungry ï instruct the nursery staff to not give supplemental bottles of formula unless instructed to do so by your Pediatrician and if a supplement is required for some reason, ask if an alternative to a bottle can be used, such as a lactation aid, finger feeding or cup. Don't underestimate the danger of a bottle, even if given occasionally, can have to your chances of breastfeeding well. ï have the hospital staff (and a lactation consultant if available) observe you breastfeeding your baby prior to discharge ï avoid supplementing with formula or using a bottle before he is 3-4 weeks old (unless instructed to do so by your Pediatrician). In fact, it is probably best to not use a bottle at all to maximize your chances of breastfeeding effectively. Finger feeding, cup feeding or a lactation aid are all better alternatives. ï avoid using a pacifier before he is 3-4 weeks old (unless he is already breastfeeding effectively, then it is probably all right to introduce a pacifier sooner). Again, it is probably best to not use a pacifier at all, since their use is associated with early weaning and prolonged use of a pacifier is associated with an increased risk of ear infections. ï don't smoke (smoking is associated with having a poor milk supply and many other negative medical effects on children and especially newborns), although if you do smoke, you can definitely breastfeed and it may help offset the increased risk of allergies and asthma that is found in children that are exposed to second hand smoke. ï limit the intake of foods and drinks that have caffeine in them ï follow a well balanced diet with about 2000 - 2700 kcal/d. Order Domperidone from Medisave Canada to save money. The breast feeding drug Domperidone has been used in Canada for years.Each tablet contains 10 mg domperidone. PHARMACOLOGICAL CLASSIFICATION Anti-emetics and anti-vertigo preparations. PHARMACOLOGICAL ACTION Domperidone is a dopamine-receptor blocking agent. Its action on the dopamine-receptors in the chemo-emetic trigger zone produces an anti-emetic effect. Domperidone does not cross the blood-brain barrier to any appreciable degree and so exerts relatively little effect on cerebral dopaminergic receptors. Domperidone has been shown to increase the duration of antral and duodenal contractions to increase gastric emptying. Domperidone does not alter gastric secretions and has no effect on intracranial pressure or on the cardiovascular system. Domperidone is rapidly absorbed, with peak plasma concentrations at approximately 1 hour after oral administration. The absolute bio-availability of oral domperidone is low (approximately 15%) due to first-pass hepatic and intestinal metabolism. Domperidone is 91 - 93% bound to plasma proteins. The plasma half-life after a single oral dose is 7 - 9 hours in healthy subjects but is prolonged in patients with severe renal insufficiency. Domperidone undergoes rapid and extensive hepatic metabolism by hydroxylation and N-dealkylation. Urinary and faecal excretion amount to 31% and 66% of the oral dose, respectively. The proportion of drug excreted unchanged is small (approximately 1% of urinary and 10% of faecal excretion). INDICATIONS MOTILIUM is indicated for: - Delayed gastric emptying of functional origin with gastro-oesophageal reflux and/or dyspepsia. - Control of nausea and vomiting of central or local origin. - As an anti-emetic in patients receiving cytostatic and radiation therapy. - Facilitates radiological examination of the upper gastro-intestinal tract. CONTRA-INDICATIONS MOTILIUM is contra-indicated in patients with known sensitivity to domperidone. MOTILIUM should not be used whenever stimulation of gastric motility is to be avoided or could be harmful, eg. in the presence of gastro-intestinal haemorrhage, obstruction or perforation. MOTILIUM is also contra-indicated in patients with a prolactin-releasing pituitary tumour (prolactinoma). The safety of use during pregnancy and lactation has not been established. DOSAGE AND DIRECTIONS FOR USE Acute conditions (mainly nausea, vomiting, hiccup) Adults: Two tablets (20 mg) 3 to 4 times per day, 15 to 30 minutes before meals and, if necessary, before retiring. Children 5 to 12 years old: One tablet (10 mg) 3 to 4 times per day, 15 to 30 minutes before meals and, if necessary, before retiring. Chronic conditions (mainly dyspepsia) Adults: One tablet (10 mg) taken 3 times per day, 15 to 30 minutes before meals and, if necessary, before retiring. The dosage may be doubled. Children 5 to 12 years old: ? tablet (5 mg) 3 to 4 times per day, 15 to 30 minutes before meals and if necessary, before retiring. This formulation is not suited for children under the age of 5 years, but for this group of patients the suspension is available. MOTILIUM should be used with caution in patients with renal impairment or in those at risk of fluid retention. In patients with severe renal insufficiency ( serum creatinine more than 6 mg/100 mL, ie. more than 0,6 mmol/L) the elimination half-life of domperidone was increased from 7,4 to 20,8 hours. The dosing frequency should be reduced to once or twice daily, depending on the severity of impairment, and the dose may need to be reduced. Patients on prolonged therapy should be reviewed regularly. Interactions Concomitant administration of anti-cholinergic drugs may inhibit the anti-dyspeptic effects of MOTILIUM. Anti-muscarinic agents and opioid analgesics may antagonise the effect of MOTILIUM. MOTILIUM suppresses the peripheral effects (digestive disorders, nausea and vomiting) of dopaminergic agonists. Since MOTILIUM has gastro-kinetic effects, it could influence the absorption of concomitant orally administered medicines, particularly those with sustained release or enteric coated formulations. As MOTILIUM interferes with serum prolactin levels, it may interfere with other hypoprolactinaemic agents and with some diagnostic tests. Antacids and anti-secretory agents lower the oral bioavailability of domperidone. They should be taken after meals and not before meals, ie. they should not be taken simultaneously with MOTILIUM. Reduced gastric acidity impairs the absorption of domperidone. Oral bioavailability is decreased by prior administration of cimetidine or sodium carbonate. KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT Symptoms of overdosage may include drowsiness, disorientation and extrapyramidal reactions especially in children. Anticholinergic, anti-Parkinson medicines or antihistamines with anticholinergic properties may be helpful in controlling the extrapyramidal reactions. There is no specific antidote to domperidone but in the event of overdosage, gastric lavage as well as the administration of activated charcoal may be useful. Symptomatic and supportive measures are recommended. IDENTIFICATION White circular, biconvex, film coated tablet 6,5 mm diameter engraved "N" above "10" on one side STORAGE INSTRUCTIONS Store below 25?C. Protect from light KEEP OUT OF REACH OF CHILDREN.
Motilium
Brand Alternative to Domperidone
Strength Size FormatProduct Price  
10mg Unavailable n/a
10mg Unavailable n/a
10mg Unavailable n/a
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