Domel MT Tab

Side Effects of Domel MT Tab

Dry mouth; increased prolactin levels (dose dependent) which may lead to galactorrhoea, amenorrhoea, gynaecomastia; breast pain and tenderness; convulsions, dystonic reactions; urticaria, rash, pruritus; transient intestinal cramps, diarrhoea; nervousness, anxiety, decreased libido, asthenia, headache, agitation; oculogyric crisis, urinary retention. Rhythm and heart rate disorders; increased QT interval, atrial fibrillation, arrhythmia, palpitation, ventricular tachycardia, bradycardia; abnormal LFT. Potentially Fatal: Serious ventricular arrhythmia, sudden cardiac death, torsade de pointes, anaphylaxis, angioedema.

Drug Interactions

May antagonise the hypoprolactinaemic effect of bromocriptine. May antagonise the prokinetic effect w/ opioid analgesics and antimuscarinics. Potentially Fatal: Potent CYP3A4 inhibitors (e.g. ketoconazole, erythromycin or ritonavir) may increase serum domperidone levels and subsequently increasing the risk of QT prolongation.

Contraindications

Patients w/ prolactin-releasing pituitary tumour, GI haemorrhage, mechanical obstruction or perforation; chronic admin or routine prophylaxis of post-op nausea and vomiting. Concomitant use w/ potent CYP3A4 inhibitors (e.g. ketoconazole, erythromycin or ritonavir).

Mechanism of Action

Domperidone is a peripheral dopamine-receptor blocker. It increases oesophageal peristalsis, enhances gastroduodenal coordination and lowers oesophageal sphincter pressure, gastric motility and peristalsis, thus facilitating gastric emptying and decreasing small bowel transit time. Absorption: Rapidly absorbed. Food may delay absorption. Bioavailability: Approx 15% (oral and rectal). Time to peak plasma concentration: Approx 30 min (oral); approx 1 hr (rectal). Distribution: Enters breast milk (small amounts). Plasma protein binding: >90%. Metabolism: Undergoes rapid and extensive hepatic metabolism via N-dealkylation by CYP3A4 isoenzyme and hydroxylation by CYP3A4, CYP1A2 and CYP2E1 isoenzymes. Excretion: Via urine (approx 30%, as metabolites); faeces (approx 10%, as unchanged drug). Elimination half-life: Approx 7.5 hr.

Special Precautions

Patients w/ pre-existing prolonged cardiac conduction or other underlying cardiac disease, hypokalaemia, or receiving other QTc-prolonging agents. Hepatic and renal impairment. Pregnancy and lactation. Monitoring Parameters Monitor renal function and ECG regularly, particularly during long-term treatment or in patients w/ predisposing factors for QT prolongation.

How to Use

Take orally with food and water, as directed by your physician.

How to Store

Keep in a cool, dry place away from sunlight and moisture.

Safety Concerns

• Alcohol: Avoid during treatment.
• Breastfeeding: Not recommended.
• Pregnancy: Contraindicated.
• Liver/Kidney: Use with caution.

Content Disclaimer

This content is for educational purposes only. Please consult your doctor before use.