Domperidone: Important safety information from the MCC
Domperidone should be used with caution in patients older than 60, as epidemiological studies suggest an increased risk of serious ventricular dysrhythmias or sudden cardiac death. It is contraindicated in patients with moderate to severe hepatic impairment and in certain heart conditions. Domperidone should not be given with potent CYP3A4 inhibitors which are also known to cause QT prolongation e.g. azoles, macrolides, atazanavir, quinolones.
The maximum daily dosage of domperidone (prescription only) has been reduced. It should only be prescribed for up to a week for the management of acute nausea and vomiting. For other indications, initial treatment is for up to four weeks after which the need for ongoing treatment should be reassessed.
The new recommended doses are:
For adults and adolescents ≥ 35 kg:
10 mg three to four times daily, with a maximum dose of 40 mg per day orally. The dose of domperidone should be the lowest effective dose for the individual situation (typically 30 mg/day) with a maximum daily oral dose of 40 mg.
For children and adolescents < 35 kg:
0,25 mg/kg body weight per intake, three to four times daily, with a maximum dose of 1 mg/kg body weight per day with a maximum daily oral dose of 35 mg.