Cardiac safety concerns for domperidone, an antiemetic and prokinetic, and galactogogue medicine

Doggrell, Sheila A & Hancox, Jules C (2014) Cardiac safety concerns for domperidone, an antiemetic and prokinetic, and galactogogue medicine. Expert Opinion on Drug Safety, 13(1), pp. 131-138.

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Introduction: Domperidone is a dopamine D2-receptor antagonist developed as an antiemetic and prokinetic agents. Oral domperidone is not approved in the US, but is used in many countries to treat nausea and vomiting, gastroparesis, and as a galactogogue (to promote lactation). The US Food and Drug Administration (FDA) have issued a warning about the cardiac safety of domperidone.

Areas covered: The authors undertook a review of the cardiac safety of oral domperidone.

Expert opinion: The data from preclinical studies are unambiguous in identifying domperidone as able to produce marked hERG channel inhibition and action potential prolongation at clinically relevant concentrations. The compound’s propensity to augment instability of action potential duration and action potential triangulation are also indicative of proarrhythmic potential. Domperidone should not be administered to subjects with pre-existing QT prolongation/LQTS, subjects receiving drugs that inhibit CYP3A4, subjects with electrolyte abnormalities or with other risk factors for QT-prolongation. With these provisos, it is possible that domperidone may be used as a galactogogue without direct risk to healthy breast feeding women but more safety information should be sought in this situation. Also, more safety information is required regarding risk to breast feeding infants or before domperidone is routinely used in gastroparesis or gastroesphageal reflux in children.

Impact and interest:

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17 citations in Web of Science®

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ID Code: 65613
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: domperidone,, cardiac safety, proarrhythmia, QT interval, torsades de pointes, anti-emetic, galactogogue
DOI: 10.1517/14740338.2014.851193
ISSN: 1744-764X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PHARMACOLOGY AND PHARMACEUTICAL SCIENCES (111500)
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2013 Informa Healthcare
Deposited On: 01 Jan 2014 23:28
Last Modified: 02 Apr 2015 23:40

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