Domperidone

Domperidone: Uses, Dosage and Side Effects

Overview

• Antiemetic with a mechanism of action similar to that of metoclopramide, but with fewer adverse CNS effects because it cannot cross the blood-brain barrier.
• It may not be prokinetic in canines, but it is gastrokinetic in humans.
• In addition, it has been demonstrated to enhance the innate cell-mediated immune response.

Uses of Domperidone

• Treatment of vomiting; however, maropitant is authorized for veterinary use and there is more clinical experience with metoclopramide and ondansetron.
• A strategic domperidone-based treatment program has shown some efficacy in reducing the risk of developing clinical canine leishmaniosis in a high-prevalence area.

Dose of Domperidone in Dogs and Cats

Dogs:

• Vomiting: 2–5 mg per animal q8h.
• Preventive strategy for leishmaniosis in a high prevalence area: 0.5 mg/kg q24h for 30 consecutive days, repeated every 4 months.

Cats:

• Vomiting: 2–5 mg per animal q8h.

Side Effects of Domperidone in Dogs and Cats

• This drug may cause gastroparesis in dogs.
• Causes galactorrhea by raising plasma prolactin.
• Domperidone is banned in the US because it prolongs the QT interval and increases the risk of cardiac arrhythmias and sudden cardiac death.
• Cats show dose-dependent excitation, aggressiveness, and motor impairment.

Contraindications of Domperidone in Dogs and Cats

• Intestinal obstruction or perforation
• severe hepatic impairment.
• Contraindicated in humans with known existing prolongation of cardiac conduction intervals, significant electrolyte disturbances, or underlying cardiac disease, but no information is available for dogs and cats.
• Use with caution in dog breeds (e.g. collies) that may have MDR1 (ABCB1) mutations.

Some Notes:

• Do not use concurrently with Class 1A or Class III antiarrhythmics (e.g. amiodarone, sotalol), erythromycin or cisapride.