motilium syrup uses

موٹیلیم شربت کا استعمال

Written by Dr. Syeda Inshall Binte Saif [PharmD student 4th year, University of Karachi (UoK)], Karachi, Pakistan.

✓Brand name

Motilium.

✓Generic name

Domperidone.

✓Available dosage forms and their doses

Available in both tablet and Suspension forms.

▪︎ Tablet = 10mg

▪︎ Suspension = 5mg/ 5ml

✓Price

Tablet: 10mg (Strip of 10 tablets)

Price  80 – 100 Rs

Suspension: 5mg/5ml

Price: 160 Rs

✓Therapeutic class

Prokinetic/ Anti emetic

✓Pharmacological class

Dopamine Antagonist

( D2 receptor antagonist)

✓Manufacturer

Originally by Janssen Pharmaceuticals, a division of Johnson & Johnson

Locally available by: Aspin Pharmaceuticals (PVT.) LTD.

✓Storage

- Store the medicine at room temperature. (Below 30°)

- Keep out of direct sunlight, excessive heat, and moisture.

✓ Prescription drug?

Yes

✓ Clinical pharmacology( mechanism of action)

Domperidone is used to treat nausea and vomiting. Domperidone maleate blocks peripheral dopamine D2 receptors, especially in the chemoreceptor trigger zone (CTZ), which lies outside the blood-brain barrier. This action enhances gastrointestinal motility and has antiemetic effects without significant central nervous system side effects.

✓ Indications and dosages

It is indicated in :

- Acute Nausea and vomiting.

- Delayed gastric emptying.

- Dyspepsia.

- Functional Dyspepsia.

- Gastric distention pain (due to pressure on the stomach.

- Gastro – Esophageal Reflux Disease.

  (GERD)

- Nausea and vomiting ( Chemotherapy Induced)

-Nausea and vomiting ( L- Dopa Induced)

-Reflux oesophagitis.

Dosage:

Oral:

Adults:

All indications: 10-20 mg orally 3-4 times daily before meals; max 80 mg daily. Re-evaluate the need for continued treatment after 4 wk.

Children:

Only Nausea & Vomiting: 0.25-0.5 mg/kg body-wt, 3-4 times daily; max 2.4 mg/kg daily.

Injection:

Adults:

With chemotherapy 1-40 mg IV (1 mg/kg IV have been used). See literature.

Children:

Not recommended.

Rectal:

Adults & Children:

Over 12 years and body weight over 35 kg: 60 mg twice daily. Children: Body weight 15-35 kg (nausea and vomiting only): 30 mg twice daily; under 15 kg, not recommended.

(Dosage section written by Dr. Taha Murtaza; reference: Pharma guide)

✓ Side effects

Common side effects include:

• Depression, Anxiety, Loss of Libido

• Headache

• Diarrhea

• Skin rashes, hives, hot flashes, skin itching

• Galactorrhoea (flow of milk from breast unrelated to pregnancy or lactation)  [with long-term use]

• Breast enlargement in men

• Breast Pain in women, irregular menstruation, lactation disorder

• QT prolongation (serious but rare)

✓ Drug Interactions 

This medication may interact with these drugs:

• CYP3A4 inhibitors

• Anti-arrhythmics class IA (e.g., disopyramide, quinidine)

• Anti arrhythmic class III (e.g., amiodarone, dofetilide, dronedarone, ibutilide, sotalol)

• Certain antipsychotics (e.g., haloperidol, pimozide, sertindole)

• Certain antidepressants (e.g., citalopram, escitalopram)

• Certain antibiotics (e.g., levofloxacin, moxifloxacin)

• Certain antifungal agents (e.g., pentamidine)

• Certain antimalarial agents (e.g., halofantrine)

• Certain gastrointestinal drugs (e.g., dolasetron)

• Certain drugs used in cancer (e.g., toremifene, vandetanib)

• Certain other drugs (e.g., bepridil, methadone

✓ Pregnancy 

Use only if needed.

( when potential benefit may justify potential risk)

- Consult your doctor before use.

✓ Lactation 

Small amounts pass into breast milk; generally considered safe in short-term use, but prolonged use should be avoided

✓ Precautions 

Please follow these cautions before taking the medicine:

• Talk to your doctor if you have any allergic reaction or known hypersensitivity to any of the medicine components.

• Talk to your doctor if you have kidney or renal impairment.

• Do not drive while using this medicine.

• Do not consume alcohol while using this medicine.

• Talk to your doctor if you are older than 60.

• If you start having heart trouble, discontinue the medication immediately.

• Not recommended in infants or children unless specifically prescribed

✓ Counselling points if any

• Take 15–30 minutes before meals

• Avoid combining with strong CYP3A4 inhibitors

• Report any signs of irregular heartbeat, dizziness, or fainting

• Do not exceed the recommended dose or duration

• Inform the doctor if menstruation becomes irregular or if galactorrhea occurs