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Common name
Motilium (Domperidone)
Description
Motilium (Domperidone) is a medicine that increases the movements or contractions of the stomach and bowel. Domperidone is also used to treat nausea and vomiting caused by other drugs used to treat Parkinson's Disease. Domperidone is to be given only by or under the immediate supervision of your doctor.
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Active Ingredients:
Domperidone
Therapeutic actions:
• Domperidone is a dopamine-receptor blocking agent. Its action on the dopamine-receptors in the chemo-emetic trigger zone produces an anti-emetic effect.
• Domperidone does not cross the blood-brain barrier to any appreciable degree and so exerts relatively little effect on cerebral dopaminergic receptors.
• Domperidone has been shown to increase the duration of antral and duodenal contractions to increase gastric emptying.
• Domperidone does not alter gastric secretions and has no effect on intracranial pressure or on the cardiovascular system.
• Domperidone is rapidly absorbed, with peak plasma concentrations at approximately 1 hour after oral administration.
• The absolute bio-availability of oral domperidone is low (approximately 15%) due to first-pass hepatic and intestinal metabolism.
• Domperidone is 91 to 93% bound to plasma proteins. The plasma half-life after a single oral dose is 7 to 9 hours in healthy subjects but is prolonged in patients with severe renal insufficiency.
• Domperidone undergoes rapid and extensive hepatic metabolism by hydroxylation and N-dealkylation. In vitro metabolism experiments with diagnostic inhibitors revealed that CYP3A4 is a major form of cytochrome P-450 involved in the N-dealkylation of domperidone, whereas CYP3A4, CYP1A2 and CYP2E1 are involved in domperidone aromatic hydroxylation.
• Urinary and faecal excretion amount to 31% and 66% of the oral dose, respectively. The proportion of drug excreted unchanged is small (approximately 1% of urinary and 10% of faecal excretion).
What is it used for?: (Indications:)
MOTILIUM is indicated for:
• Delayed gastric emptying of functional origin with gastro-oesophageal reflux and/or dyspepsia.
• Control of nausea and vomiting of central or local origin.
• As an anti-emetic in patients receiving cytostatic and radiation therapy.
• Facilitates radiological examination of the upper gastro-intestinal tract.
Contraindications and cautions:
MOTILIUM is contra-indicated in patients with known hypersensitivity to domperidone. MOTILIUM should not be used whenever stimulation of gastric motility is to be avoided or could be harmful, eg. in the presence of gastro-intestinal haemorrhage, obstruction or perforation.
MOTILIUM is also contra-indicated in patients with a prolactin-releasing pituitary tumour (prolactinoma). The safety of use during pregnancy and lactation has not been established.
Side effects:
The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
• Allergic reactions, such as rash or urticaria, have been reported.
• Abdominal cramps have been reported.
• Dystonic reactions (extrapyramidal phenomena) may occur.
• Reversible raised serum prolactin levels have been observed which may lead to galactorrhoea and gynaecomastia.
• Hypertensive crises in patients with phaeochromocytoma may occur with administration of domperidone.
• Where the blood brain barrier is not fully developed (mainly in young babies) or is impaired, the possible occurrence of neurological side-effects cannot be totally excluded. The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
Interactions:
Tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine.
• Concomitant administration of anti-cholinergic drugs may inhibit the anti-dyspeptic effects of MOTILIUM.
• Anti-muscarinic agents and opioid analgesics may antagonise the effect of MOTILIUM.
• MOTILIUM suppresses the peripheral effects (digestive disorders, nausea and vomiting) of dopaminergic agonists.
• Since MOTILIUM has gastro-kinetic effects, it could influence the absorption of concomitant orally administered medicines, particularly those with sustained release or enteric coated formulations.
• As MOTILIUM interferes with serum prolactin levels, it may interfere with other hypoprolactinaemic agents and with some diagnostic tests.
• Antacids and anti-secretory agents lower the oral bioavailability of domperidone. They should be taken after meals and not before meals, i.e. they should not be taken simultaneously with MOTILIUM.
• Reduced gastric acidity impairs the absorption of domperidone.
• Oral bioavailability is decreased by prior administration of cimetidine or sodium bicarbonate.
• The main metabolic pathway of domperidone is through CYP3A4. In vitro data suggests that concomitant use of drugs that significantly inhibit this enzyme may result in increased plasma levels of domperidone. Examples of CYP3A4 inhibitors include the following:
o azole antifungals o macrolide antibiotics
o HIV protease inhibitors
o Nefazodone
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Motilium brands
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Product |
Manufacturer |
Price |
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Domperidon-Hexal
20 tablets (10 mg/tablet)
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Hexal AG, Germany |
$14.00 |
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Domperon
100 tablets (10 mg/tablet)
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Cadila, India |
$39.00 |
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Motilium
10 tablets (10 mg/tablet)
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Janssen Cilag, Belgium |
$10.00 |
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Motilium
30 tablets (10 mg/tablet)
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Janssen Cilag, Belgium |
$18.00 |
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