Domperidone: an alternative to metoclopramide

Abstract

The anti-emetic drug domperidone (Motilium - Janssen) was introduced in 1982.1 Like metoclopramide the drug blocks dopamine receptors in the medullary chemoreceptor trigger zone, thereby influencing the central control of nausea and vomiting, and in the gut to increase gastrointestinal motility.2 Parenteral domperidone which was used to prevent vomiting caused by cytotoxic drugs or postoperatively was withdrawn in 1984 because ventricular arrhythmias had followed high intravenous doses.3,4 Oral and rectal domperidone continue to be promoted, especially since the arrival of a second brand (Evoxin - Sterling). The tablets and suppositories are licensed ‘for the treatment of acute nausea and vomiting of any aetiology, in adults’ - a remarkably broad indication. The suppositories are also for children receiving cytotoxic drugs or radiotherapy.