The place and role of domperidone in the practice of a gastroenterologist. Overview of options at the present stage

Abstract

Diseases of the gastrointestinal tract (GIT) occupy a significant place in the overall structure of somatic diseases worldwide. Apart from functional diseases (the incidence of functional dyspepsia (FD) in population is 20 %), the following inflammatory and destructive diseases are widespread: gastroesophageal reflux disease (GERD) in up to 40 % of the population, chronic gastritis and chronic duodenitis in 45 — 50 % of the population, peptic ulcer of the stomach and duodenum in 14 — 15 % of the population. Each of these diseases has its own features of etiopathogenesis and approaches to treatment. However, a common pathological factor contributing to the development of these nosologies is a violation of motor‑evacuation function. The administration of drugs for the normalization of peristaltic activity is a component of treatment. The range of existing drugs with prokinetic activity against the gastrointestinal tract is quite large.One of the effective and safe prokinetics registered in October 2020 in Ukraine is the domperidone preparation Doprokin (World Medicine). This drug has a proven effectiveness in the treatment of patients with FD, GERD, chronic gastritis, especially in comorbidity with Diabetes mellitus II (diabetic gastroparesis) and gastroparesis of other etiology. This is a selective dopamine antagonist, that blocks D2‑receptors in the central and peripheral nervous systems. It increases the pressure of the lower esophageal sphincter, esophageal clearance, reduces intragastric pressure, activates peristalsis of the esophagus and antrum of the stomach, increases the frequency, amplitude and duration of contractions of the duodenum, reduces the time of passage of food masses through the small intestine. The indications for domperidone administration include relief of symptoms of nausea, vomiting, heartburn, belching, early satiety, bloating. In contrast to metoclopramide, it almost does not cross the blood‑brain barrier and does not cause unwanted central adverse reactions. Doprokin is over the counter preparation. For adults, the recommended dose is 1 tablet (10 mg) 3 times a day (15 — 30 minutes before the meals). The maximal daily dose is 30 mg, maximal treatment duration should not exceed 1 week.