Dose Of Domperidone Research Articles

Women’s experiences with using domperidone as a galactagogue to increase breast milk supply: an Australian cross-sectional survey

BackgroundDomperidone is one of the most commonly utilised pharmacological galactagogues, with evidence of increasing use in clinical practice. However, the use of domperidone as a galactagogue remains controversial, with mixed evidence on safety and efficacy, leading to variable clinical practice recommendations. We sought to evaluate contemporary patterns of domperidone use and examine maternal experiences related to perceived safety and effectiveness.MethodsIn 2019, we conducted an online, cross-sectional survey of Australian breastfeeding women to examine individual experiences related to domperidone use, in addition to perceptions of safety and effectiveness.ResultsAmong 1876 survey responses, 19% (n = 355) reported using domperidone. Domperidone use was significantly higher in women who were primiparous, gave birth preterm, delivered by caesarean section, had self-perceived low milk supply, and saw a lactation consultant. Nearly 20% of women commenced domperidone use in the first week postpartum (19%, n = 67). The median duration of use was six weeks (interquartile range 3–16 weeks). Maximum reported doses of domperidone used ranged from 20 mg/day to 160 mg/day. Half (n = 178, 50%) of women reported using a dose of 30 mg/day or less, 44% (n = 155) reported using a dose between 31 and 60 mg/day, and 6% (n = 22) reported using a dose greater than 61 mg/day. Nearly half of the respondents reported domperidone as ‘very’ or ‘extremely effective’ (45%, n = 161), with only 8% (n = 27) reporting it was ‘not at all effective’. Almost half (n = 172, 48%) of all women using domperidone reported side effects, including weight gain (25%), headaches (17%) and dry mouth (13%). Higher doses were associated with an increased likelihood of any side effects (≤ 30 mg/day, 38%; >31-≤60 mg/day, 48%, > 61 mg/day 73%; P < 0.004), with 31 (9%) stopping domperidone because of side effects.ConclusionWe identified widespread variation in domperidone utilisation patterns, with domperidone broadly perceived to be effective in increasing breast milk supply. Side effects associated with domperidone treatment were common, appeared to be dose-related, and were frequently associated with treatment cessation. These findings highlight the importance of improved clinical practice recommendations and generation of evidence from additional high-quality clinical trials evaluating the efficacy and safety of domperidone. More conclusive clinical trials are needed to determine the efficacy, as well as optimal dose and duration, of domperidone use.

Cardiac safety and clinical efficacy of high-dose domperidone for long-term treatment of gastroparesis symptoms

Domperidone is an effective antiemetic used worldwide, but there have been reports of possible cardiotoxicity. Our goal was to explore the cardiac safety and clinical efficacy of long-term domperidone, titrated...

Beyond Metoclopramide for Gastroparesis

Beyond Metoclopramide for Gastroparesis

Практические подходы к ведению больных с диспепсией

Статья посвящена проблемам лечения синдрома диспепсии. Поскольку в последнее время у большинства больных функциональной диспепсией отмечается сочетание симптомов эпигастрального болевого синдрома и постпрандиального дистресс-синдрома, на практике значительно чаще в качестве первой линии эмпирического лечения применяется комбинированная терапия ингибиторами протонной помпы (ИПП) и прокинетиками. В этом отношении очень удобен прием готовых комбинированных препаратов, таких как Омез Д или Омез ДСР, содержащих ИПП и безопасную дозу домперидона.

Domperidone-Related Acute Dystonia in a Young Child With Underlying Abnormal Electroencephalogram

Domperidone is the preferred treatment for vomiting and gastroesophageal reflux in pediatric population. It is known to have lesser side effects compared to metoclopramide and is rarely associated with extrapyramidal side effects. We report a case of acute dystonia in a 4-year-old girl that occurred after given two doses of domperidone. She initially presented to the emergency department for persistent vomiting and treated with syrup domperidone, ranitidine and oral rehydration salts. Approximately 24 h after last dose of oral domperidone, she developed five episodes of abnormal movement, i.e. stiffness over bilateral upper and lower limbs with eye staring to one direction without blinking. Each episode lasted for less than 10 s and patient did not lose consciousness. No history of head trauma or any family history of neurological diseases was documented. Patient was admitted for workup to rule out seizure. In ward, she developed another two brief episodes of similar presentations which resolved spontaneously without any treatment. No re-occurrence of similar episodes throughout the 3 days of hospitalization was noted. Computed tomography scan of brain confirmed no acute intracranial bleed or focal brain lesion. Electroencephalogram done during subsequent clinic follow-up noted some abnormal records due to increase in slow delta activity, but parents did not consent for magnetic resonance imaging. Patient remained well on biannual follow-up without any seizure or dystonia episode. Rare adverse event involving the central nervous system should be carefully evaluated although product label for domperidone did not mention precaution of use in patients with underlying cerebral abnormalities or epilepsy. Int J Clin Pediatr. 2020;9(2):55-58 doi: https://doi.org/10.14740/ijcp364

Cardiovascular alterations in rats with Parkinsonism induced by 6-OHDA and treated with Domperidone

After Alzheimer, Parkinson disease (PD) is the most frequently occurring progressive, degenerative neurological disease. It affects both sympathetic and parasympathetic nervous systems in a variable fashion. Cardiovascular symptoms are present in almost all stages of PD and narrower heart rate variability is the earliest sign. Administration of Levodopa to PD patients has proven to provide some degree of neurological protection. This drug, however, causes side effects including nausea and vomiting, lessened by the administration of domperidone. Autopsies in PD patients led some researchers to suggest the involvement of the ventricular arrhythmia induced by domperidone. The aim of the present study was to determine the impact of the adjusted human maximal dose of domperidone, on cardiological features of Wistar rats. domperidone was administered to both 6-hydroxydopamine Parkinsonism models and regular Wistar rats. Quantitative analysis of ranges of heart beat variation showed significant abnormal distribution in both groups receiving domperidone as compared with respective sham counterparts. However, qualitative analysis of Poincaré plots showed that 6-hydroxydopamine Parkinsonism models receiving domperidone had the narrowest full range of heart beat and the worst distribution heart beat ranges as compared with all study groups corroborating with previous suggestion that domperidone administration to PD patients is likely to play a role in sudden unexpected death in this group of patients.

Critical review of European Medicines Agency (EMA) assessment report and related literature on domperidone.

European Medicines Agency (EMA) issued a final decision on September 01, 2014 that restricts the maximum daily dose of domperidone to 30mg and treatment duration to 7days. This paper presents a critical review of the scientific basis of the literatures having a role in the decision of EMA on domperidone with an approach based on statistical and epidemiological perspective. Although observational studies used by EMA were published, the EMA didn't use an algorithm including "randomized clinical trials" according to evidence-based medicine when presenting their results. In conclusion, the results obtained from published studies are controversial, especially for the bias. From these publications, it cannot be concluded that domperidone exposure definitely increases the risk of "sudden cardiac death", "death associated with ventricular arrhythmia" or "ventricular arrhythmia" The most concrete result of these studies is that the risk is higher with metoclopramide exposure compared to domperidone exposure.

Using domperidone to induce and sustain hyperprolactinemia in late-pregnant gilts

Prolactin controls mammary development as well as the lactogenic and galactopoietic processes in sows and increasing prolactin during gestation can augment milk yield. The dopamine receptor antagonist domperidone can increase circulating prolactin concentrations in pigs, but the ideal dose to achieve sustained hyperprolactinemia remains unknown. An experiment was performed to develop a protocol for using domperidone in studies of rapid and sustained hyperprolactinemia in late-pregnant gilts. On day 90 of gestation, gilts were divided into 4 groups: (1) intramuscular (IM) injections of canola oil (3 mL, controls [CTL], n = 9), (2) IM injections with 0.1 mg/kg BW of domperidone (low [LO], n = 8), (3) IM injections with 0.5 mg/kg BW of domperidone (medium [ME], n = 11), and (4) IM injections with 1.0 mg/kg BW of domperidone (high [HI], n = 11). Injections were given daily at 8:05 from days 90 to 109 of gestation. Treated gilts also received domperidone per os (0.5 mg/kg BW) at 8:00 and 20:00 on days 89, 90, and 91 of gestation. Three jugular blood samples were collected from all gilts at 6-h intervals on days 89, 90, and 91 of gestation, then twice daily on days 92, 93, and 94. Thereafter, samples were obtained at 8:00 every other day until day 114 of gestation. Blood was sampled serially from 9 CTL and 11 HI gilts on days 89 and 94 of gestation. On day 89 of gestation, prolactin concentrations for LO, ME, and HI gilts increased within 6 h of domperidone per os (P < 0.001). From days 89 until 93 of gestation, the area under the curve (AUC) for LO, ME, and HI gilts was greater than that for CTL gilts (P < 0.001), whereas from days 89 until 114, ME and HI gilts had greater AUC than CTL and LO gilts (P < 0.05). Results demonstrate that the combination of per os treatment with IM injections of 0.5 mg/kg of domperidone in an oil emulsion leads to the rapid and sustained release of prolactin over 24 d in late-pregnant gilts. Higher doses of domperidone failed to further increase circulating prolactin levels. These findings provide a useful strategy to induce sustained hyperprolactinemia in late-pregnant gilts.

ACCP Virtual Poster Symposium

<scp>ACCP</scp> Virtual Poster Symposium

Biochemical Effect of Damperidone on Cardiac Functions after Induction of Peptic Ulcer in Albino Rats

The objective of the present study was to evaluate the biochemical effect of Domperidone on the cardiac functions after induction of peptic ulcer on albino rats. Sixty white male albino rats, average body weight 200- 250 gm and 12-16 weeks old were used in the experimental investigation of the study. Rats were randomly divided into two large groups Group A consist of thirty rats divided into three subgroups (subgroup G1,G2,G3) and this group is completely healthy without ulcer induction receiving Domperidone three times per day half an hour before meal each sub group receives a different dose using subgroup G1 as control. Group B consist of thirty rats undergo stomach ulcer induction and it is divided in to three subgroup (subgroup G4,G5,G6) receiving Domperidone three times per day half an hour before meal with different doses according to the subgroup. Blood samples were collected for biochemical examination three times during the study after one week, two weeks and four weeks. Tissue specimens where taken from heart for histopathological examination. We found elevated levels of Troponin (cTnT), CK-MB, LDH, and AST in groups treated with high doses of Domperidone and results was time dependent. Histopathological examination of heart showing coagulative necrosis, swollen, vacuolated myocytes with disruption and hyperesinophilia

Domperidone, cytochrome P450 3A4 isoenzyme inhibitors and ventricular arrhythmia: a nationwide case-crossover study.

Recent evidence suggested that oral form of domperidone may possess pro-arrhythmic effects and increase the risk of ventricular arrhythmia. The concomitant use of cytochrome P450 (CYP) 3A4 isoenzyme inhibitors may further potentiate this association. Nevertheless, empirical data supporting these associations are very limited. The aim of this study was to investigate the association between oral domperidone, CYP 3A4 inhibitors, and ventricular arrhythmia. We identified 25,356 patients who were admitted or were seen in the emergency room for ventricular arrhythmia between 2000 and 2011 from Taiwan's Longitudinal Health Insurance Database. We adopted a case-crossover study design to compare the exposure to oral domperidone for the same patient within a "case period" and within a "control period". Conditional logistic regression models showed that domperidone use was significantly associated with an increased odds of ventricular arrhythmia (aOR 1.56, 95%CI [1.41-1.72]). The association was stronger with a higher daily dose of domperidone (>30 mg, aOR 1.98, 95%CI [1.50-2.63]). Furthermore, the co-exposure of domperidone and CYP 3A4 inhibitors was significantly associated with an increased odds of ventricular arrhythmia, especially considering the lasting effect of CYP 3A4 inhibitors (1 day apart: aOR 1.91, 95%CI [1.33-2.75], 3 days apart: aOR 1.90, 95%CI [1.33-2.71], 7 days apart: aOR 1.80, 95%CI [1.28-2.54]). Our results suggested that oral domperidone was significantly associated with an increased odds of ventricular arrhythmia and that the association was stronger with exposure to >30 mg of domperidone. In addition, our study reported increased odds of ventricular arrhythmia among those who concomitantly used domperidone and CYP 3A4 inhibitors.

Cardiovascular Safety Profile and Clinical Experience With High-Dose Domperidone Therapy for Nausea and Vomiting

IntroductionDomperidone is a dopamine receptor antagonist with peripheral prokinetic and central antiemetic properties. Prolongation of the QTc interval with chronic use of oral domperidone in standard doses has been reported in the literature. our goal was to investigate cardiac toxicity in patients receiving 2-fold greater doses than in previous reports. MethodsA retrospective chart review was conducted of patients with nausea (N) and vomiting (v) receiving domperidone from 2009 to 2013 under an Investigational New Drug (iND) protocol. Patient demographics, indications for therapy, clinical outcomes, cardiac symptoms and electrocardiogram tracings were reviewed. Prolonged QTc was verified if >470 milliseconds in females (F) and >450 milliseconds in males (M). ResultsA total of 64 patients, 44 female (37% Hispanic, 60% white, 3% African American), were taking domperidone for diabetic gastroparesis 45%; idiopathic gastro-paresis 36%; chronic N&V 8%; dumping syndrome 5%; cyclic vomiting 5% and conditioned vomiting 1%. Mean duration of therapy was 8 months (range, 3 months to 4 years). Doses ranged from 40 to 120mg/ d with 90% receiving 80 to 120mg compared with the standard dose of 40mg. Of note, 73% of subjects benefited from treatment with reduced nausea and vomiting. Thirty-seven patients had follow-up electrocardiograms available, and they showed that the mean QTc at baseline was 424 milliseconds±28.4 (SD) compared with 435 milliseconds±27.2 (sD) at follow-up (not significant). Ten of these patients had prolonged QTc at F/U ranging from 453 to 509 milliseconds, without any cardiovascular complaints. There was no relationship between prolonged QTc and daily dose of domperidone, body mass index or age. ConclusionsOur data indicate that at very high dosing, the prokinetic/antiemetic agent domperidone has a low risk of adverse cardiovascular events while exhibiting good clinical efficacy.

Current use of domperidone and co-prescribing of medications that increase its arrhythmogenic potential among older adults: a population-based cohort study in Ontario, Canada.

Domperidone is commonly used to treat nausea and gastrointestinal disorders. Recent data suggests that it may increase the risk of sudden cardiac death, particularly in older people. Little is known about how it is used in contemporary practice. This study sought to characterize the population of older adults newly dispensed domperidone, describe dosages of domperidone used, and determine the frequency of co-prescribing domperidone with medications that may increase the arrhythmogenic potential of domperidone. This is a retrospective cohort study using administrative health database information from Ontario, Canada. Prescription medication records were obtained from the Ontario Drug Benefit Claims Database. Diagnostic codes were obtained from the Ontario Health Insurance Plan Database, the Canadian Institute for Health Information Discharge Abstract Database, and the same-day surgery database. Patients who received a new prescription for domperidone between April 1, 2003 and March 31, 2010 were included. A total of 122,233 patients met inclusion criteria; 85 % were between 66 and 84 years old and 63 % were female. The mean estimated daily domperidone dose was 35 mg, and the estimated daily dose was <40 mg for 62 % of users. Strong or moderately strong cytochrome P-450 (CYP) 3A4 inhibitors were co-prescribed for 4.3 and 10.7 % of users, while medications with a known risk or possible risk for torsades de pointes (TdP) were co-prescribed to 18.3 and 18.8 % of users. Older domperidone users were commonly co-prescribed drugs with the potential to increase the risk for TdP. These combinations should be avoided, as iatrogenic QT prolongation is a modifiable risk factor for TdP.

Piperine and ketoconazole increase plasma domperidone concentrations in the rat (1064.2)

This study was carried out to investigate the effect of piperine, a major pungent constituent of the black and red peppers and ketoconazole on the pharmacokinetics of domperidone. Animals received a single dose of domperidone(20mg/kg, p.o.) alone or together with piperine (60mg/kg, p.o.) or ketoconazole(50 mg/kg, p.o.) daily for 5 days. Plasma samples were collected at 0.25, 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0 and 12h after drug administration. The concentrations of domperidone in the plasma were measured using an HPLC method. The concomitant administration of piperine or ketoconazole with domperidone resulted in a significant (p&lt;0.05) increase in the maximum plasma concentration(Cmax), the mean area under the plasma concentration‐ time curve(AUC), and the elimination half‐life(t1/2) of domperidone as compared to those obtained for domperidone alone. These results suggest that an important pharmacokinetic interaction may occur if piperine or ketoconazole are administered concurrently with domperidone.

Domperidone

Domperidone (antinausea/vomiting agent) was recently shown by several groups to increase sudden cardiac death (SCD). Drug-induced disturbances of cardiac repolarization may be a major mechanism. Experiments were executed in isolated female rabbit hearts perfused for 150 minutes with domperidone 30, 60, or 100 nM. Domperidone significantly prolonged the action potential duration: +9% at 30 nM, +32% at 60 nM, and +48% at 100 nM. Domperidone induced significant disturbances of repolarization in 83% of hearts at 60 nM and in 100% at 100 nM, including early afterdepolarizations and polymorphic ventricular tachycardia. Maximum therapeutic free drug plasma concentration of domperidone (19 nM) yields a safety index of only ∼2.5, that is, 12-fold below the accepted minimum. Gastrointestinal benefits and risks for SCD were derived from the literature. The defined daily dose of domperidone (30 mg/day) fails to show unequivocal gastrointestinal benefits beyond a placebo effect. In contrast, 5 of 5 population-based studies show that oral domperidone significantly increases the odds ratio for SCD to 2.8 (1.53-6.21) and it increases sharply above 30 mg/day. Because domperidone has placebo-like benefits but is associated with increased SCD and a narrow safety margin, it should not be used in medicine.

Ultrasonographic Evaluation of Duodenal and Cecal Motility after Administration of Different Doses of Domperidone in Donkeys (Equus Asinus).

The objective of the present study was to evaluate the effect of different doses of domperidone on duodenal and cecal motility in donkeys. Six adult donkeys (n = 6) were used in a crossover study. Domperidone was administered orally via nasogastric tube at a dose rate of 0.5, 1 and 2 mg kg-1. Duodenal and cecal contractions were evaluated by ultrasonography using a 5 MHz curved-linear transducer. Examinations were performed before administration and at 15, 30, 60, 120 and 180 minutes post-administration. There was a significant (p< 0.05) increase of duodenal contractions after 15 minutes of domperidone administration at 1 mg kg-1 and lasted until 60 minutes. The cecal contractions were also significantly increased after 15 minutes and lasted until 60 minutes at a dose rate of 1 and 2 mg kg -1 (MANOVA fit, p< 0.01; Wilks, Lambda for dose × time interaction, p < 0.05). The results of the present study indicate that 1 mg kg-1 domperidone is the most effective prokinetic dose on duodenal and cecal contraction. Domperidone may be an alternative prokinetic drug for intestinal and cecal disorders in equines.

Effects of dopamine 2 receptor antagonist on sex steroid levels, oocyte maturation and spawning performances in Waigieu seaperch (Psammoperca waigiensis)

The present study has investigated the effects of domperidone (DOM), a dopamine 2 receptor antagonist, on plasma steroid hormone levels and reproductive performances of a female tropical marine finfish, Waigieu seaperch (Psammoperca waigiensis), with potential for cultivation in Vietnam. We showed that oral treatment of DOM during early stage of the reproductive cycle had no significant effects on the maturation and reproductive performances of the female fish, while plasma steroid hormone (testosterone (T), 11-ketotestosterone (11-KT), 17β-estradiol (E2) and progesterone (P)) levels were modulated based on month, DOM dose and the individual hormones measured. Overall, these findings suggest that DOM may not be needed for the induction of maturation and spawning of this species under aquaculture conditions. The data in the present study are significant in highlighting practical efforts for reducing drug use, production costs and for a sustainable aquaculture in a developing country such as Vietnam.

The Effect of Two Different Domperidone Doses on Maternal Milk Production

The benefits of breast milk to the newborn infant are well established. The Canadian Paediatric Society recommends exclusive breastfeeding for the first 6 months of life for healthy, term infants. Mothers of premature newborns, however, may have difficulty providing an adequate supply of breast milk. Domperidone is officially used as a prokinetic agent. However, it is used widely around the world as a galactogogue. Despite its widespread use as a galactogogue, only a small number of investigators have studied domperidone for this indication. The purpose of this study was to determine an optimal dosage of domperidone as a galactogogue. Eligible subjects were randomized to receive domperidone 10 mg 3 times daily or domperidone 20 mg 3 times daily for 4 weeks. At week 5, the frequency was decreased to twice daily in both groups, and finally once daily for week 6. Over the entire first 4-week period, there was a significant increase in daily milk volumes within each group (P < .01). The between-group difference over this period, although not statistically significant, was clinically significant. Additionally, there was no significant within- or between-group difference during weeks 5 and 6. A dose of domperidone of 20 mg, 3 times daily instead of 10 mg, 3 times daily was associated with a clinical, but not statistically significant, increase in milk production.

Tu1486 Towards a Wellness Index for Motility Disorders: the use of Desirability Functions to Evaluate Health Status in Patients With Gastroparesis

G A A b st ra ct s research. Oral domperidone has been reported in some cases to prolong the QT interval and predispose to ventricular arrhythmias (Reddymasu et al. Am J Gastro 2007;102:20362045). The aims: 1) To establish an indications and clinical profile of patients receiving domperidone through the limited access protocol 2) to investigate possible side effects of domperidone 3) to analyze ECG reports and the duration of QT intervals. Methods: Study involved a retrospective chart review of 163 patients referred to a single physician at the tertiary GI Motility Center. Patients demographics, GI diagnosis, cardiovascular complain and ECG tracings were obtained. Prolonged QTc were verified if they were longer than 470 ms in females and longer than 450 ms in male patients. Results: Overall 23 out of 163 (13%) patients (15 F; mean age 47, range 18-73) presenting with chief complaints of nausea and vomiting were enrolled in FDA approved protocol and received doses of domperidone ranging from 10 to 30mg QID for at least 6 up to 12 months. 8 (36%) patients were Hispanic, 12 (52%) Caucasian, and 3(12%) African American. A total 16 (60%) of these patients (9F) were diagnosed with GP, 4 females met the criteria for Cyclic Vomiting Syndrome and 3 patients had symptoms of unexplained nausea. 6 (27%) ECG reports showed non-significant sinus arrhythmias, and one male patient had an irregular rhythm. Women had mean heart rates of 82 (range 52-112) and men's average HR was 86 (range 55-105) bpm. Overall the mean value of QTc for all domperidone patients was 427 ms (ranges 383 507 ms). Further analysis of ECGs for females showed, mean QTc duration of 425 (394-507) ms and in males it was 429 (383-469) ms. Two patients (9%), one of each gender, had QTc prolongation above the normal respected value. No patients complained about palpitation or cardiac/ chest pain. Two patients noticed breast discomfort. No other potential adverse events including extra-pyramidal side effects were reported during this investigation. Conclusions:1) Domperidone is legally available in USA under the FDAIND approved protocol and can be prescribed for patients with symptoms of nausea and vomiting related to gastroparesis and other motility disorders 2) No clinically relevant cardiac complaints and ECG changes including QTc prolongations were discovered during this observation 3) Domperidone can be regarded as a safe prokinetic and antiemetic agent.

Tu1487 Progressive Occlusion of Mesenteric Artery Changes Biomagnetic Signature of Intestinal Slow Wave

G A A b st ra ct s research. Oral domperidone has been reported in some cases to prolong the QT interval and predispose to ventricular arrhythmias (Reddymasu et al. Am J Gastro 2007;102:20362045). The aims: 1) To establish an indications and clinical profile of patients receiving domperidone through the limited access protocol 2) to investigate possible side effects of domperidone 3) to analyze ECG reports and the duration of QT intervals. Methods: Study involved a retrospective chart review of 163 patients referred to a single physician at the tertiary GI Motility Center. Patients demographics, GI diagnosis, cardiovascular complain and ECG tracings were obtained. Prolonged QTc were verified if they were longer than 470 ms in females and longer than 450 ms in male patients. Results: Overall 23 out of 163 (13%) patients (15 F; mean age 47, range 18-73) presenting with chief complaints of nausea and vomiting were enrolled in FDA approved protocol and received doses of domperidone ranging from 10 to 30mg QID for at least 6 up to 12 months. 8 (36%) patients were Hispanic, 12 (52%) Caucasian, and 3(12%) African American. A total 16 (60%) of these patients (9F) were diagnosed with GP, 4 females met the criteria for Cyclic Vomiting Syndrome and 3 patients had symptoms of unexplained nausea. 6 (27%) ECG reports showed non-significant sinus arrhythmias, and one male patient had an irregular rhythm. Women had mean heart rates of 82 (range 52-112) and men's average HR was 86 (range 55-105) bpm. Overall the mean value of QTc for all domperidone patients was 427 ms (ranges 383 507 ms). Further analysis of ECGs for females showed, mean QTc duration of 425 (394-507) ms and in males it was 429 (383-469) ms. Two patients (9%), one of each gender, had QTc prolongation above the normal respected value. No patients complained about palpitation or cardiac/ chest pain. Two patients noticed breast discomfort. No other potential adverse events including extra-pyramidal side effects were reported during this investigation. Conclusions:1) Domperidone is legally available in USA under the FDAIND approved protocol and can be prescribed for patients with symptoms of nausea and vomiting related to gastroparesis and other motility disorders 2) No clinically relevant cardiac complaints and ECG changes including QTc prolongations were discovered during this observation 3) Domperidone can be regarded as a safe prokinetic and antiemetic agent.