Introduction: Domperidone is a peripheral D2 and D3 dopamine receptor blocker used for nausea, vomiting, dyspepsia, gastroparesis, and gastroesophageal reflux disease. Prolongation of the QT interval, and life-threatening arrhythmias including Torsades de Pointes have been described with its use. Electrocardiogram (EKG) monitoring in patients receiving the drug is advised. Patients receiving domperidone also are at risk for interactions with drugs that prolong the QT interval. We reviewed EKG monitoring of patients on domperidone and the co-prescription of other QT-prolonging medications in a large, multihospital community-based practice and reports of adverse cardiac events to the Food and Drug Administration (FDA).Figure 1Figure 2Methods: The electronic medical records for all patients in the community practice receiving domperidone from January 1, 2008 to December 1, 2013 were reviewed. EKG monitoring before and during domperidone use was noted. Normal values for corrected QT interval (QTc) were The co-administration of QT prolonging medications and inhibitors of cytochrome P450-3A4 was determined (termed QTinteracting medications). The Adverse Event Reporting System (FAERS) database of the FDA was queried for all reports of adverse events (ADRs) with domperidone. Co-administration of QT-interacting medications was noted. Results: 155 patients (115 female, 40 male, average age 56.2) were prescribed domperidone in the community practice. Only 59 (38.1%) underwent a baseline EKG, with 9 having prolonged QTc. Of 40 follow up EKGs, 13 (32.5%) had prolongation of the QTc. All were co-prescribed a QT-prolonging medication. In total, 108 of 155 patients (69.7%) were co-prescribed QT-interacting drugs along with domperidone (Table 1). There were a total of 5000 reports of ADRs with domperidone between January 2008 and June 2014. Of these, 1979 patients were co-prescribed domperidone and QT-interacting medications. There were 221 non-fatal cardiac events reported. Of these, 162 (73%) patients received concomitant QT-interacting medications. There were 151 deaths and 61 cardiac arrests reported, Co-prescription of QT- interacting medications occurred in 53 (35%) of reported deaths (Table 2). Conclusion: Sporadic EKG monitoring and co-prescription of QT-interacting medications commonly occur with domperidone prescription. Correction of these practices will improve safety and quality of care in patients receiving domperidone.