A recent Europe-wide review has recommended updates to the treatment advice for domperidone following evaluation of the benefits and risks. The review was triggered following continued reports of cardiac side effects and a small increased risk of serious cardiac side effects was confirmed. A higher risk was observed in patients older than 60 years, adults taking daily oral doses of more than 30mg, and those taking QT-prolonging medicines or CYP3A4 inhibitors concomitantly.
As domperidone is also available to buy in a pharmacy as tablets for use in adults and adolescents aged 16 years and above, pharmacists are asked to take the following steps when supplying domperidone without prescription:
• Ask questions to exclude supply for use by people for whom domperidone is contraindicated.• Advise people to take domperidone without prescription only for nausea and vomiting.• Advise people to take the lowest dose for the shortest possible time up to a maximum daily dose of 3 tablets and for a maximum period of 48 hours.
The full recommendations from the Co-ordination Group for Mutual Recognition and Decentralised Procedures-Human (CMDh) to restrict the use of domperidone-containing medicines in the EU can be accessed from the link below.