(Domperidone) Online without Prescription.
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Brand name: Motilium
Generic Name : Domperidone
Medicine Category :
Miscellaneous : Antiemetics & Antivertigo Drugs
FDA Pregnant Category
: Not established
What is it used for?
- Nausea and vomiting in adults and children
- Relief of upper abdominal discomfort, sense of fullness and
regurgitaion of stomach contents in adults
How does it work?
This medicine contains the active ingredient
domperidone, which is a type of medicine called a dopamine antagonist.
It is an anti-emetic medicine, meaning it is used to treat nausea
and vomiting. It can also be used to treat abdominal bloating,
fullness and discomfort in adults.
Domperidone works primarily by blocking dopamine
receptors found in an area of the brain known as the chemoreceptor
trigger zone (CTZ). The CTZ is activated by nerve messages from
the stomach when an irritant is present. It is also activated
directly by agents circulating in the blood, for example anti-cancer
medicines. Once activated, it sends messages to another area of
the brain, the vomiting centre, which in turn sends messages to
the gut, causing the vomiting reflex.
Blocking the dopamine receptors in the CTZ prevents
nausea messages from being sent to the vomiting centre. This reduces
the sensation of nausea and prevents vomiting.
Domperidone also blocks dopamine receptors found
in the upper end of the digestive system. This results in tightening
of the muscles at the entry to the stomach, relaxation of the
muscles at the exit of the stomach and increased contraction of
the muscles in the stomach itself. These actions speed the passage
of food through the stomach into the intestine, which physically
helps to prevent vomiting.
Both actions make domperidone useful in treating
nausea and vomiting due to many causes, including anti-cancer
chemotherapy, emergency hormonal contraception and in migraine.
Domperidone is also used to prevent nausea and vomiting that can
be caused by medicines for Parkinson's disease, such as levodopa,
bromocriptine and apomorphine.
Due to its stimulating action on the gut, which
speeds up stomach emptying into the intestine, domperidone can
also be used to relieve upper abdominal discomfort, a sense of
fullness or bloating, and regurgitation of the stomach contents
that some people experience following meals. Domperidone can be
bought over-the-counter from pharmacies for this purpose as the
branded product Motilium 10. It should only be used for these
purposes in adults.
Peripheral dopamine antagonist.
Motilium: Motilium's mechanism of action is based on a marked
dopamine-blocking activity. Due to its weak penetration across
the hematoencephalic barrier, Motilium has almost no effect on
the dopaminergic receptors in the brain, therefore excluding any
psychotropic or neurologic effect.
In vitro and in vivo pharmacologic studies in
man and animals have shown the following:
Motilium not only relieves experimental inhibition
of gastric motility (eg, that provoked by the dopaminomimetic
apomorphine) but it also quickens postprandial gastric evacuation
which is not artificially slowed down.
Motilium increases the tonicity of the cardial
sphincter and augments the dilation amplitude of the postprandial
motility of the pyloric sphincter.
Motilium does not influence gastric secretion.
Motilium-M: The mechanism of action of Motilium-M
is probably based on its antidopamine activity. Motilium-M has
virtually no effect on the dopaminergic receptors of the brain
so that psychotropic or neurologic effect are practically absent.
Motilium-M is well absorbed and rapidly metabolised.
On the intact stomach preparation of the guinea
pig, dopamine induces pronounced relaxations. These relaxations
could be antagonized by both domperidone base (ED50 = 1.9 x 106
H) and domperidone maleate (ED50 = 1.8 x 106 H). There was no
difference in potency observed between the base and maleate salt
Motilium: Motilium is absorbed and rapidly metabolized.
Distribution: Peak plasma concentrations are attained
at 10-30 min after oral administration, and at 1-2 hrs after rectal
administration of suppositories.
Distribution data in rats with radiolabelled
drug have shown wide distribution in body tissues except the CNS,
where only low concentrations occur. Tissue concentrations after
oral Motilium were higher than the corresponding plasma concentration,
except in the brain and reproductive organs.
Motilium undergoes rapid and extensive biotransformation by hydroxylation
and oxidative N-dealkylation. The proportion of the drug remaining
unchanged is small, accounting for only 1.4% of the total urinary
radioactivity and 10% of the faecal radioactivity. After oral
administration of 409 mg 14C-domperidone in healthy volunteers,
31% of the radioactivity is excreted in the urine and 60% in the
faeces over a period of 4 days (Meuldermans et al, 1981). Practically
all of the urinary radioactivity is recovered within the first
24 hrs, with only 1.4% (0.43% of the dose) present as unchanged
drug. The greatest proportion of that part of the dose recovered
in the urine is in the form of glucuronide conjugates of the metabolite
formed by oxidative N-dealkylation. The elimination half-life
of Motilium is 7.5 hrs in healthy subjects (Heykants et al, 1981b),
and is prolonged to up to 20.8 hrs in patients with severe renal
dysfunction (data on file, Janssen). However, since renal clearance
is small compared with total plasma clearance (700 mL/min), accumulation
should not occur in renal dysfunction.
The Place of Motilium in Therapy: Motilium has
been shown to control the cluster of symptoms commonly referred
to as postprandial dyspepsia and to be an effective antiemetic
in adults and children with nausea and vomiting due to a variety
The bioavailability of domperidone was studied in healthy male
volunteers in the normal fasted state and when pre-treated with
cimetidine and sodium bicarbonate (to reduce gastric acidity).
Two dosage forms were compared: Domperidone base (R 33 812) in
film-coated tablets and domperidone maleate (R 50 121). In the
normal fasted state, the bioavailability of domperidone was similar
for both dosage forms. Reduced gastric acidity lowered the bioavailability
of the drug in some subjects when domperidone base was administered,
but it did not influence the absorption from its maleate salt.
How should Motilium (Domperidone)
In deciding to use a medicine, the risks of taking
the medicine must be weighed against the good it will do. This
is a decision you and your doctor will make. For Motilium the
following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or
allergic reaction to domperidone.
Pregnancy—Pregnancy—domperidone has not been studied in pregnant
women. However, domperidone has not been shown to cause birth
defects or other problems in animal studies.
Breast-feeding— Breast-feeding—Domperidone passes
into the breast milk, but it is not known if domperidone will
cause unwanted effects in the newborn. It may be necessary for
you to take another medicine or to stop breast-feeding during
treatment. Be sure you have discussed the risks and benefits of
the medicine with your doctor.
Children—Children—Studies on Motilium have been
done only in adult patients, and there is no specific information
comparing use of domperidone in children with use in other age
Older adults—Many medicines have not been studied
specifically in older people. Therefore, it may not be known whether
they work exactly the same way they do in younger adults or if
they cause different side effects or problems in older people.
There is no specific information comparing the use of domperidone
in the elderly with use in other age groups.
Other medicines—Although certain medicines should
not be used together at all, in other cases two different medicines
may be used together even if an interaction might occur. In these
cases, your doctor may want to change the dose, or other precautions
may be necessary. Tell your doctor or pharmacist if you are taking
any other prescription or nonprescription (over-the-counter [OTC])
Monoamine oxidase (MAO) inhibitors (furazolidone
[e.g., Furoxone], phenelzine [e.g., Nardil], procarbazine [e.g.,
Matulane], selegilene [e.g., Eldepryl], tranylcypromine [e.g.,
- This medicine is not recommended for long term
- Motilium tablets contain lactose and may be unsuitable for people
with lactose intolerance, glucose/galactose malabsorption or a
genetic disorder leading to accumulation of galactose in the blood
(galactosaemia). Motilium suspension contains sorbitol and may
be unsuitable for people with sorbitol intolerance.
Use with caution in
- Decreased liver function
- Infants and young children
- Prolonged repeated use in severely decreased kidney function
Not to be used in
- Abnormal hole in the stomach or intestines
- Bleeding from the gut (gastrointestinal haemorrhage)
- Cancer of the pituitary gland resulting in over-production of
the hormone prolactin (prolactinoma)
- Conditions in which stimulating movement through the stomach
could be harmful (your doctor will know)
- Obstruction of the stomach or intestines
This medicine should not be used if you are allergic
to one or any of its ingredients. Please inform your doctor or
pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic
reaction, stop using this medicine and inform your doctor or pharmacist
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy
or breastfeeding. However, other medicines may be safely used
in pregnancy or breastfeeding providing the benefits to the mother
outweigh the risks to the unborn baby.Always inform your doctor
if you are pregnant or planning a pregnancy, before using any
- The safety of this medicine for use during
pregnancy has not been established. It is not recommended for
use in pregnancy unless considered essential by your doctor. Seek
medical advice from your doctor.
- This medicine passes into breast milk in small amounts. Seek
medical advice from your doctor before breastfeeding.
Medicines and their possible side effects can
affect individual people in different ways. The following are
some of the side effects that are known to be associated with
this medicine. Because a side effect is stated here, it does not
mean that all people using this medicine will experience that
or any side effect.
- Abnormal enlargement of breasts in men (gynaecomastia)
- Abnormal movements of the hands, legs, face, neck and tongue,
eg tremor, twitching, rigidity (extrapyramidal effects)
- Breast pain
- High blood prolactin (milk producing hormone) level (hyperprolactinaemia).
Sometimes this can lead to symptoms such as breast enlargement,
production of milk and stopping of menstrual periods.
- Stomach cramps
- Decreased sex drive
- Itchy rash (urticaria)
The side effects listed above may not include
all of the side effects reported by the drug's manufacturer.
For more information about any other possible
risks associated with this medicine, please read the information
provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other
Domperidone may increase the speed of absorption
of certain medicines from the gut, for example paracetamol.
Dyspepsia: Preferably oral administration.
10-20 mg 3-4 times a day, 15-30 min before meals. If necessary,
this dose can again be taken before retiring.
oral solution: ¼ measuring spoon (to the 1.25-mL mark)/5
kg body weight 3 times a day before meals (and if necessary, before
Remarks: If required,
the dosage mentioned can be doubled.
Acute and Subacute Conditions (mainly nausea,
vomiting, hiccups): Adults: Oral Route: 20 mg (5 tsp of oral suspension
3-4 times a day, before meals and before retiring (this dose can
Children: Oral Route: 0.1% oral solution: ¼ measuring spoon/5
kg body weight 3-4 times a day before meals.
Dyspepsia (mainly oral administration): Adults: 10-20 mg 3-4 times
daily, 15-30 min before meals and if necessary, once more before
When results are not satisfactory, the dosage may be doubled.
When antacids or antisecretory agents are used
concomitantly, they can be taken together with Motilium-M.
Acute and Subacute Conditions (particularly
nausea and vomiting): Adults: 20 mg (2 tabs) 3-4 times daily before
meals and before bedtime (if necessary, this dosage may be doubled).
Symptoms of overdosage may include drowsiness, disorientation
and extrapyramidal reactions, especially in children.
Anticholinergics, anti-parkinsonian agents or
antihistamines with anticholinergic properties may be helpful
in controlling the extrapyramidal reactions. In the event of accidental
overdosage supportive measures including gastric lavage with sodium
bicarbonate, should be employed. There is no specific antidote.
Close observation and supportive therapy are recommended. Symptoms
are self-limiting and usually disappear within 24 hours.
Protect from light. Store at room temperature.
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Buy Motilium (Domperidone)
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