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Motilium (domperidone)
is a dopamine antagonist primarily known for three different
functions:
- Suppression of nausea and vomiting caused by other
medications
- Stimulation of lactation in nursing mothers
- Enhancement of gastrointestinal motility
While
there are a number of similar medications which may produce equally
good results, Motilium does not pass through the blood-brain
barrier, resulting in fewer side effects for many
patients.
Mechanism & Uses
As a dopamine antagonist, Motilium blocks dopamine receptors found
in the digestive system and the brain. In the digestive system,
this causes the natural contraction and relaxation of the stomach
and bowels, which moves solids through the digestive system. In the
brain, it interferes with the signals that tell the stomach to
expel an irritant, or vomit. Dopamine suppression in the brain also
triggers prolactin secretion, which promotes lactation.
As a nausea suppressant, this medication is usually given in
situations where the nausea is caused by a medication, such as
chemotherapy or medications used in treating Parkinson's disease.
It may also be used during a migraine headache, but in most
non-medication causes, such as morning sickness or motion sickness,
a milder, alternative treatment will suffice.
Motilium is used in a range of gastrointestinal disorders,
including:
- Gastroparesis (delayed emptying of the stomach)
- Acid reflux disease (also called GERD)
- Bloating, gas and/or abdominal discomfort
- Irritable bowel syndrome
- Gastritis (inflammation of stomach lining)
- Dyspepsia (impaired digestion)
- Hiatal hernia (stomach protrudes through diaphragm)
Though
not a cure for the above gastrointestinal conditions, Motilium will
significantly reduce symptoms associated with
them.
Motilium has been used extensively around the globe as a lactation
stimulant, though it may not be formally approved as such in all
locations. Regardless, it is a widely-recognized off-label use and
many doctors will not hesitate to prescribe it for mothers who are
not producing sufficient milk. Even at relatively high dosage
strengths there do not appear to be any negative side effects on
nursing infants, though, again, as an off-label use there is little
formal data to back these claims up. Its effect on unborn babies is
unknown.
Administration & Dosage
Motilium comes in tablets, oral suspension and suppositories. In
most respects treatment with Motilium is similar regardless of the
condition being treated; it is usually taken 3 to 4 times daily on
an empty stomach, 15 to 30 minutes prior to eating. Dosage strength
tends to depend on the type of condition as well as individual
patient circumstances:
- For nausea suppression, 20 mg in each dose, or 60 to 80 mg
daily.
- For gastrointestinal motility, 10 mg in each dose, or 30 to 40
mg daily, though dosage strength may be raised if needed.
- For stimulating lactation, 10 to 40 mg in each dose, or 30 to
160 mg daily.
Duration
of treatment may last from weeks to months or even years, depending
on the condition being treated and patient response to
treatment.
Warnings & Side Effects
As previously mentioned, side effects with this medication are
quite rare and, when they do occur, are typically very mild,
including dry mouth, heartburn, drowsiness, and swollen breasts.
Very rarely serious reactions may be experienced, which call for
medical attention:
- Rapid or uneven heart rate
- Severe dizziness or weakness
- Painful or difficult urination
- Swelling of face, hands or feet
Patients
with heart or liver disease, brain tumors, abnormal heart rhythms,
or issues with bleeding in the stomach or intestines may be at
greater risk of serious side effects from using this
medication.