Last update: Feb. 11, 2020

دومبيريدون

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Approved as an antiemetic and prokinetic in many countries, although not in the US (Rowe 2013, Sachs 2013, Da Silva 2004) and often prescribed in young infants for the treatment of gastroesophageal reflux disease. Indicated for the control of nausea and vomiting.
Oral administration 3 times a day.

It is excreted in breastmilk in clinically insignificant amounts (Knoppert 2013, Wan 2008) and no problems have been recorded in infants whose mothers were taking it (Madjunkov 2017, Osadchy 2012, Da Silva 2001, De Leo 1986, Petraglia 1985). 

Being a dopamine antagonist, it increases the production of prolactin (Hofmeyr 1985, Brouwers 1980) and of milk, being able to produce galactorrhea (Cann 1983), so it is widely used as a galactogogue (Brodribb 2018, Rowe 2013, Grzeskowiak 2013, Anderson 2013, Winterfeld 2012, Anderson 2007, Da Silva 2004, Brown 2000).
It does not cross the blood-brain barrier (Amir 2011, Gabay 2002, Hofmeyr 1985, Petraglia 1985, Brouwers 1980) as it has no neurological effects, so it would be preferable to metoclopramide for that purpose.

The maternal perception of insufficient milk is one of the main causes of abandoning breastfeeding (Winterfeld 2012, Jones 2011, Zuppa 2010, Amir 2006).
The best galactogogue is effective support and advice during pregnancy and after childbirth to achieve breastfeeding on frequent demand and with correct technique in a mother who retains her self-confidence (Brodribb 2018, Anderson 2013, Mannion 2012, Forinash 2012, Comité 2012, ABM 2011, Jones 2011, Anderson 2007, Amir 2006, Seema 1999).

At a dose of 10 to 20 mg every 8 hours for 2 to 4 weeks, milk production increases, especially in mothers of preterm infants admitted to neonatal units (Taylor 2019, Asztalos 2019, Grzeskowiak 2018, Brodribb 2018, Asztalos 2017, Haase 2016, Rai 2016, Bazzano 2016, Knoppert 2013, Inam 2013, Donovan 2012, Ingram 2012, Osadchy 2012, Campbell 2010, Wan 2008, Da Silva 2001, Petraglia 1985, Hofmeyr 1983), after a Cesarean Section (Jantarasaengaram 2012) and in cases of relactation ( Muresan 2011), lactation induction (Bryant 2006), breast hypoplasia (Duran 2011) and transgender women (Reisman 2018).

Some studies show that it is not effective in all mothers (Wan 2008), that it may cease to be effective by the 4th week of its administration (Asztalos 2017), that there are no significant differences in the increase in milk production with 30 or 60 mg daily (Knoppert 2013), side effects in mothers (abdominal pain, headache and dry mouth) are more frequent at high doses (Wan 2008) and that, despite the increase in milk production, weight gain might not be observed in breastfed infants (Rai 2016) or decreased risk of breastfeeding abandonment (Grzeskowiak 2018).


In order to avoid withdrawal symptoms (Doyle 2018, Papastergiou 2013) it is advisable to carry out a slow progressive withdrawal over several weeks.

Domperidone increases the concentration of calcium in breastmilk without altering the caloric content or that of other components (Campbell 2010).

Domperidone has been associated with an increased risk of severe ventricular arrhythmias in older people (Leelakanok 2016) or with previous cardiac abnormalities (lengthened QT on the ECG) or associated with medications that lengthen the QT (Doggrell 2014), being extraordinarily rare in healthy women of childbearing age (Madjunkov 2017, Smolina 2016). Only one woman with a previous history of arrhythmia presented ventricular arrhythmia among the more than 200,000 treated with domperidone in the postpartum period (Smolina 2016, Grzeskowiak 2018 and 2017).
Do not use as a galactogogue without health checks.

Several medical societies and expert consider the use of this medication to be safe or very probably safe during breastfeeding (Grzeskowiak 2018, Hale 2017 p300, Amir 2011, Zuppa 2010, Marasco 2008, Mahadevan 2006, Lee 1993).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

Alternatives

We do not have alternatives for دومبيريدون since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

دومبيريدون is Domperidone in Arabic.

Is written in other languages:

دومبيريدون is also known as

Group

دومبيريدون belongs to this group or family:

Tradenames

Main tradenames from several countries containing دومبيريدون in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 15 - 20 %
Molecular weight 426 daltons
Protein Binding 91 - 93 %
VD 6 l/Kg
pKa 7,03 -
Tmax 0,5- 1 hours
T1/2 7 - 9 hours
M/P ratio 0,25 - 0,6 -
Theoretical Dose 0,00004 - 0,001 mg/Kg/d
Relative Dose 0,004 - 0,1 %
Relat.Ped.Dose 0,016 - 0,4 %

References

  1. Asztalos EV, Kiss A, daSilva OP, Campbell-Yeo M, Ito S, Knoppert D; EMPOWER Study Collaborative Group.. Role of days postdelivery on breast milk production: a secondary analysis from the EMPOWER trial. Int Breastfeed J. 2019 Jun 4;14:21. Abstract
  2. Taylor A, Logan G, Twells L, Newhook LA. Human Milk Expression After Domperidone Treatment in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Hum Lact. 2019 Aug;35(3):501-509. Abstract
  3. Asztalos EV, Kiss A, daSilva OP, Campbell-Yeo M, Ito S, Knoppert D; EMPOWER Study Collaborative Group. Evaluating the Effect of a 14-Day Course of Domperidone on Breast Milk Production: A Per-Protocol Analysis from the EMPOWER Trial. Breastfeed Med. 2019 Mar;14(2):102-107. Abstract
  4. Grzeskowiak LE, Amir LH, Smithers LG. Longer-term breastfeeding outcomes associated with domperidone use for lactation differs according to maternal weight. Eur J Clin Pharmacol. 2018 Abstract
  5. Doyle M, Grossman M. Case report: domperidone use as a galactagogue resulting in withdrawal symptoms upon discontinuation. Arch Womens Ment Health. 2018 Abstract
  6. Reisman T, Goldstein Z. Case Report: Induced Lactation in a Transgender Woman. Transgend Health. 2018 Jan 1;3(1):24-26. Abstract Full text (link to original source) Full text (in our servers)
  7. ABM: Brodribb W. ABM Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting Maternal Milk Production, Second Revision 2018. Breastfeed Med. 2018 Jun;13(5):307-314 Abstract Full text (link to original source) Full text (in our servers)
  8. Grzeskowiak LE, Smithers LG, Amir LH, Grivell RM. Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis. BJOG. 2018 Abstract
  9. Madjunkov M, Chaudhry S, Fujioka I, Pfaller-Eiwegger B, Newman J, Ito S. Safety of domperidone as a galactogogue: A retrospective chart review study. In 30th Annual Education Meeting for Organization of Teratology Information Specialists Members and MotherToBaby Affiliates. Birth Defects Res. 2017;109 (SI):712, Poster 10. 2017
  10. Asztalos EV, Campbell-Yeo M, da Silva OP, Ito S, Kiss A, Knoppert D; EMPOWER Study Collaborative Group.. Enhancing Human Milk Production With Domperidone in Mothers of Preterm Infants. J Hum Lact. 2017 Abstract
  11. Grzeskowiak LE. Domperidone for Lactation: What Health Care Providers Really Should Know. Obstet Gynecol. 2017 Abstract
  12. Haase B, Taylor SN, Mauldin J, Johnson TS, Wagner CL. Domperidone for Treatment of Low Milk Supply in Breast Pump-Dependent Mothers of Hospitalized Premature Infants: A Clinical Protocol. J Hum Lact. 2016 Abstract
  13. Leelakanok N, Holcombe A, Schweizer ML. Domperidone and Risk of Ventricular Arrhythmia and Cardiac Death: A Systematic Review and Meta-analysis. Clin Drug Investig. 2016 Abstract
  14. Smolina K, Mintzes B, Hanley GE, Oberlander TF, Morgan SG. The association between domperidone and ventricular arrhythmia in the postpartum period. Pharmacoepidemiol Drug Saf. 2016 Abstract
  15. Rai R, Mishra N, Singh DK. Effect of Domperidone in 2nd week Postpartum on Milk Output in Mothers of Preterm Infants. Indian J Pediatr. 2016 Abstract
  16. Bazzano AN, Hofer R, Thibeau S, Gillispie V, Jacobs M, Theall KP. A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding. Ochsner J. 2016 Abstract Full text (link to original source) Full text (in our servers)
  17. Doggrell SA, Hancox JC. Cardiac safety concerns for domperidone, an antiemetic and prokinetic, and galactogogue medicine. Expert Opin Drug Saf. 2014 Abstract
  18. Anderson PO. The galactogogue bandwagon. J Hum Lact. 2013 Abstract
  19. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  20. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  21. Papastergiou J, Abdallah M, Tran A, Folkins C. Domperidone withdrawal in a breastfeeding woman. Can Pharm J (Ott). 2013 Abstract Full text (link to original source) Full text (in our servers)
  22. Knoppert DC, Page A, Warren J, Seabrook JA, Carr M, Angelini M, Killick D, Dasilva OP. The effect of two different domperidone doses on maternal milk production. J Hum Lact. 2013 Abstract
  23. Grzeskowiak LE, Lim SW, Thomas AE, Ritchie U, Gordon AL. Audit of domperidone use as a galactogogue at an Australian tertiary teaching hospital. J Hum Lact. 2013 Abstract
  24. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ; Canadian Headache Society Acute Migraine Treatment Guideline Development Group. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Abstract Full text (in our servers)
  25. Winterfeld U, Meyer Y, Panchaud A, Einarson A. Management of deficient lactation in Switzerland and Canada: a survey of midwives' current practices. Breastfeed Med. 2012 Aug;7:317-8. Abstract
  26. Osadchy A, Moretti ME, Koren G. Effect of domperidone on insufficient lactation in puerperal women: a systematic review and meta-analysis of randomized controlled trials. Obstet Gynecol Int. 2012 Abstract Full text (link to original source) Full text (in our servers)
  27. Asztalos EV, Campbell-Yeo M, daSilva OP, Kiss A, Knoppert DC, Ito S. Enhancing breast milk production with Domperidone in mothers of preterm neonates (EMPOWER trial). BMC Pregnancy Childbirth. 2012 Abstract Full text (link to original source) Full text (in our servers)
  28. Bozzo P, Koren G, Ito S. Health Canada advisory on domperidone should I avoid prescribing domperidone to women to increase milk production [corrected]? Can Fam Physician. 2012 Abstract Full text (in our servers)
  29. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Abstract
  30. CML - Comité de Lactancia Materna AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  31. Ingram J, Taylor H, Churchill C, Pike A, Greenwood R. Metoclopramide or domperidone for increasing maternal breast milk output: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2012 Abstract
  32. Jantarasaengaram S, Sreewapa P. Effects of domperidone on augmentation of lactation following cesarean delivery at full term. Int J Gynaecol Obstet. 2012 Abstract
  33. Donovan TJ, Buchanan K. Medications for increasing milk supply in mothers expressing breastmilk for their preterm hospitalised infants. Cochrane Database Syst Rev. 2012 Abstract
  34. Mannion C, Mansell D. Breastfeeding self-efficacy and the use of prescription medication: a pilot study. Obstet Gynecol Int. 2012;2012:562704. Abstract Full text (link to original source) Full text (in our servers)
  35. Forinash AB, Yancey AM, Barnes KN, Myles TD. The use of galactogogues in the breastfeeding mother. Ann Pharmacother. 2012 Oct;46(10):1392-404. Abstract
  36. ABM. Academy Of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #9: Use of galactogogues in initiating or augmenting the rate of maternal milk secretion (First Revision January 2011). Breastfeed Med. 2011 Abstract Full text (link to original source) Full text (in our servers)
  37. Jones W, Breward S. Use of domperidone to enhance lactation: what is the evidence? Community Pract. 2011 Abstract
  38. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Abstract Full text (link to original source) Full text (in our servers)
  39. ABM. Comité de Protocolos de la Academia Médica de Lactancia Materna. ABM Protocolo Clínico #9: Uso de Galactogogos para Iniciar o aumentar la tasa de secreción de Leche Materna. Breastfeed Med. 2011 Full text (link to original source) Full text (in our servers)
  40. Duran MS, Spatz DL. A mother with glandular hypoplasia and a late preterm infant. J Hum Lact. 2011 Abstract
  41. Muresan M. Successful relactation--a case history. Breastfeed Med. 2011 Abstract
  42. Campbell-Yeo ML, Allen AC, Joseph KS, Ledwidge JM, Caddell K, Allen VM, Dooley KC. Effect of domperidone on the composition of preterm human breast milk. Pediatrics. 2010 Abstract Full text (in our servers)
  43. Zuppa AA, Sindico P, Orchi C, Carducci C, Cardiello V, Romagnoli C. Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production. J Pharm Pharm Sci. 2010;13(2):162-74. Abstract Full text (link to original source) Full text (in our servers)
  44. Szucs KA, Axline SE, Rosenman MB. Induced lactation and exclusive breast milk feeding of adopted premature twins. J Hum Lact. 2010 Aug;26(3):309-13. Abstract
  45. Marasco L. Inside track. Increasing your milk supply with galactogogues. J Hum Lact. 2008 Abstract
  46. Wan EW, Davey K, Page-Sharp M, Hartmann PE, Simmer K, Ilett KF. Dose-effect study of domperidone as a galactagogue in preterm mothers with insufficient milk supply, and its transfer into milk. Br J Clin Pharmacol. 2008 Abstract Full text (link to original source) Full text (in our servers)
  47. Anderson PO, Valdés V. A critical review of pharmaceutical galactagogues. Breastfeed Med. 2007 Abstract
  48. Bryant CA. Nursing the adopted infant. J Am Board Fam Med. 2006 Abstract Full text (link to original source) Full text (in our servers)
  49. Amir LH. Breastfeeding--managing 'supply' difficulties. Aust Fam Physician. 2006 Abstract Full text (link to original source) Full text (in our servers)
  50. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  51. da Silva OP, Knoppert DC. Domperidone for lactating women. CMAJ. 2004 Abstract Full text (in our servers)
  52. Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact. 2002 Aug;18(3):274-9. Abstract
  53. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  54. da Silva OP, Knoppert DC, Angelini MM, Forret PA. Effect of domperidone on milk production in mothers of premature newborns: a randomized, double-blind, placebo-controlled trial. CMAJ. 2001 Abstract Full text (in our servers)
  55. Brown TE, Fernandes PA, Grant LJ, Hutsul JA, McCoshen JA. Effect of parity on pituitary prolactin response to metoclopramide and domperidone: implications for the enhancement of lactation. J Soc Gynecol Investig. 2000 Abstract
  56. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  57. Petraglia F, De Leo V, Sardelli S, Pieroni ML, D'Antona N, Genazzani AR. Domperidone in defective and insufficient lactation. Eur J Obstet Gynecol Reprod Biol. 1985 Abstract
  58. Hofmeyr GJ, Van Iddekinge B, Blott JA. Domperidone: secretion in breast milk and effect on puerperal prolactin levels. Br J Obstet Gynaecol. 1985 Abstract
  59. Cann PA, Read NW, Holdsworth CD. Galactorrhoea as side effect of domperidone. Br Med J (Clin Res Ed). 1983 Abstract Full text (in our servers)
  60. Hofmeyr GJ, van Iddekinge B. Domperidone and lactation. Lancet. 1983 Abstract
  61. Brouwers JR, Assies J, Wiersinga WM, Huizing G, Tytgat GN. Plasma prolactin levels after acute and subchronic oral administration of domperidone and of metoclopramide: a cross-over study in healthy volunteers. Clin Endocrinol (Oxf). 1980 Abstract

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