Amiodarone
Contraindicated
Database
Additive QT prolongation; high risk of torsades de pointes
Avoid combination; if unavoidable, monitor QTc closely
Source: Kimi deep-research + Cla
Drug reference
Domperidone
Dopamine D2-receptor antagonist (prokinetic / antiemetic) · Antiemetic
Also known as Domperidone maleate, Motilium, Domstal
START
10 mg TDS before meals; check QTc and electrolytes baseline; avoid in known QT prolongation
TYPICAL MAX
20 mg QDS (80 mg/day) maximum; reassess need regularly
STOP IF
QTc >500 ms, syncope, palpitations, or signs of arrhythmia
WATCH
QTc interval (ECG at baseline if cardiac risk), electrolytes (K+, Mg2+), prolactin if long-term use
CDSCO approvedSchedule HJan AushadhiNPPA price-controlledATC A03FA03
KDIGO 2024 + manufacturer label
- ONSET
- 45min · Antiemetic onset
- PEAK
- 1h · Peak plasma concentration
- t½
- 8h · Elimination half-life
- DURATION
- 6h · Duration of antiemetic effect
EXCRETION
Urine (31%) and feces (66%)
route + CYP
INTERACTIONS
3 major
incl. contraindicated
PREGNANCY
Not recommended in pregnancy; limited data available
FDA category + note
Top interactions
- AmiodaroneContraindicatedDatabaseKimi deep-research + Cla
- ErythromycinContraindicatedDatabaseKimi deep-research + Cla
- KetoconazoleContraindicatedDatabaseKimi deep-research + Cla
Available in India
312 branded formulations and 571 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Peripheral dopamine D2-receptor antagonist that increases lower esophageal sphincter tone and gastric emptying; antiemetic via chemoreceptor trigger zone (CTZ) blockade with limited CNS penetration due to poor BBB crossing
Indications
Nausea and vomitingDelayed gastric emptying / gastroparesisGastroesophageal reflux disease (GERD)
Dosing
- Adult
- 10-20 mg three to four times daily (before meals and at bedtime); max 80 mg/day (oral)
- Pediatric
- 0.25-0.5 mg/kg three to four times daily (suspension); max 2.4 mg/kg/day
- Renal adjustment
- Reduce dosing frequency in severe renal impairment; domperidone is renally excreted
- Hepatic adjustment
- Contraindicated in severe hepatic impairment; use caution in moderate impairment
- Geriatric
- Use with caution; increased risk of QT prolongation and arrhythmias
- Max dose
- 80 mg/day (oral); 30 mg/day (rectal)
Pharmacokinetics
Onset
30-60 minutes (antiemetic)
Peak effect
1 hour (Tmax)
Duration
6-8 hours
Half-life
7-9 hours
Bioavailability
13-17% (low due to extensive first-pass metabolism)
Protein binding
92%
Metabolism
Hepatic CYP3A4 (major) and CYP1A2, CYP2E1, CYP2D6; extensive first-pass effect
Excretion
Urine (31%) and feces (66%), primarily as metabolites
Contraindications
- Prolonged QT interval or congenital long QT syndrome
- Significant electrolyte disturbances (hypokalemia, hypomagnesemia)
- Severe hepatic impairment
- Concomitant QT-prolonging medications or potent CYP3A4 inhibitors
- Gastrointestinal hemorrhage, mechanical obstruction, or perforation
- Prolactin-secreting pituitary tumor (prolactinoma)
- Hypersensitivity to domperidone
Side effects
Common
Dry mouthHeadacheDiarrheaAbdominal crampsGalactorrheaAmenorrheaBreast tenderness/enlargement
Serious
- QT interval prolongation
- Torsades de pointes / ventricular arrhythmias
- Sudden cardiac death (rare, dose-related)
- Hyperprolactinemia
- Extrapyramidal symptoms (rare in adults)
- Anaphylaxis
Pregnancy & lactation
Pregnancy
Not recommended in pregnancy; limited data available
Lactation
Excreted in breast milk in small amounts; compatible with breastfeeding at usual doses per WHO
Drug interactions
Erythromycin
Contraindicated
Database
CYP3A4 inhibition and QT prolongation; significantly increased cardiac risk
Avoid combination
Source: Kimi deep-research + Cla
Ketoconazole
Contraindicated
Database
Potent CYP3A4 inhibition increases domperidone levels and QT prolongation risk
Avoid combination
Source: Kimi deep-research + Cla
9 additional unreviewed or low-confidence interactions hidden because their provenance or source detail is insufficient.
Related guidelines
Ask House about Domperidone
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Textbook-sourced·Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Updated: 2026-05-19·Cockpit curated: 2026-05-19