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
12 major
incl. contraindicated
PREGNANCY
Not recommended in pregnancy; limited data available
FDA category + note
Top interactionssee all 12 →
- AmiodaroneContraindicatedDatabaseKimi deep-research + Cla
- CitalopramContraindicatedDatabase
- ClarithromycinContraindicatedDatabase
- ErythromycinContraindicatedDatabaseKimi 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
Citalopram
Contraindicated
Database
Increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Clarithromycin
Contraindicated
Database
Increased domperidone plasma levels, leading to increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Erythromycin
Contraindicated
Database
CYP3A4 inhibition and QT prolongation; significantly increased cardiac risk
Avoid combination
Source: Kimi deep-research + Cla
Haloperidol
Contraindicated
Database
Increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Itraconazole
Contraindicated
Database
Increased domperidone plasma levels, leading to increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Ketoconazole
Contraindicated
Database
Potent CYP3A4 inhibition increases domperidone levels and QT prolongation risk
Avoid combination
Source: Kimi deep-research + Cla
Quinidine
Contraindicated
Database
Increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Ritonavir
Contraindicated
Database
Significantly increased domperidone plasma levels, leading to increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Saquinavir
Contraindicated
Database
Significantly increased domperidone plasma levels, leading to increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Aprepitant
Severe
Database
Increased domperidone plasma levels, leading to increased risk of QT prolongation and Torsades de Pointes (TdP)
Avoid co-administration. If absolutely necessary, use with extreme caution and close ECG monitoring. Consider alternative antiemetics.
Diltiazem
Severe
Database
Increased domperidone plasma levels, leading to increased risk of QT prolongation and Torsades de Pointes (TdP)
Avoid co-administration. If absolutely necessary, use with extreme caution and close ECG monitoring. Consider alternative antiemetics.
Related guidelines
Ask House about Domperidone
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19