Domperidone: Not for Under 12 Years

Drug Safety Update

In 2014, the European Medicines Agency (EMA) reviewed the safety of domperidone-containing products due to its association with the risk of serious and potentially life-threatening cardiovascular adverse effects such as ventricular arrhythmias and sudden cardiac death.

In 2019, a randomised controlled study showed that the use of domperidone in children below 12 years of age with acute gastroenteritis (in combination with oral rehydration therapy) showed no difference in efficacy when compared to placebo. As a result, domperidone is no longer indicated for the relief of nausea and vomiting in children aged under 12 years.



Recommendations

Healthcare professionals are advised to adhere to the licensed dose and to use the lowest effective dose for the shortest possible duration (maximum treatment duration should not usually exceed 1 week).

Moreover, domperidone is contraindicated in

  • Patients with known existing prolongation of cardiac conduction intervals;
  • Patients with significant electrolyte disturbances or underlying cardiac diseases;
  • Patients concomitantly taking QT-prolonging drugs or potent CYP3A4 inhibitors.

This update is practice changing. Has your facility adopted it?

NOTE: In UK, starting December 2019, domperidone is no longer licensed for use in children younger than 12 years or those weighing less than 35 kg.



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