What are the efficacy and side effects of Domperidone?

Generally speaking, Motilium refers to domperidone tablets. The main effects of this medication include promoting gastrointestinal motility, relieving symptoms of indigestion, antiemesis, preventing gastroesophageal reflux, and assisting in the treatment of specific diseases. Side effects include drowsiness, lactation, dry mouth, constipation, diarrhea, cardiovascular abnormalities, allergic reactions, and others. Detailed explanations are as follows:

I. Effects of Domperidone Tablets

1. Promoting Gastrointestinal Motility

Domperidone tablets act directly on the gastrointestinal wall by blocking peripheral dopamine receptors, enhancing intestinal peristalsis, accelerating gastric emptying, shortening the retention time of food in the stomach, and increasing the diameter of the pylorus with prolonged relaxation, thereby facilitating the passage of food from the stomach into the duodenum and small intestine for better absorption of nutrients.

2. Relieving Symptoms of Dyspepsia

Domperidone tablets can improve delayed gastric emptying and are especially suitable for conditions such as diabetic gastroparesis. They can also treat nausea and vomiting caused by infections, dietary factors, and other causes, and alleviate symptoms such as belching, abdominal distension, and abdominal pain. The underlying pathophysiological mechanism involves promoting gastrointestinal peristalsis and accelerating digestion and gastric emptying.

3. Antiemetic Effect

Domperidone tablets can relieve vomiting without affecting gastric secretion. They can be used to treat nausea and vomiting caused by surgery or certain medications, as well as vomiting associated with functional dyspepsia. The mechanism involves inhibiting the stimulation of prolactin-releasing factors through the chemoreceptor trigger zone in the central nervous system, thereby reducing prolactin secretion and influencing the functional state of breast tissue, thus achieving an antiemetic effect.

4. Prevention of Gastroesophageal Reflux

Domperidone tablets can increase the tone of the cardia sphincter and lower esophageal sphincter, preventing gastric contents or acid from refluxing into the esophagus, thereby protecting the esophageal mucosa. This is particularly important for patients with gastroesophageal reflux disease (GERD). The underlying mechanism involves enhancing sphincter tension to prevent reflux.

5. Adjunctive Treatment of Specific Diseases

Domperidone tablets can be used to treat delayed gastric emptying caused by conditions such as diabetes and chronic gastritis. Additionally, they have a certain therapeutic effect on nausea and vomiting caused by migraine, radiotherapy, or chemotherapy.

II. Side Effects of Domperidone Tablets

1. Drowsiness

Domperidone tablets may affect the nervous system, causing symptoms such as drowsiness and fatigue in some individuals. These side effects are usually mild and resolve spontaneously after discontinuation of the medication. Management includes reducing the dosage or stopping the medication while ensuring adequate rest and avoiding excessive fatigue.

2. Lactation

Domperidone tablets may elevate prolactin levels, leading to non-lactational lactation, breast tenderness, and menstrual irregularities, especially in women of childbearing age, postmenopausal women, and male patients. The mechanism involves affecting prolactin secretion through the chemoreceptor trigger zone in the central nervous system.

3. Dry Mouth, Constipation, Diarrhea

Domperidone tablets may cause adverse gastrointestinal symptoms such as dry mouth, constipation, and diarrhea, although these are generally mild and reversible upon discontinuation. The underlying mechanism may involve irritation of the gastrointestinal mucosa by the drug. Management includes discontinuing the medication and adjusting dietary habits, such as increasing dietary fiber intake and avoiding spicy or greasy foods.

4. Cardiovascular Abnormalities

Some patients may experience arrhythmias following intravenous administration. The mechanism may involve the drug's effects on cardiac electrophysiology. Management includes immediate discontinuation of the drug, performing electrocardiographic monitoring, and using antiarrhythmic drugs such as lidocaine or amiodarone if necessary.

5. Allergic Reactions

Use of domperidone tablets may cause skin itching, rash, and other allergic symptoms. Severe allergic reactions, such as anaphylactic shock, are rare but should be taken seriously. The etiology involves the drug acting as an allergen that triggers an immune response. In such cases, the medication should be discontinued immediately and replaced under medical guidance.

It is recommended to use domperidone tablets under the guidance of a physician. During treatment, maintaining healthy lifestyle habits and avoiding excessively greasy or spicy foods can help enhance the therapeutic effect.