- Upper GI prokinetic – low side effect profile – no significant central effects, e.g. it is safe to use in patients with Parkinson’s Disease.
- 10 mg TDS PO A/C (maximum dose 40 mg/24 hours).
- Worth trying if patient is intolerant to metoclopramide – NOT to be used in conjunction.
- No parenteral or rectal preparation. Consider metaclopramide if not contraindicated.
- Dopamine (D2) Receptor Antagonist.
- A potent centrally acting antiemetic – VERY effective for opioid induced nausea and vomiting, hypercalcaemia and renal failure.
- 0.5 - 3 mg nocte PO or subcut.
- Can be given as a subcut bolus (0.5-1 mg q8h) or infusion (1-5 mg/ 24 hours).
- Available in 0.5 mg and 1.5 mg tabs.
- If concerned about side effects start at 0.5 mg 6- 8 hourly PRN.
- Contraindicated in Parkinson's Disease.
- Antihistaminic, antimuscarinic.
- Indicated for motion sickness, pharyngeal stimulation, mechanical bowel obstruction and raised intracranial pressure.
- 25-50 mg TDS PO. (Maximum daily dose is 150 mg.)
- Can be given by slow IV bolus or subcut infusion (not subcut bolus injection as this can cause severe skin irritation and abscess formation).
- If concerned about sedation, start at 25 mg BD (particularly in the elderly).
- If treating patient for nausea thought to be caused by delayed gastric emptying or poor gastrointestinal motility, cyclizine will reduce effect of the domperidone/ metoclopramide.
- Upper GI prokinetic plus weak central effects via dopamine receptors.
- Indicated for GI gastroparesis and functional bowel obstruction (commonly caused by opioids) and for GORD.
- 10 mg TDS/QID PO or subcut (or IV 4-6 hourly).
- Important to give A/C – 20-30 minutes before meals.
- Contraindicated in complete proximal bowel obstruction and Parkinson's Disease.
- Watch for agitation, particularly in higher doses and in young people (especially women).
- The elderly are at increased risk of extrapyramidal side effects.
Note: Domperidone should be considered if metoclopramide use is contraindicated, e.g., Parkinson's Disease. It can only be used orally.
Topic Code: 4084