Medication

Domrid

Structure

1 tablet includes 10 mg domperidone.

Additionally: microcrystalline cellulose, croscarmellose sodium, colloidal silicon dioxide, magnesium stearate, white Opadry II 31 G 58920.

1 tablet SR includes 30 mg domperidone.

Additionally: lactose monohydrate, yellow quinoline, talc, povidone, croscarmellose sodium, magnesium stearate, hydroxypropyl methylcellulose, colloidal silicon dioxide.

1 ml of suspension includes 1 mg domperidone.

Additionally: polysorbate 80, sucrose, colloidal silicon dioxide, sodium carboxymethyl cellulose, propylene glycol, sodium chloride, glycerin, propyl parahydroxybenzoate, methyl paraben, ponso 4R, purified water, strawberry flavoring.

Release form

Domrid is made in the form of tablets No. 10 or No. 30 in a package; in the form of tablets SR (prolonged action) No. 10 or No. 30 per pack; in the form of an oral suspension of 60 ml or 100 ml in a vial.

Pharmachologic effect

Stimulating gastrointestinal motility.

Pharmacodynamics and pharmacokinetics

The active ingredient in the drug Domrid - domperidone - is an antagonist dopamine and possesses antiemetic effects presumably due to the combination gastrokinetic the influence of the drug and the phenomena of its antagonism to dopamine receptors in the chemoreceptor trigger zone outside BBB in the back field of the central nervous system (area postrema). Animal studies have shown a rather low level domperidone in the brain of experimental subjects, which indicates its predominantly peripheral effect on dopaminergic receptor complexes.

Effects studies domperidone on the human body, when taken orally, showed increased pressure in the lower digestive system, improved antroduodenal motility and accelerating the emptying of the stomach, while gastric secretion remained at the same level. The drug activates the secretion from the pituitary gland prolactin. Low concentrations domperidone penetrate through BBB. Internal administration of the drug very rarely leads to extrapyramidal adverse side effects (especially for adult patients).

Absorption domperidone when administered internally on an empty stomach, fast enough, plasma Cmax is reached after 30-60 minutes. The drug has a low absolute bioavailability equal to about 15%, which is due to extensive metabolic transformations domperidone when it first passes through the intestinal walls and liver. Bioavailability domperidone in healthy people, it increases with its use after meals, but patients with complaints of gastrointestinal tract function need to take this drug 15-30 minutes before eating. Reduced gastric acidity reduces absorption domperidone. In the case of oral administration of tablets or suspension after a meal, a slowdown in the maximum absorption of the drug and an increase in its AUC are observed.

When taken orally domperidone does not induce personal exchange and does not cumulate. Marked plasma Cmax of the drug after 1.5 hours is 21 ng / ml. With daily intake of 30 mg domperidone over a period of 14 days, its plasma Cmax was almost equivalent to that observed with a single dose and corresponded to 18 ng / ml. Communication with plasma proteins occurs at 91-93%. Animal studies to determine distribution domperidone using a labeled radioactive drug, they confirmed its low content in the brain and a significant concentration in peripheral tissues, as well as the penetration of a large amount of the drug through placental barrier.

Domperidone undergoes rapid and extensive metabolic transformations in the liver through N-dealkylation and hydroxylation. Research metabolism in vitro preparations using a diagnostic inhibitor showed that N-dealkylation of domperidone mainly occurs by enzyme cytochrome systems P450 - CYP 3A4, and hydroxylation via enzymes - CYP 3A4, CYP 2E1 and CYP 1A2.

From the human body, taken orally domperidone it is excreted in urine by 31% (1% in unchanged form) and by 66% with feces (10% in unchanged form). T1 / 2 single dose of the drug from serum blood equals 7-9 hours and increases with kidney pathologies heavy character.

Indications for use

Domrid prescribed to reduce the severity of manifestations of the observed nausea/vomitinglasting for less than 48 hours, as well as for stopping negative symptoms heartburn and epigastric discomfortobserved after eating (sensation severity in the stomach, bloating, nausea, burping).

Contraindications

  • increased personal sensitivity to the ingredients of drugs;
  • diagnosed prolactinoma (pituitary gland neoplasm);
  • liver pathology/kidney moderate or severe in nature;
  • heart diseasesoccurring with increasing intervals heart conduction, in particular QT interval;
  • lactation and pregnancy (due to insufficient reliable data);
  • serious painful conditions electrolyte imbalance with background cardiac abnormalities (e.g. heart failure);
  • bleeding, perforationmechanical gastrointestinal obstruction or other conditions with a risk of progression during stimulation of motor gastric function;
  • concurrent therapy using powerful CYP 3A4 inhibitors (Erythromycin, Ketoconazole etc.) and drugs increasing QT interval (Ritonavir, Amiodarone, Saquinavir, Telithromycin, Telaprevir, Clarithromycin, Voriconazole and etc.);
  • age group up to 12 years (for all tablet forms of the drug).

Side effects

In the dosages recommended by the instruction, taking Domrida rarely leads to the formation of any negative side effects. The majority of patients taking this drug tolerate therapy with its use.

The immune system:

  • manifestations allergic nature including phenomena hypersensitivity and anaphylactic shock.

Nervous system:

  • extrapyramidal disorders;
  • anxiety;
  • insomnia/drowsiness;
  • excitation;
  • dizziness;
  • irritability;
  • feeling of thirst;
  • depression;
  • cramps;
  • nervousness;
  • lethargy;
  • akathisia;
  • headache;
  • decline or complete lack of libido.

Endocrine system:

  • increase in content prolactin.

The cardiovascular system:

  • swelling;
  • rhythm disturbance and heart rate;
  • heartbeat;
  • increase QT interval;
  • ventricular arrhythmias heavy character;
  • heart death (sudden).

Organs of vision:

  • development oculogyric crisis.

Digestive system:

  • regurgitation;
  • dry mouth
  • intestinal cramps (short term);
  • diarrhea;
  • heartburn;
  • sore stomach;
  • nausea;
  • change in appetite;
  • constipation.

Skin and subcutaneous tissue:

  • Quincke's edema;
  • itching/rash;
  • hives.

Musculoskeletal system:

  • pain in the lower extremities.

Mammary glands and reproductive system:

  • increase soreness, edemasensitivity mammary glands;
  • galactorrhea;
  • gynecomastia;
  • breastfeeding disorders;
  • discharge from the nipples;
  • amenorrhea;
  • disorders menstrual cycle.

Urinary system:

  • dysuria;
  • urinary retention;
  • frequent urination.

Others:

  • stomatitis;
  • asthenia;
  • conjunctivitis.

Laboratory indicators:

  • deviations in liver function tests;
  • level increase liver enzymes and prolactin in blood.

Due to the fact that pituitary is outside BBBreception domperidone may cause an increase in content plasma prolactin. Sometimes such hyperprolactinemia accompanied by the formation of neuroendocrine negative phenomena, including galactorrhea, amenorrhea and gynecomastia.

In post-marketing testing domperidone its safety profile was almost the same, both for adult patients and for children, although development was more often noted in childhood seizures, extrapyramidal disorders and excitement.

Domrid, instructions for use

All dosage forms of the drug Domrid are intended for oral use.

Pills

In order to reduce the severity of manifestations of the observed nausea/vomitinglasting for less than 48 hours is prescribed to patients weighing more than 35 kilograms and after they reach 12 years of age 3-4 single daily intake of 10 mg (1 tablet) of the drug. The maximum duration of the therapeutic course of such painful conditions is 48 hours. At the age of 12-18 years, the minimum effective dosage should be selected for treatment domperidone.

For stopping negative symptoms heartburn and discomfort in the epigastric region noted after eating, it is prescribed to patients weighing more than 35 kilograms and after they reach 12 years of age, 3-4 single daily doses of 10 mg (1 tablet) of the drug. A maximum of 80 mg (8 tablets) can be taken per day domperidone. Therapy is usually limited to 2 weeks.

SR tablets

For the purpose of stopping acute conditions (mainly nausea/vomiting) is prescribed only to adult patients 15-30 minutes before a meal once every 24 hours, 30 mg (1 tablet), if necessary, you can additionally take another 30 mg of the drug before bedtime. The maximum duration of a therapeutic course of these painful conditions is 48 hours.

At chronic pathologies of the gastrointestinal tract (mainly dyspepsia) shows a dose of 30 mg domperidone (1 tablet) 15-30 minutes before meals once a day. If necessary, take another 30 mg of the drug before bedtime. A maximum of 60 mg (2 tablets) can be taken per day. Therapy is usually limited to 2 weeks.

Suspension

It is recommended to take the suspension before meals (when taking domperidone after eating, there is a slowdown in its absorption). The duration of the therapeutic course should be limited to 7 days.

Patients weighing more than 35 kilograms and after they reach 12 are prescribed 10 mg three times a day domperidone (10 ml). In a maximum of 24 hours, you can drink 30 mg of the drug (30 ml).

Children weighing up to 35 kilograms and under the age of 12 years are shown a three-day daily intake of 0.25 mg domperidone (0.25 ml) per kilogram of body weight. In 24 hours, you can take a maximum of 0.75 mg of the drug (0.75 ml) per kilogram of body weight.

The measuring spoon included with the suspension is intended only for measuring dosages of 2.5 or 5 ml. In the case of a smaller dose, for its accurate dosage, you can use a disposable syringe with a volume of 2 ml (without a needle).

Domrid Suspension should be prescribed to pediatric patients in the lowest effective dosages. Careful use of suspensions with meticulous dosing is required by newborns, especially premature babies, due to the possible formation of extrapyramidal disorders.

Overdose

Observed Overdose Symptoms domperidone most often expressed impaired consciousness, agitation, spasmsdisorientation drowsiness and extrapyramidal effects (especially in childhood).

Due to absence antidote domperidone, treatment of overdose conditions should consist in cleansing the gastrointestinal tract (during the first 60 minutes) and taking sorbents. In the future, careful monitoring of the patient's condition and the implementation of maintenance therapy are recommended. Application antiparkinsonian and anticholinergic drugs effective for stopping extrapyramidal phenomena.

Interaction

Parallel reception anticholinergic drugs can neutralize effects domperidone.

Bioavailability domperidone decreases when taken after sodium bicarbonate or Cimetidine. For the same reason (reduced bioavailability), combined use should be avoided. antisecretory and antacid preparations.

Simultaneous use domperidone with narcotic analgesics and m-anticholinergics reduces its effect on motor evacuation activity gastrointestinal tract.

Since the main factor affecting metabolism domperidoneis an enzyme cytochrome P450 - CYP3A4, the combined use of drugs that significantly inhibit this enzyme can lead to an increase in plasma concentrations domperidone. In this regard, it is necessary to avoid the simultaneous use of drugs that suppress CYP3A4, namely: antifungal drugs (Itraconazole, Voriconazole, Fluconazole, Ketoconazole), macrolides (Erythromycin, Clarithromycin), HIV protease inhibitors (Saquinavir, Atazanavir, Amprenavir, Fosamprenavir, Nelfinavir, Indinavir, Ritonavir), calcium antagonists (ATerapamil, Diltiazem), as well as Amiodarone, Nefazodona, Aprepitant, Telithromycin and some others.

Concurrent appointment with Erythromycin, Ketoconazole or other drugs that inhibit CYP3A04, also leads to an increase QT interval. In case of combined use domperidone in a daily dose of 40 mg and ketoconazole in a daily dose of 400 mg, an increase was noted QT interval for 10-20 milliseconds. When taking Domrida in monotherapy in a daily dose of up to 160 mg inclusive (twice the maximum allowable), a clinically significant increase QT interval not observed.

Domperidone does not affect the plasma level co-administered Paracetamol and Digoxin.

Perhaps combined appointment of Domrid with antipsychoticswhose effectiveness is not enhanced domperidoneas well as dopaminomimetics (Levodopa, Bromocriptine) whose negative effects (including nausea/vomit, digestive disorders), domperidone inhibits, while not affecting the main effect of the drugs.

Terms of sale

All dosage forms of Domrida are sold without a prescription.

Storage conditions

Suspension and tablets Domrid can be stored at temperatures up to 25 ° C.

Shelf life

From the moment of production: 4 years for tablets; 2 years for SR tablets; 3 years for suspension.

Special instructions

If necessary, parallel use of Domrida with antisecretory or antacid drugs should be taken first before meals, and the last after meals.

Independently increase recommended dosages domperidone, and also to prolong the therapeutic course of its reception is prohibited.

If symptoms persist gastrointestinal discomfort against the background of a two-week intake of Domrida, you should consult a doctor.

In case of continuation nausea/vomiting for more than 48 hours, the patient must consult a doctor.

Domrid is not a remedy used to alleviate manifestations motion sickness.

Caution is required in patients with existing risk factors. QT interval prolongationincluding: heavy hypomagnesemia, hypokalemiaorganic pathology of the heart, kidney disease/liver and parallel therapy with drugs that increase this indicator.

Findings of some epidemiological studies associated treatment domperidone with an increased risk of severe ventricular arrhythmiasas well as with sudden heart death. The highest risk of these complications was observed with a daily intake of more than 30 mg of the drug or in elderly patients (over 60 years old).

Caution is advised to prescribe Domrid in patients with sugar intolerance.

Analogs

Matches for ATX Level 4 code:PassengerAceclidineMotinormMotiliumItomedMetoclopramideDomperidoneMotilakGanatonTserukal
  • Zirid;
  • Primer;
  • Ganaton;
  • Itomed;
  • Metoclopramide;
  • Tserukal;
  • Metucal;
  • Mosid Mt.

Synonyms

  • Domidon;
  • Brulium Lingvatabs;
  • Motilium;
  • Perilium;
  • Motinol;
  • Peridonium;
  • Motorrix;
  • Peridon;
  • Nausilium;
  • Motorikum.

For children

Children under 12 years of age are indicated for the use of Domrida in the form of a suspension in minimally effective dosages.

In pregnancy (and lactation)

Purpose of Domrida pregnant women are only possible in cases of a significant excess of the likely benefits of therapy compared with possible complications for the fetus.

Effects domperidonedetected in milk Nursing mothers for babies are still not fully installed. In this connection, when taking Domrida, one should refrain from breastfeeding.

Reviews

Doctors who use this drug in their practice, as well as patients who have ever taken it, in most cases leave positive feedback about Domrida and note a rather quick and prolonged effect of this drug. Mention of the side effects of Domrida is quite rare and in the total mass of reviews, in comparison with a positive assessment of the drug, occupy almost the last place. Naturally, drugs domperidone should be taken strictly according to indications, only after consultation with gastroenterologist and in compliance with the recommended dosages and duration of treatment.

Price, where to buy

The average price of Domrida is: tablets No. 10 - 22 hryvnias, No. 30 - 56 hryvnias; SR tablets No. 10 - 16 hryvnias, No. 30 - 100 hryvnias; suspension of 60 ml - 42 hryvnias, 100 ml - 54 hryvnias.

  • Online pharmacies in UkraineUkraine

Pharmacy24

  • Domrid 1 mg / ml 100 ml suspension 68 UAH
  • Domrid SR 30 mg No. 10 tablets TOV "Kusum Pharm", Ukraine51 UAH order
  • Domrid SR 30 mg No. 30 tablets TOV "Kusum Pharm", Ukraine113 UAH to order
  • Domrid 10 mg N30 tablets TOV "Kusum Pharm", Ukraine62 UAH order
  • Domrid 10 mg No. 10 tablets TOV "Kusum Pharm", Ukraine29 UAH order

Pani Pharmacy

  • Domrid tablets Domrid tablets. PO 10mg No. 30 Ukraine, Kusum Farm OOO 72 UAH to order
  • Domrid liquid Domrid suspension 1mg / ml 60ml fl No. 1 Ukraine, Kusum Farm OOO 60 UAH. Order
  • Domrid liquid Domrid Suspension 1mg / ml 100ml vial No. 1 Ukraine, Kusum Farm OOO 75 UAH order
  • Domrid tablets Domrid tablets. PO 10mg No. 10 Ukraine, Kusum Farm OOO 31 UAH to order
  • Domrid SR tablets Domrid SR extended-release tablets 30mg No. 30 Ukraine, Kusum Farm LLC 125 UAH order
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