Domperidone/Motilium: A Commentary

Even though Domperidone is a relatively safe drug, rare and unknown health risks must also be weighed when considering this drug as an aid to inducing lactation. Serious health risks from Domperidone are considered rare, perhaps as low as 1 in 10,000; however, if you are that *one* in 10,000, statistics are of little comfort.

Who Is At Risk:
Medical examination by a qualified Endocrinologist can evaluate potential health risks from preexisting hormonal imbalances; however, medical tests are expensive, and not always available to everyone. When medical evaluations are not practical, reviewing family health history/records can also give insight into your own personal health risks.

Some diseases and health risks are genetic, and hereditary by nature. If your family history reflects high occurrences of breast cancer, and/or health problems related to hormonal imbalances, you may also be at high risk for these same diseases. If you are genetically at risk for breast cancer and/or diseases related to hormonal imbalances, Domperidone may increase that risk!

Published Side Effects:
The most frequent reactions to Domperidone/Motilium are those related to elevated Prolactin levels: which include breast tenderness, spontaneous lactation, increase in breast size, and abnormal suppression or absence of menstruation. These effects are dose-related and gradually resolve after lowering dosage or discontinuing treatment.

Other rare adverse reactions may include headache, diarrhea, dizziness, mild and transient abdominal cramps, dry mouth and drowsiness. Rare allergic reactions, such as rash and urticaria (itching, burning, stinging), have also been reported.

Extrapyramidal reactions, (loss of motor control), occur rarely in young children, and very rarely in adults. Extrapyramidal reactions are usually resolved completely and spontaneously after cessation of treatment.

Dosage:
For the relief of Dyspeptic Symptom Complex, (Acid Reflux Disease), manufacturer's recommended dosage for adults is one, 10 mg tablet, 3 to 4 times daily, (total of 30 to 40 mg per day). If adequate relief is not realized after two weeks, dosage may be doubled. For relief of acute conditions, such as nausea or vomiting, 20 mg, 3 to 4 times daily is recommended for adults, (total of 60 to 80 mg per day).

Since Domperidone was not intended for use as a galactagogue, the manufacturer has published no recommended guidelines for inducing lactation. Dosages discussed here are the result of independent research, and personal experiences of women who have successfully used Domperidone as an aid for inducing lactation.

A double-blind study conducted by the University of Western Ontario and St. Joseph's Health Care London, (Canada), into the effectiveness of Domperidone as a galactagogue recommended one, 10 mg tablet, three times daily, (total of 30 mg per day). Women in this study taking Domperidone experienced an average increase in milk production of 46%, over a 7 day period. While women in the study taking a placebo experienced an average increase in milk production of only 21%, over the same 7 day period.

However, this study involved only mothers of prematurely born infants, and does not appear to have taken into consideration stress which may have been caused by the premature birth of their children. Stress is a major lactation inhibitor, even when lactation has been chemically induced.

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