Description
Motonium Pharmacodynamics
Domperidone is a dopamine antagonist with antiemetic properties.
Domperidone poorly penetrates through the blood-brain barrier. Domperidone use is rarely accompanied by extrapyramidal side effects, especially in adults, but domperidone stimulates prolactin release from the pituitary gland. Its antiemetic effect may be due to a combination of peripheral (gastrokinetic) action and antagonism to dopamine receptors in the chemoreceptor trigger zone, which is outside the blood-brain barrier.
Animal studies and low concentrations of the drug detected in the brain indicate a predominantly peripheral effect of domperidone on dopamine receptors.
When administered orally, domperidone increases the duration of antral and duodenal contractions, accelerates gastric emptying and increases lower esophageal sphincter pressure. Domperidone has no effect on gastric secretion.
Indications
For relief of symptoms of nausea and vomiting.
Contraindications
-Hypersensitivity to domperidone or any other component of the drug;
-lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
-prolactinoma;
-concomitant use of oral forms of ketoconazole, erythromycin, or other potent CYP3A4 isoenzyme inhibitors that cause QT interval prolongation (such as clarithromycin, itraconazole, fluconazole, posaconazole, ritonavir, saquinavir, amiodarone, telithromycin, telaprevir, and voriconazole), except for apomorphine (see “Interaction of CYP3A4 isoenzyme inhibitors”). other medicinal products (see sections “Interaction with other medicinal products” and “Cautions”);
-excessive electrolyte disturbances or cardiac diseases such as chronic heart failure;
-bleeding from the gastrointestinal tract, mechanical intestinal obstruction, gastric or intestinal perforation;
-hepatic insufficiency of moderate to severe severity;
-body weight less than 35 kg;
-children under 12 years of age with a body weight less than 35 kg;
-pregnancy;
Breast-feeding period.
Dosage and administration method
- Inside. It is recommended to take Motonium® tablets 15-30 minutes before a meal; absorption of domperidone may delay after a meal.
- Adults and children over 12 years of age with body weight of 35 kg or more
1 tablet (10 mg) 3 times a day, the maximum daily dose is 3 tablets (30 mg). - Children under 12 years of age and those weighing 35 kg or more
1 tablet (10 mg) 3 times daily, the maximum daily dose is 3 tablets (30 mg). - Continuous use of Motonium® without physician’s consultation should not exceed 7 days.
- If necessary, the physician may prolong the course of treatment.
- Administration in patients with renal insufficiency
Since the half-life of domperidone is prolonged in severe renal failure (serum creatinine ˃ 6 mg/100 ml, ˃ 0.6 mmol/l), the frequency of administration of Motonium® film-coated tablets should be decreased to 1 or 2 times per day, depending on the degree of failure. - Regular examination of patients with severe renal failure is necessary (see section “Pharmacological properties”).
- Administration in patients with hepatic insufficiency.
- Motonium® use is contraindicated in patients with moderate to severe hepatic insufficiency (see sect. “Contraindications”). In patients with mild hepatic insufficiency, no dose adjustment is required (see section “Pharmacological properties”).
