Domperidone
Also known as: Motilium, Equidone, Leisguard
- **Purpose**: Domperidone is used to improve stomach emptying and reduce nausea in dogs and cats. In horses, it is used to prevent complications from eating toxic fescue grass and to stimulate milk production in nursing mothers. - **Administration**: Give exactly as directed by your veterinarian. - **Human Safety Warning**: Pregnant and lactating women should use extreme caution when handling the equine gel product, as systemic exposure can affect human reproductive hormones. Wear gloves and wash hands thoroughly. - **Side Effects**: You may notice inappropriate milk production or breast enlargement in pets. In horses, milk may drip before the foal is born. Contact your veterinarian if you notice any unusual lethargy, twitching, or behavioral changes.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- As a prokinetic agent
- Antiemetic / Prokinetic
- For fescue toxicity
- As a prokinetic agent
- For vomiting due to gastritis
- Antiemetic / Prokinetic
- Leishmaniasis (Treatment and Prevention)
How it is given
Possible side effects
- Galactorrhea (inappropriate milk production)
- Gynecomastia
- Premature lactation in horses (dripping milk prior to foaling)
- Failure of passive transfer in foals
- Rarely: somnolence or dystonic reactions
- Arrhythmias (associated with withdrawn injectable human products, especially with hypokalemia or heart disease)
- Galactorrhea (milk production in females)
- Mammary gland hyperplasia
- Changes in estrus cycle
- Mild gastrointestinal upset
Cautions & contraindications
- Known hypersensitivity to domperidone
- Presence or suspicion of gastrointestinal obstruction, perforation, or hemorrhage
- Pregnant mares >15 days prior to expected foaling date (unless specifically managed)
- Horses intended for human consumption
- Gastrointestinal hemorrhage
- Mechanical GI obstruction or perforation
- Prolactin-secreting pituitary tumors (prolactinomas)
- Known hypersensitivity to the drug
- > **MDR1 Mutation Warning**: Domperidone is potentially a neurotoxic substrate of **P-glycoprotein**. Use with extreme caution in herding breeds (e.g., Collies, Australian Shepherds) that may possess the MDR1 (ABCB1) gene mutation causing a nonfunctional blood-brain barrier efflux pump. - **Foal Immunity**: In horses, failure of passive transfer of immunoglobulins (IgG) may occur even without visible leakage of colostrum. **All foals** born to treated mares must be tested for serum IgG concentrations. - **Reproductive Impact**: May lead to premature birth, low birth weight, or foal morbidity if administered >15 days prior to the expected foaling date. Accurate breeding dates are essential. - **Laboratory Alterations**: May increase serum prolactin, ALT, and AST. Can cause false-positive results on milk calcium tests used to predict foaling.
Drug interactions
- Azole Antifungals (e.g., ketoconazole): May increase domperidone levels due to metabolic inhibition.
- Anticholinergic Drugs: May reduce the gastrointestinal prokinetic efficacy of domperidone.
- Bromocriptine / Cabergoline: Domperidone may antagonize their dopamine-agonist effects on prolactin.
- Macrolide Antibiotics (e.g., erythromycin, clarithromycin): May increase domperidone levels.
- Opioids: May reduce the gastrointestinal prokinetic efficacy of domperidone.
- Sustained-Release or Enteric-Coated Oral Medications: Domperidone may alter the absorptive characteristics of these drugs by decreasing GI transit times.
- Antacids: May decrease the oral absorption of domperidone
- H2-receptor antagonists (e.g., famotidine): May decrease the oral absorption of domperidone due to altered gastric pH
- Ketoconazole: Inhibits CYP3A4 metabolism of domperidone, potentially increasing plasma concentrations and risk of QT prolongation
- Erythromycin: Inhibits CYP3A4 metabolism of domperidone, increasing plasma concentrations.
Frequently asked questions
What is Domperidone used for in pets?
- **Purpose**: Domperidone is used to improve stomach emptying and reduce nausea in dogs and cats. In horses, it is used to prevent complications from eating toxic fescue grass and to stimulate milk production in nursing mothers. - **Administration**: Give exactly as directed by your veterinarian. - **Human Safety Warning**: Pregnant and lactating women should use extreme caution when handling the equine gel product, as systemic exposure can affect human reproductive hormones. Wear gloves and wash hands thoroughly. - **Side Effects**: You may notice inappropriate milk production or breast enlargement in pets. In horses, milk may drip before the foal is born. Contact your veterinarian if you notice any unusual lethargy, twitching, or behavioral changes.
Is Domperidone safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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