ドンペリドン

使用用途

• As a prokinetic agent
• Antiemetic / Prokinetic
• For fescue toxicity
• As a prokinetic agent
• For vomiting due to gastritis
• Antiemetic / Prokinetic
• Leishmaniasis (Treatment and Prevention)

投与方法

考えられる副作用

• 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• Arrhythmias (associated with withdrawn injectable human products, especially with hypokalemia or heart disease)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

注意事項と禁忌

• 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.

薬物相互作用

• 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.
• Anticholinergics (e.g., Atropine): May antagonize the gastrokinetic effects of domperidone.
• Antacids and H2 Blockers (e.g., Famotidine, Omeprazole): Increase gastric pH, which may decrease the oral absorption of domperidone. Administer at least 2 hours apart.

よくある質問