Emetrol (domidone, domperidone) is used to relieve the symptoms of nausea and vomiting. But it is not recommended to use it for motion sickness.
How to use and dosage
For relief of symptoms of nausea and vomiting. Adults and children over 12 years of age with body weight of at least 35 kg: 1 tablet (10 mg) 3 times a day. Maximal daily dose is 3 tablets (30 mg per day). It is recommended to take the drug emetrol before meals. Absorption of the drug is somewhat delayed if it is taken after a meal. The duration of treatment should not exceed 1 week. Patients over 60 years of age should consult their physician before taking the drug.
Renal function impairment
Since the half-life of domperidone in severe renal dysfunction (serum creatinine ˃ 6 mg/100 ml, i.e. ˃ 0.6 mmol/L) is prolonged, the frequency of Domidone administration should be reduced to 1 or 2 times per day, depending on the severity of the disorder; a dose reduction may also be required. Patients with severe renal dysfunction should be examined regularly.
Impaired liver function
Domidone is contraindicated in patients with moderate (7-9 Child-Pugh) or severe (˃ 9 on the Child-Pugh scale) hepatic impairment. Dosage adjustment is not required for patients with mild hepatic impairment (5-6 points on the Child-Pugh scale).
The drug should be used for treatment of children from 12 years old and body weight of at least 35 kg. Domperidone should be administered in children in the lowest effective dose for the shortest period.
Symptoms: symptoms of overdose may include agitation, impaired consciousness, seizures, disorientation, somnolence and extrapyramidal reactions.
Treatment. There is no specific antidote for domperidone, but in case of a significant overdose, gastric lavage within 1 hour after taking the drug and use of activated charcoal is recommended, as well as close monitoring of the patient and supportive therapy. Anticholinergic drugs, Parkinson’s disease agents may be effective in controlling extrapyramidal reactions.
Subject to compliance with the recommendations for the dosage and duration of treatment, domperidone is usually well tolerated and adverse events occur infrequently.
Immune system disorders: very rare – allergic reactions, including anaphylaxis, anaphylactic shock, hypersensitivity.
Endocrine system: rare – increase in prolactin levels.
Mental disorders: very rare – nervousness, irritability, agitation, depression, anxiety, decreased or absent libido.
Nervous system: very rare – insomnia, dizziness, thirst, seizures, lethargy, headache, somnolence, akathisia, extrapyramidal disorders.
Cardiovascular system: very rare – edema, palpitations, disorders of heart rate and rhythm, prolongation of QT interval (frequency is unknown), serious ventricular arrhythmias, ventricular arrhythmias of the type “torsade de pointes”, sudden cardiac death.
Gastrointestinal tract: rare – gastrointestinal disorders, including abdominal pain, regurgitation, change in appetite, nausea, heartburn, constipation; very rare – dry mouth, short-term intestinal cramps, diarrhea.
Skin and subcutaneous tissue: very rare – itching, rash, frequency unknown – urticaria, angioedema.
The musculoskeletal system and connective tissue: rare – pain in the legs.
Urinary system: very rare – urinary retention, dysuria, frequent urination.
General disorders: rare – asthenia.
Organs of vision: frequency is unknown – oculogyric crises.
Other: conjunctivitis, stomatitis.
Changes in laboratory indexes: very rarely – increased levels of ALT, AST and cholesterol; infrequently – abnormal values of liver function tests; rarely – increased levels of prolactin in blood. Since pituitary gland is located behind the blood-brain barrier, domperidone may cause increase in prolactin level. In single cases, such hyperprolactinemia may lead to neuroendocrine side effects, such as galactorrhea, gynecomastia, and amenorrhea. During the period of post-marketing use of domperidone, no differences in the safety profile of the drug in adults and children were noted, except for extrapyramidal disorders and other phenomena, seizures and agitation related to the central nervous system, observed mainly in children.