Lancashire and South Cumbria
Formulary
Formulary
4 Central nervous system
04-06 Domperidone and metoclopramide
| Metoclopramide |
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Formulary
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Tablets 10mg Metoclopramide can induce acute dystonic reactions involving facial and skeletal muscle spasms and oculogyric crises. These dystonic effects are more common in the young (especially girls and young women) and the very old. Metoclopramide should only be prescribed for short-term use (up to 5 days). |
 MHRA: Metoclopramide: risk of neurological adverse effects |
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| Domperidone |
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Formulary
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Tablets 10mg Domperidone is no longer indicated for the relief of nausea and vomiting in children aged under 12 years or those weighing less than 35 kg. Healthcare professionals are advised to adhere to the licensed dose and to use the lowest effective dose for the shortest possible duration (max. treatment duration should not usually exceed 1 week).
Appropriate for initiation and ongoing prescribing in both primary and secondary care for a maximum period of seven days at a total maximum daily dose not exceeding 30mg.
Any health professional or lactation consultant with the appropriate skills, knowledge and competency within midwifery, health visiting and neonatal services can signpost a woman to her GP for discussion about the use of galactagogues where there is evidence of:
• an effective breastfeeding or expressing assessment and
• implementation of a breastfeeding care-plan to increase maternal lactation and
• an assessment of the need for the use of a galactagogue
See link below for full details |
 LSCMMG: Domperidone Green (restricted) As an aid to the initiation and maintenance of breast milk supply MHRA: Apomorphine with domperidone: minimising risk of cardiac side effects MHRA: Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents MHRA: Domperidone: risks of cardiac side effects |
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As an aid to the initiation and maintenance of breast milk supplyLinks
- Hypersalivation – can hyoscine hydrobromide be used to treat it?
- Hypersalivation treatment options
- LSCMMG: ADHD combined adult and child shared care guideline
- LSCMMG: Domperidone Green (restricted) As an aid to the initiation and maintenance of breast milk supply
- LSCMMG: Doxylamine and Pyridoxine NMR
- LSCMMG: Opioid reduction: best interests opioid reduction position statement
- LSCMMG: Opioid treatment: patient-prescriber opioid treatment agreement
- LSCMMG: Restless Legs Syndrome in Adults in Primary Care
- MHRA Drug Safety Update April 2016: Apomorphine with domperidone: minimising risk of cardiac side effects
- MHRA Drug Safety Update Dec 2019: Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents
- MHRA Dug Safety Update Jan 2020: Ondansetron in pregnancy – small increased risk of oral clefts following use in the first 12 weeks of pregnancy
- MHRA update on restricted dose information (Aug 13)
- MHRA: Advice for domperidone (April 2014)
- MHRA: Apomorphine with domperidone: minimising risk of cardiac side effects
- MHRA: Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents
- MHRA: Domperidone: risks of cardiac side effects
- MHRA: Hyoscine hydrobromide patches (Scopoderm 1.5mg Patch or Scopoderm TTS Patch): risk of anticholinergic side effects, including hyperthermia
- MHRA: Metoclopramide: risk of neurological adverse effects
- MHRA: Ondansetron for intravenous use: dose-dependent QT interval prolongation
- MHRA: Ondansetron for intravenous use: dose-dependent QT interval prolongation
- MHRA: Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy
- MHRA: Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy
- NICE CG150: Headaches in over 12s: diagnosis and management
- NICE TA:919 Rimegepant for treating migraine
- NICE: Management of vomiting in children and young people with gastroenteritis: ondansetron
- Ondansetron for vomiting in children with gastroenteritis- NICE evidence summary
- RCOG: The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum (Green-top Guideline No.69)
- UKMI: Domperidone - New restrictions in GI conditions (May 2014)