Indications

Ridon (Domperidone) is indicated for the treatment of various gastrointestinal issues, including:

• Dyspeptic symptom complex: Associated with delayed gastric emptying, reflux, and esophagitis, causing symptoms like epigastric fullness, bloating, upper abdominal pain, nausea, vomiting, and heartburn.
• Non-ulcer dyspepsia.
• Acute nausea and vomiting: Due to functional, organic, infectious, dietetic, radiotherapy-induced, or drug-induced causes, as well as in migraine.
• Parkinson's disease: To manage nausea and vomiting induced by dopamine agonists.
• Radiological studies: To speed up barium transit during follow-through studies.

Pharmacology

Domperidone is a dopamine antagonist that primarily blocks dopamine receptors in the Chemoreceptor Trigger Zone (CTZ) and the stomach. This action stimulates gastrointestinal motility, facilitating gastric emptying, and enhancing peristalsis in the stomach and duodenum. Due to its limited ability to cross the blood-brain barrier, it has minimal central nervous system (CNS) effects, thereby reducing the risk of psychotropic or neurological side effects.

Dosage & Administration

• Adults: 10-20 mg (1-2 tablets or 10-20 ml suspension) every 6-8 hours. Maximum dose is 80 mg daily.
• Children: 2-4 ml suspension/10 kg body weight or 0.4-0.8 ml pediatric drops/10 kg body weight, every 6-8 hours.
• Acute Nausea and Vomiting: Maximum treatment period is 12 weeks.
• Suppositories (Rectal):
  • Adults: 30-60 mg every 4-8 hours.
  • Children: Maximum daily dose is 30 mg for those weighing 10-25 kg, and the dose may be divided. Domperidone should be taken 15-30 minutes before meals.

Interaction

• Anticholinergic drugs, Antacids, and Antisecretory drugs: May reduce Domperidone's effectiveness and bioavailability.
• CYP3A4 inhibitors (e.g., azole antifungals, macrolide antibiotics): Concomitant use may increase Domperidone plasma levels.
• Dopaminergic agonists (bromocriptine, L-dopa): Domperidone can suppress their peripheral side effects without affecting their central properties.

Contraindications

Domperidone is contraindicated in:

• Patients with known hypersensitivity to the drug.
• Neonates.
• Conditions where gastrointestinal stimulation could be dangerous, such as hemorrhage, mechanical obstruction, or perforation.
• Patients with a prolactin-releasing pituitary tumor.

Side Effects

Side effects are rare. Reported effects include transient intestinal cramps, extrapyramidal phenomena (rare in young children and exceptional in adults), and an increase in plasma prolactin levels, which can lead to galactorrhea and gynecomastia in rare cases.

Pregnancy & Lactation

• Pregnancy: Should only be used during the first trimester if the anticipated therapeutic benefit justifies the risk. There is no evidence of increased risk of malformations in humans.
• Lactation: The drug is excreted in breast milk. Nursing is not recommended unless the benefits outweigh the potential risks.

Precautions & Warnings

• Children: Use with extreme caution in children, especially young ones, due to the increased risk of extrapyramidal reactions from an incompletely developed blood-brain barrier.
• Hepatic Impairment: Use with caution in patients with hepatic impairment as the drug is highly metabolized in the liver.
• Renal Impairment: In severe renal insufficiency, the dosing frequency should be reduced.

Overdose Effects

Symptoms of overdose may include drowsiness, disorientation, and extrapyramidal reactions, particularly in children. Treatment involves activated charcoal, close observation, and anticholinergic antiparkinsonian drugs or antihistamines to control extrapyramidal reactions.

Therapeutic Class

Ridon is classified as a motility stimulant and a dopamine antagonist/prokinetic drug.

Storage Conditions

Store below 30°C, protected from light and moisture. Keep out of children's reach.