Motilium

Overview of Motilium

Motilium, with the generic name domperidone, is primarily indicated for the relief of symptoms of nausea and vomiting, fullness, bloating, and stomach discomfort. It is also used to treat gastric motility disorders and as an adjunct therapy in patients with gastroparesis.

Pharmacological Classification

Motilium belongs to the class of medications known as antiemetics and prokinetics. It acts as a peripheral dopamine D2 and D3 receptor antagonist, which promotes gastric motility and accelerates gastric emptying.

Formulations and Strengths

Motilium is available in various formulations, including tablets, orally disintegrating tablets (ODT), suspension, and suppositories. Tablet strengths typically include 10mg. Concentration in suspension may vary and should be verified with the specific product’s labeling.

Dosing Instructions

For adults and adolescents weighing over 35 kg, the standard dose is 10 mg three to four times daily, 15-30 minutes before meals and at bedtime if required, but not to exceed 80 mg per day. For children and other specific populations, dosing will differ and should be determined by a healthcare provider.

Directions for Use

Tablets should be taken before meals to optimize the effects on gastric motility. Patients are advised to swallow the tablets whole with a glass of water. Orally disintegrating tablets should be placed on the tongue and allowed to dissolve before swallowing, with no need for water.

Administration with Food

Motilium is more effective when taken 15-30 minutes before meals. If taken after meals, absorption of the drug can be delayed.

Drug Interactions

Concomitant use of Motilium with ketoconazole, erythromycin, and other CYP3A4 inhibitors can increase domperidone blood levels. Co-administration with MAO inhibitors, antidepressants, or antipsychotics may also affect the metabolism of Motilium and should be closely monitored.

Special Populations Consideration

For patients with renal impairment, the dosing frequency of Motilium should be reduced as domperidone is excreted by the kidneys. In those with hepatic impairment, Motilium should be used with caution and possibly at a lower dose, as it may not be metabolized as effectively.

Adjustments in Dosage

A healthcare provider may adjust the Motilium dosage for elderly patients or those with existing health conditions that affect drug metabolism and excretion.

Potential Side Effects

Side effects can include, but are not limited to, dry mouth, abdominal cramps, and dizziness. Serious side effects such as heart rhythm problems or allergic reactions are less common but warrant immediate medical attention.

Monitoring Parameters

Patients taking Motilium should be monitored for changes in electrolyte levels, cardiac symptoms, and any signs of hormonal imbalances, such as breast enlargement or secretion of milk (galactorrhea).

Pregnancy and Lactation

In pregnancy, Motilium should be used if the anticipated benefit justifies the potential risk to the fetus. The effect of domperidone on the breastfeeding infant is not well documented, so caution is advised and a risk-benefit analysis should be considered.

Overdose Management

In the case of overdose, symptomatic and supportive measures are recommended. Activated charcoal may be administered, and close observation of the patient is essential, particularly monitoring of cardiac function due to the risk of QT interval prolongation.

Storage and Handling

Motilium should be stored at controlled room temperature, away from light and moisture. The medication should be kept out of reach of children.

Patient Counseling Information

Patients should be counseled on the importance of adhering to prescribed dosages. They should be advised to report any adverse reactions or unusual symptoms, and informed not to consume alcohol or other CNS depressants concurrently with Motilium.

Disposal of Unused Medication

Unused or expired Motilium should be disposed of properly, not through wastewater or household waste. Patients should be encouraged to return the medication to a pharmacy for safe disposal.