Motilium (Generic)

Generic Motilium is used to supress nausea and vomiting, and works primarily by blocking dopamine receptors found in the upper end of the digestive system. This causes tightening of the muscles at the entry to the stomach, relaxation of the muscles at the exit of the stomach and increased contraction of the muscles in the stomach itself. These actions speed up the passage of food through the stomach into the intestine, which physically helps prevent vomiting and reduces feelings of sickness, bloating and fullness. It also prevents food from flowing the wrong way through the stomach and so prevents reflux (regurgitation of the stomach contents back into the foodpipe).

You should take Generic Motilium tablets with a glass of water 15 to 30 minutes before meals. If you are over 16, you can take a tablet three times a day and at bedtime. To increase breastmilk the dosage recommended by lactation consultants is up to TWO tablets FOUR times a day.

Side effects include:

• Allergic reactions, such as rash or urticaria.
• Abdominal cramps.
• Dystonic reactions (extrapyramidal phenomena) may occur.
• Reversible raised serum prolactin levels have been observed which may lead to galactorrhoea and gynaecomastia.
• Hypertensive crises in patient.

Since domperidone is highly metabolised in the liver, domperidone should be used with caution in patients with hepatic impairment (and in the elderly).

Domperidone should be used with caution in patients with renal impairment or in those at risk of fluid retention. In patients with severe renal insufficiency (serum creatinine more than 6mg/100ml, i.e. more than 0,6mmol/L) the elimination half-life of domperidone was increased from 7,4 to 20,8 hours. The dosing frequency should be reduced to once or twice daily, depending on the severity of impairment, and the dose may need to be reduced. Patients on prolonged therapy should be reviewed regularly.

Antacids and anti-secretory agents lower the oral bioavailability of domperidone. They should be taken after meals and not before meals, i.e. they should not be taken simultaneously with domperidone.

Reduced gastric acidity impairs the absorption of domperidone.

Oral bioavailability is decreased by prior administration of cimetidine or sodium bicarbonate.

The main metabolic pathway of domperidone is through CYP3A4. In vitro data suggests that concomitant use of drugs that significantly inhibit this enzyme may result in increased plasma levels of domperidone.

Examples of CYP3A4 inhibitors include the following:

• azole antifungals
• macrolide antibiotics
• HIV protease inhibitors
• nefazodone

If you miss a dose of Generic Motilium, take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

Store below 25 degrees Celsius, away from moisture and sunlight. Do not store in the bathroom. Keep away from children and pets.