| |
Domperidone
(Lactation Stimulant)
Domperidone is a dopamine receptor antagonist, which is used for its anti-emetic and
gastric emptying properties. A side
effect of domperidone is that it can stimulate milk production, presumably by
increasing prolactin production by the pituitary gland. Domperidone is sold in Canada under the
trade name Motilium®, and is used for the treatment of
gastric disorders in adults and pediatric patients. Domperidone is not available in the US at this time, but can be
prepared by a compounding pharmacy at the request of your physician.
Domperidone should never be considered as the first approach to correcting breast-feeding
difficulties. All other considerations
regarding insufficient milk production should be ruled out first before using
domperidone. Other considerations may include: improper latching at the
nipple, use of a breast pump, milk expression after feedings to increase
supply, and infant sucking problems.
Contraindications: This medication should not be used whenever
the risk of gastric stimulation should be avoided - such as in patients with GI
bleeding, bowel obstruction, and bowel perforation.
Side effects may occur with any medication. Side effects from domperidone are uncommon
but may include headache (minimized when the dose is reduced), abdominal
cramping, and dry mouth. The amount of
medication that is secreted into the breast milk is minimal. Since the drug can be used safely in
pediatric patients, there would not be expected to be any harmful effects to a
breast-feeding baby.
Dosage: The usual starting dose is 20mg, taken four
times daily. Some prescribers recommend
30mg, three times daily. Domperidone is
usually taken for 3-8 weeks. Mothers
who are nursing adopted babies may have to take the drug much longer. After starting the medication, it may take
3-4 days to notice any effects, although some women notice an effect within 24
hours. Most lactation specialists and
physicians recommend that you should take the medication for at least 2 weeks
before evaluating its usefulness. In
some women it may take 4-6 weeks to reach full effectiveness. A full 4-week trial is not unreasonable to
determine if the medication will work for you.
How long do you take domperidone? Your lactation specialist and physician
should determine your actual length of treatment. Once milk production becomes satisfactory, it may be possible to
start weaning the dose of domperidone. Start by cutting back one pill per day every 4-5 days. If there is no drop in milk production, drop
another pill per day and continue this process every 4-5 days until no pills
are being taken. If, however, the
supply of milk has dropped significantly, return to the previously effective
dose and maintain that for a couple of weeks before you try weaning off your
dosage. The goal is to take the least
amount of medication needed to be effective.
Available by Prescription Only Apothecary Options prepares domperidone capsules in 10mg,20mg and 30mg
strengths.
100 x 10mg capsules = $39.
100 x 20mg capsules = $59.
100 x 30mg capsules = $79.
Click here to download an order form.
|
|
