Domperidone: Uses, Dosing, and Safety You Should Know

Domperidone can help stop nausea, speed up slow digestion, and sometimes increase breast milk. It works fast for stomach-related nausea but comes with real safety checks. Before you consider it, know when it helps, how people usually take it, and what warning signs to watch for.

Uses and common dosing

Domperidone blocks dopamine receptors in the gut to reduce nausea and improve gastric emptying. Doctors prescribe it for gastroparesis, chemotherapy-related nausea in some regions, and off-label for low milk supply in breastfeeding mothers. Typical adult dosing is 10 mg taken 15–30 minutes before meals up to three times a day (commonly 30 mg total). Some prescribers use 20 mg per day or shorter courses depending on risk. Pediatric dosing and use during breastfeeding need specialist guidance. Never increase dose without medical advice.

Safety, interactions, and buying advice

The main safety issue is heart rhythm. Domperidone can prolong the QT interval, which raises the chance of dangerous arrhythmias in susceptible people. Risk factors include older age, existing heart disease, low potassium or magnesium, higher doses, and combining domperidone with other QT-prolonging drugs. Strong CYP3A4 inhibitors — for example, ketoconazole, itraconazole, erythromycin, clarithromycin, and some HIV protease inhibitors — increase domperidone levels and raise risk. Common side effects are dry mouth, abdominal cramps, diarrhea, and raised prolactin (which can cause breast milk production, breast pain, or menstrual changes). Extrapyramidal symptoms such as tremor or muscle stiffness are rare but possible.

Before starting domperidone, tell your doctor about any heart problems, fainting spells, or family history of sudden cardiac death. Mention all medicines and supplements — many common drugs interact. Your clinician may order an ECG, check electrolytes, or avoid domperidone if you take a strong CYP3A4 inhibitor. Use the lowest effective dose for the shortest time needed. If you notice palpitations, dizziness, fainting, or unexplained muscle problems, stop the drug and seek medical help.

Common medicines that raise domperidone levels include macrolide antibiotics (erythromycin, clarithromycin), many azole antifungals (ketoconazole, itraconazole, voriconazole), some antivirals, and grapefruit juice. Drugs that themselves prolong QT — certain antipsychotics, some antidepressants, and antiarrhythmics — add risk when combined. If you take any of these, your doctor will pick a safer option.

For nausea try concrete steps first: small frequent meals, avoid fatty or spicy foods, sip clear fluids, try ginger or acupressure wrist bands. For low milk supply, check latch and pumping technique and see a lactation consultant before starting domperidone; if medication is used, providers usually weigh benefits and heart risk carefully and monitor the mother.

Regulatory rules vary. In some countries domperidone is available with restrictions; in others it’s not routinely approved. Check local guidance and get a prescription from a licensed clinician. Avoid buying prescription-strength domperidone from unknown online sellers — if you buy online, use a well-known, regulated pharmacy and ask a pharmacist about authenticity and labeling.

If you want, I can make a short checklist for your prescriber, list drugs that interact with domperidone, or compare it to alternatives like metoclopramide and ondansetron. Tell me which you'd prefer now.