Nuances of the drug Emetrol (domperidone)
This is a drug that regulates gastric peristalsis and has antiemetic properties. In addition, emetrol relieves or alleviates dyspeptic symptoms such as heartburn, nausea, belching, relieves the feeling of “full stomach”, reduces pain in the abdominal area that occurs after eating, etc.
When using the drug emetrol (domperidone) in combination with antacids or antisecretory drugs, the latter should be taken after meals and not before meals, i.e. they should not be taken simultaneously with the drug. Using emetrol in children in rare cases may cause neurological side effects. In this regard, the recommended dose should be strictly adhered to. Neurological undesirable effects may be caused by overdose of the drug in adolescents, but it is necessary to take into account other possible causes of such effects.
Use in diseases of the cardiovascular system. Some epidemiological studies have shown that domperidone use may be associated with an increased risk of serious ventricular arrhythmias or sudden coronary death. The risk may be more likely in patients over 60 years of age and in patients taking the drug in daily doses greater than 30 mg. Patients over 60 years old should take the drug emetrol with caution. The use of domperidone and other drugs causing prolongation of QTc interval is not recommended in patients with conduction disorders, particularly prolongation of QTc interval, and in patients with significant electrolyte balance disorders (hypokalemia, hyperkalemia, hypomagnesemia) or with bradycardia, or in patients with concomitant cardiac diseases, such as congestive heart failure. It is known that against the background of electrolyte imbalance and bradycardia, the risk of arrhythmias increases. In the case of signs or symptoms that may be associated with cardiac arrhythmias, therapy with emetrol should be discontinued and a physician should be consulted.
Use in cases of kidney disease. Since a very small percentage of the drug is excreted unchanged by the kidneys, no adjustment of the single dose in patients with renal insufficiency is required. However, during repeated prescription of Emetrol, the frequency of use should be reduced to one or two times a day, depending on the severity of renal impairment. During long-term therapy, patients should be regularly monitored. Potential of drug interactions The main route of metabolism of domperidone is via CYP3A4 isoenzyme. In vitro data and results of studies in humans show that concomitant use of drugs that significantly inhibit this enzyme may be accompanied by increased plasma concentrations of domperidone. Concomitant use of domperidone with potent inhibitors of CYP3A4 isoenzyme, which have been reported to cause prolongation of the QT interval, is contraindicated. Caution should be exercised when combining domperidone with potent CYP3A4 isoenzyme inhibitors that do not cause QT interval prolongation, such as indinavir, and careful monitoring of patients for signs or symptoms of adverse reactions is necessary. Caution should be exercised when combining domperidone with the medicinal products that have been reported to cause QT interval prolongation, and careful monitoring of patients for signs or symptoms of cardiovascular adverse reactions is required. Examples of such medications are: Class IA antiarrhythmic drugs (e.g., disopyramide, quinidine); Class III antiarrhythmic drugs (e.g., amiodarone, dofetilide, dronedarone, ibutilide, sotalol); certain antipsychotics (e.g., haloperidol, pimozide, sertindol); certain antidepressants (e.g., citalopram, escitalopram); certain antibiotics (e.g., levofloxacin, moxifloxacin) certain antifungal drugs (e.g., pentamidine); certain antimalarials (e.g., halofantrine); certain gastrointestinal drugs (e.g., dolasetron); certain anticancer drugs (e.g., toremifene, vandetanib); certain other drugs (e.g., bepridil, methadone).
If a medication has expired or is out of date, do not throw it down the drain or outdoors! Put the medication in a bag and put it in the trash. These measures will help protect the environment!