What is domperidone used to treat?

October 9, 2025 •

3 min read

Available in many countries, domperidone is a medication that primarily acts as a dopamine antagonist to treat symptoms of nausea, vomiting, and certain gastrointestinal motility disorders. Its approved and off-label uses vary widely around the world, leading to differing availability and safety guidelines.

Quick Summary

Domperidone, sold under the brand name Motilium in some regions, is used for conditions like gastroparesis, nausea, and vomiting. It works by blocking dopamine receptors in the digestive system and the brain's vomiting center. Uses are restricted in many places due to cardiac risk, with some regulatory bodies cautioning against its unapproved use for increasing breast milk supply.

Key Points

Antiemetic and Prokinetic: Domperidone is primarily used to treat nausea and vomiting and to speed up gastric emptying in conditions like gastroparesis.
Dopamine Antagonist: It works by blocking dopamine D2 and D3 receptors in the gut and the brain's chemoreceptor trigger zone, which controls vomiting.
Fewer CNS Side Effects: Unlike metoclopramide, domperidone minimally crosses the blood-brain barrier, resulting in a lower risk of neurological side effects such as tardive dyskinesia.
Controversial Lactation Use: The drug is used off-label in some countries to increase breast milk production by boosting prolactin levels, but major health agencies like the FDA strongly caution against this due to safety risks.
Cardiac and Other Risks: Domperidone is associated with potential cardiac arrhythmias and QT prolongation, especially at higher doses.
Regulatory Limitations: Domperidone is not FDA-approved in the U.S. for human use and can only be obtained for severe GI cases through an investigational new drug application.
Withdrawal Symptoms: Discontinuing domperidone, particularly after high-dose use for lactation, can lead to neuropsychiatric withdrawal symptoms.

Domperidone: A Dopamine Antagonist for Digestive Issues

Domperidone is an antiemetic and prokinetic agent that is not approved for human use in the United States by the FDA but is available in many other countries. It functions as a dopamine-2 (D2) receptor antagonist. Unlike some similar drugs, it has minimal ability to cross the blood-brain barrier, which helps to reduce central nervous system side effects. It blocks D2 receptors in the gastrointestinal tract and the chemoreceptor trigger zone in the brain.

Primary medical uses of domperidone

Domperidone is used for several gastrointestinal issues by improving motility and reducing nausea.

Nausea and vomiting

Domperidone is commonly used to treat nausea and vomiting caused by various factors. It is recommended by the {Link: Canadian Headache Society https://en.wikipedia.org/wiki/Domperidone} for nausea associated with acute migraine. It also helps alleviate gastrointestinal symptoms caused by certain Parkinson's disease medications.

Gastroparesis (delayed stomach emptying)

Often prescribed for gastroparesis, domperidone helps address symptoms of this disorder. By blocking dopamine's effect, it increases stomach muscle contractions and improves emptying.

Functional dyspepsia

Domperidone can be used in both adults and children with functional dyspepsia. Its prokinetic effects can help relieve symptoms like bloating and feeling full after eating.

The controversial use of domperidone for lactation

While not an approved use globally, domperidone is sometimes used off-label to increase breast milk production. This happens because the drug blocks D2 receptors in the pituitary gland, which raises prolactin levels.

However, health agencies, including the U.S. FDA, strongly advise against this use due to significant safety concerns. The FDA has highlighted serious risks such as cardiac arrhythmias, cardiac arrest, and sudden death. There are also concerns about neuropsychiatric withdrawal symptoms when stopping the medication.

Domperidone vs. Metoclopramide: A comparative overview

Domperidone and metoclopramide are both dopamine receptor antagonists used for similar GI conditions, but they differ in side effect profiles partly due to how they cross the blood-brain barrier.


Feature	Domperidone	Metoclopramide (Reglan)
Mechanism of Action	Peripheral D2 and D3 receptor antagonist.	D2 receptor antagonist, also affects serotonin receptors.
Blood-Brain Barrier Penetration	Minimally crosses, leading to fewer CNS effects.	Readily crosses, higher risk of CNS side effects.
Extrapyramidal Side Effects (EPS)	Very low risk, though case reports exist, especially in children with immature blood-brain barriers.	Higher risk, especially with long-term use, leading to potential tardive dyskinesia.
Cardiac Risks	Associated with QT prolongation, requiring caution in patients with pre-existing heart conditions or high doses.	Also carries a risk of QT prolongation and cardiac effects, especially with intravenous use.
Regulatory Status (USA)	Not FDA-approved for human use, available via an expanded access Investigational New Drug (IND) application for severe cases only.	FDA-approved, though use is often limited to 12 weeks due to CNS risk.
Primary Benefits	Effective for gastroparesis, nausea/vomiting, with a better neurological side effect profile.	Also effective for gastroparesis and nausea, but with a greater risk of neurological side effects.

Potential side effects and risks

Domperidone is generally tolerated at recommended doses, but it can cause side effects, some of which are serious.

Common side effects

Common issues include dry mouth, headaches, and digestive problems.

Prolactin-related effects

Increased prolactin levels can lead to breast enlargement or tenderness, inappropriate milk production (galactorrhea), and irregular menstrual cycles.

Serious risks

Serious risks include cardiac arrhythmias and QT prolongation. This risk is elevated in those over 60, taking high doses, or with existing heart conditions. Suddenly stopping the medication, especially after high-dose use for lactation, can cause severe psychological withdrawal symptoms.

Conclusion

Domperidone is an antiemetic and prokinetic medication used globally for various gastrointestinal conditions, particularly gastroparesis, nausea, and vomiting. It offers symptom relief by targeting peripheral dopamine receptors. Potential cardiac issues and prolactin-related effects are risks. Its use to increase lactation is not approved and is strongly cautioned against by some health authorities due to safety concerns. Domperidone is not legally marketed for human use in the United States and is strictly regulated elsewhere. Patients should consult a healthcare provider to understand the risks and benefits. For detailed medical information, consider consulting resources like the {Link: Wikipedia https://en.wikipedia.org/wiki/Domperidone} article on domperidone.

Frequently Asked Questions

Domperidone primarily acts as a prokinetic agent to accelerate gastric emptying and as an antiemetic to relieve nausea and vomiting.

No, domperidone is not legally marketed or FDA-approved for general human use in the U.S. It is only accessible to patients with severe, refractory gastrointestinal disorders through an expanded access investigational new drug (IND) application.

The most significant risk is potential cardiac complications, including QT prolongation and serious arrhythmias. The risk is higher with age (over 60), higher doses, and in patients with pre-existing heart conditions.

It is used off-label as a galactagogue because it increases prolactin levels. However, the FDA and other health bodies strongly caution against this use due to the cardiac risks and potential for serious neuropsychiatric withdrawal symptoms.

Domperidone is less likely to cause neurological side effects than metoclopramide because it does not readily cross the blood-brain barrier. Both, however, carry a cardiac risk.

Common side effects include dry mouth, headaches, abdominal cramps, diarrhea, and prolactin-related effects like breast tenderness or enlargement.

Domperidone can be used in children for certain conditions like reflux or functional dyspepsia, but caution is advised. While a lower risk than with metoclopramide, central nervous system effects have been reported in children.

For short-term treatment of nausea and vomiting, domperidone is often used for no more than one week. For chronic conditions like gastroparesis, treatment duration is determined by a doctor and requires careful monitoring.