What is the use of motilium Tablet?

October 6, 2025 •

4 min read

Functional dyspepsia, a condition often causing nausea and bloating, affects up to 40% of people globally. So, what is the use of Motilium tablet in managing such symptoms? This medication is primarily an anti-sickness agent that helps regulate digestive movement.

Quick Summary

Motilium, with its active ingredient domperidone, is a medication used to treat nausea, vomiting, and symptoms of delayed stomach emptying like bloating and fullness. It works by blocking dopamine receptors in the gut and brain.

Key Points

Primary Use: Motilium (domperidone) is mainly used to treat nausea and vomiting.
Mechanism: It works by blocking dopamine receptors in the gut to improve stomach motility and in a part of the brain to stop nausea signals.
Key Advantage: Unlike similar drugs, it does not easily cross the blood-brain barrier, resulting in fewer neurological side effects.
Major Risk: It is associated with a small but serious risk of cardiac side effects, including irregular heartbeat and sudden cardiac death, especially at high doses.
US Status: Motilium is not approved by the FDA for sale in the United States due to safety concerns.
Lactation Use: Its off-label use to increase milk supply is not recommended by regulatory agencies like the FDA due to potential cardiac risks for the mother and unknown risks for the infant.
Important Precaution: Use is contraindicated in people with existing heart conditions or those taking certain interacting medications.

Understanding Motilium (Domperidone)

Motilium is the brand name for the drug domperidone, a medication primarily used to relieve nausea and vomiting. It belongs to a class of drugs known as dopamine antagonists. Developed by Janssen Pharmaceutica in the 1970s, it works by increasing the contractions of the stomach and bowel, helping to move food more efficiently through the digestive system. Unlike some other dopamine antagonists, domperidone does not readily cross the blood-brain barrier, which means it generally has fewer central nervous system side effects, such as drowsiness or movement-related issues.

How Does Motilium Work?

The primary mechanism of action for domperidone involves blocking peripheral dopamine D2 and D3 receptors. It acts in two main areas:

In the Gastrointestinal Tract: By blocking dopamine receptors in the stomach muscles, it enhances gastrointestinal peristalsis (the wave-like muscle contractions that move food) and helps coordinate the movement of food from the stomach to the intestine. This action helps alleviate symptoms like bloating, early satiety (feeling full quickly), and discomfort associated with slow stomach emptying.
In the Brain: It acts on the chemoreceptor trigger zone (CTZ), an area of the brain that detects emetic (vomit-inducing) signals in the blood. Because the CTZ is located outside the blood-brain barrier, domperidone can block dopamine receptors here to prevent nausea and vomiting signals from being sent.

Primary Medical Uses

In countries where it is approved, Motilium is prescribed for several conditions:

Nausea and Vomiting: This is its most common use. It is effective for nausea and vomiting from various causes, including migraine-associated nausea.
Gastroparesis: This condition involves delayed stomach emptying without a physical blockage, common in people with diabetes. Domperidone can help manage symptoms like nausea, vomiting, abdominal pain, and bloating by improving stomach motility.
Functional Dyspepsia: It can relieve discomfort from a slow-moving stomach, such as indigestion, feeling overly full after a meal, loss of appetite, and belching.
Parkinson's Disease Treatment Side Effects: Patients with Parkinson's disease often take medications (like levodopa) that can cause significant nausea. Domperidone can counteract this side effect without worsening the motor symptoms of Parkinson's, as it does not interfere with dopamine in the brain's main control centers.

Off-Label Use: Promoting Lactation

Domperidone is sometimes used off-label to increase milk supply in breastfeeding mothers. It does this by blocking dopamine, which in turn increases the level of prolactin, the hormone responsible for milk production. However, this use is highly controversial and comes with significant warnings. Regulatory bodies like the U.S. Food and Drug Administration (FDA) have issued strong advisories against using domperidone for lactation due to risks of serious cardiac adverse events in the mother and unknown risks to the breastfed infant. Additionally, sudden withdrawal from high doses used for lactation has been linked to psychiatric events like anxiety and insomnia.

Important Safety Information and Side Effects

While effective for some, domperidone is associated with significant risks, particularly related to heart health. It has been linked to a small increased risk of serious cardiac side effects, including QT prolongation (an electrical disturbance in the heart), ventricular arrhythmias (irregular heartbeats), and sudden cardiac death.

This risk is higher in:

Patients over 60 years of age.
Individuals taking certain daily amounts.
Those with pre-existing heart conditions like heart failure or a prolonged QT interval.
Patients taking other medications that also affect the QT interval or interfere with how domperidone is metabolized (CYP3A4 inhibitors).

Because of these risks, its use is now often restricted to the short-term relief of nausea and vomiting at the lowest effective dose, typically for a limited duration.

Common side effects may include dry mouth, headache, diarrhea, and breast tenderness or enlargement due to increased prolactin levels.

Comparison with Other Medications


Feature	Domperidone (Motilium)	Metoclopramide (Reglan)
Mechanism	Peripherally selective dopamine D2/D3 antagonist.	Central and peripheral dopamine D2 antagonist; also has serotonin receptor activity.
Blood-Brain Barrier	Does not readily cross.	Crosses the blood-brain barrier.
CNS Side Effects	Less common (e.g., drowsiness, restlessness).	More common; can cause drowsiness, anxiety, and movement disorders (tardive dyskinesia).
Cardiac Risk	Risk of QT prolongation and ventricular arrhythmia.	Also carries a risk of QT prolongation, though some studies show different risk profiles compared to domperidone.
Regulatory Status (US)	Not approved for sale; available only through a special access program.	FDA-approved for conditions like gastroparesis and GERD.

Regulatory Status and Availability

Domperidone's availability varies significantly by country. It is available over-the-counter or by prescription in many nations in Europe, Canada, and Asia. However, in the United States, domperidone is not approved by the FDA for any human use. The FDA has issued warnings about its risks and considers its distribution illegal. It is only available in the U.S. for patients with severe, treatment-resistant gastrointestinal motility disorders through a specific expanded access investigational new drug (IND) application.

Conclusion

The primary use of a Motilium tablet is to treat nausea, vomiting, and symptoms related to delayed gastric emptying. It functions as a peripheral dopamine antagonist, which allows it to be effective with a lower risk of central nervous system side effects compared to drugs like metoclopramide. However, its use is tempered by a known risk of serious cardiac events, leading to restrictions on dosage and duration in many countries and a lack of approval in the United States. Any use of this medication should be strictly guided by a healthcare professional who can weigh its benefits against the potential risks.

For more information from a regulatory perspective, see the FDA Information about Domperidone.

Frequently Asked Questions

Symptoms of nausea and vomiting usually begin to resolve within a few days of taking domperidone. It is often recommended to take the medication before meals.

Dosage of Motilium varies depending on the condition being treated and individual factors. Due to cardiac risks, healthcare professionals typically prescribe the lowest effective dose for the shortest duration necessary, often for up to one week.

The U.S. FDA has not approved domperidone because of safety concerns, primarily the risk of serious cardiac adverse events like cardiac arrhythmias, cardiac arrest, and sudden death.

No, its use is now generally restricted to only treating nausea and vomiting. It is no longer recommended for symptoms like bloating or heartburn due to the risk of side effects not outweighing the benefits for these conditions.

The main difference is that Motilium (domperidone) does not easily cross the blood-brain barrier, leading to fewer central nervous system side effects like drowsiness and restlessness compared to metoclopramide, which does cross it.

Yes. Stop taking domperidone and seek immediate medical attention if you experience signs of an allergic reaction, uncontrolled movements, or a very fast or unusual heartbeat, as this could indicate a life-threatening heart problem.

You should not take Motilium if you have a known allergy to it, a pituitary gland tumor (prolactinoma), a tear or blockage in your intestines, moderate to severe liver disease, or certain heart conditions like heart failure or a 'prolonged QT interval' on an ECG.