Motilium (domperidone) is a peripheral dopamine D2/D3 receptor antagonist that enhances gastrointestinal motility and helps relieve symptoms caused by delayed gastric emptying. By blocking dopamine receptors in the gut wall and chemoreceptor trigger zone outside the blood–brain barrier, domperidone increases the strength and frequency of stomach contractions, promotes coordinated emptying of the stomach into the small intestine, and reduces nausea signals. Unlike some other antiemetics, domperidone has minimal penetration into the central nervous system at usual doses, which lowers the risk of certain neurological side effects.
Clinically, Motilium may be used for short-term relief of:
Additional uses vary by country. In some regions outside the United States, domperidone is prescribed to manage reflux-associated nausea or functional dyspepsia. It has also been used off-label to support lactation by increasing prolactin levels; this should only be considered under specialized medical supervision after non-pharmacologic strategies have been optimized and risks are carefully weighed. Regulatory authorities in several countries emphasize using the lowest effective dose for the shortest possible duration because of rare but serious cardiac risks.
Key benefits when used appropriately include improved gastric motility (prokinetic effect), reduction in nausea and vomiting frequency, and relief of fullness and bloating. Symptom improvement often begins within 30 to 60 minutes of a dose, especially when taken before meals.
Always take Motilium exactly as prescribed by your healthcare professional. Doses can vary based on your condition, age, and other medications. Do not exceed the recommended dose or duration without medical guidance.
Typical adult dosing for short-term nausea and vomiting:
For gastroparesis and chronic motility disorders (where permitted in your region):
Older adults and those with risk factors for heart rhythm changes require careful dose selection and monitoring. Many regulators recommend using the lowest effective dose and avoiding use longer than necessary for acute nausea (often a few days). Long-term use should be supervised by a specialist.
Directions for administration:
Renal and hepatic considerations:
Pediatric use is restricted and varies by country. Domperidone should not be used in infants and is generally avoided in children under 12 years of age or those weighing less than 35 kg unless a pediatric specialist recommends and supervises treatment. Safety concerns, particularly regarding heart rhythm, are more pronounced in very young populations.
Before starting Motilium, discuss your full medical history and medication list with your healthcare provider. Important considerations include:
Precautionary advice during treatment:
Pregnancy and breastfeeding:
Do not use Motilium (domperidone) if you:
In older adults (especially over 60), those with underlying cardiac disease, and patients requiring doses above recommendations, the risk–benefit balance may not favor use. A thorough clinical assessment is essential.
Most people tolerate domperidone well at recommended doses, but side effects can occur. Seek medical advice if symptoms are persistent, severe, or concerning.
Common side effects:
Hormonal/endocrine-related effects (linked to increased prolactin):
Cardiac effects (less common but potentially serious):
Neurological effects (uncommon):
Allergic reactions:
Stop using Motilium and contact your clinician promptly if you develop chest pain, rapid or irregular heartbeat, severe dizziness, fainting, swelling of the face or throat, or any unusual or severe symptoms.
Domperidone is metabolized primarily by the cytochrome P450 3A4 (CYP3A4) enzyme system and can affect cardiac repolarization. Interactions that raise domperidone levels or compound QT prolongation can increase safety risks.
Medications that can raise domperidone levels (avoid or use only with specialist oversight):
Drugs that prolong QT interval (usually avoid coadministration):
Additional interaction considerations:
Because interaction profiles are complex, provide your prescriber and pharmacist a complete list of prescription drugs, over-the-counter medicines, and supplements before starting Motilium.
If you miss a dose of Motilium, take it as soon as you remember, provided it is still at least several hours before your next scheduled dose. If it is almost time for the next dose, skip the missed dose and resume your regular schedule. Do not double up doses to make up for a missed one. If frequent misses occur, consider setting reminders or speaking with your pharmacist about adherence strategies.
Symptoms of domperidone overdose can include marked drowsiness, agitation, confusion, involuntary muscle movements, and serious heart rhythm disturbances (including arrhythmias). In infants and young children, neurological symptoms can be more pronounced. If an overdose is suspected, seek emergency medical attention immediately.
Clinical management typically involves:
There is no specific antidote for domperidone overdose.
Store Motilium at controlled room temperature (68–77°F / 20–25°C). Short excursions between 59–86°F (15–30°C) are generally acceptable. Keep tablets in their original blister or container, tightly closed, protected from moisture, heat, and direct light. Do not store in a bathroom. Keep out of the reach of children and pets. Do not use after the expiry date printed on the packaging; if unsure, consult your pharmacist about safe disposal.
Motilium (domperidone) is not approved by the U.S. Food and Drug Administration (FDA) for general use, due largely to concerns about rare but serious cardiac adverse events, particularly when used at higher-than-recommended doses or with interacting medicines. In the United States, routine prescribing and dispensing are not permitted outside specific, regulated pathways.
Access pathways in the U.S.:
Safety and compliance expectations:
Important note regarding institutional access claims: In some settings, U.S. healthcare institutions help coordinate legal access to therapies through established regulatory mechanisms (for example, IND or expanded access) when no suitable alternatives exist. These are structured clinical pathways that require physician oversight and patient consent; they are not “no-prescription” channels. Be cautious with any third-party statements suggesting that a specific hospital offers domperidone “without a formal prescription.” In the U.S., dispensing domperidone without appropriate clinical oversight and regulatory authorization is not permitted.
HealthSouth Rehabilitation Hospital of Texarkana and similar institutions may provide comprehensive care coordination for patients with complex rehabilitation or gastrointestinal needs; however, patients should confirm directly with the institution and their treating physician how any therapy is accessed. Any lawful access to domperidone in the U.S. must involve clinician oversight and adherence to FDA requirements. Offers claiming access to Motilium without a valid prescription or outside regulatory pathways should be avoided.
This article is for informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for professional judgment. Always consult your licensed healthcare provider to determine whether Motilium (domperidone) is appropriate for your specific situation, to establish the correct dose and duration, and to review potential risks and interactions. Regulatory status, approved indications, and clinical guidance may differ by country; follow local laws and your clinician’s directions. Never start, stop, or change a medication without medical supervision.
Motilium contains domperidone, a dopamine D2 receptor antagonist that works mainly outside the brain. It speeds up gastric emptying (prokinetic effect) and blocks nausea signals from the chemoreceptor trigger zone, helping relieve nausea, vomiting, bloating, and feelings of fullness.
It is used short term for nausea and vomiting from various causes (gastroenteritis, migraine, medication-related). In some regions, specialists may use it for gastroparesis or functional dyspepsia symptoms like early satiety and bloating. Use and approvals vary by country.
In most countries, domperidone is prescription-only. In the United States it is not FDA-approved and is available only through an expanded access (investigational) program for certain gastrointestinal motility disorders under specialist care.
A common adult dose is 10 mg taken 15–30 minutes before meals, up to three times daily. Many regulators advise a maximum of 30 mg per day and limiting use for acute nausea/vomiting to 7 days. Longer use should be specialist-guided. Always follow your local product label and your clinician’s advice.
Onset is typically within 30–60 minutes when taken before meals. Effects last several hours. For predictable triggers (for example, migraine-associated nausea), timing a dose before the trigger can help.
Dry mouth, headache, abdominal cramps, diarrhea or constipation, and mild dizziness can occur. Elevated prolactin (galactorrhea, breast tenderness, menstrual changes) is possible with dopamine antagonists, though less common at short durations and low doses.
Domperidone can prolong the QT interval and, rarely, cause serious arrhythmias or sudden cardiac death, especially in people over 60, at doses above 30 mg/day, or when combined with CYP3A4 inhibitors or other QT‑prolonging drugs. Seek urgent care for palpitations, fainting, or severe dizziness.
Avoid if you have known prolonged QT, significant cardiac disease (e.g., ventricular arrhythmias, heart failure), uncorrected low potassium/magnesium, moderate to severe liver impairment, gastrointestinal bleeding/obstruction/perforation, or if you are taking potent CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin). Review your full medication list with a clinician.
It crosses the blood–brain barrier minimally, so sedation is uncommon compared with some antiemetics. However, dizziness or faintness can occur. Do not drive or operate machinery if you feel unwell, lightheaded, or have palpitations.
It may relieve upper GI symptoms related to delayed gastric emptying, such as early fullness and bloating. It is not an acid suppressant and does not replace treatments like PPIs or H2 blockers for heartburn. A clinician can help determine whether prokinetic therapy is appropriate.
Pediatric use is restricted in many regions due to limited benefit and cardiac risk. If used, it must be strictly weight‑based, short term, and prescribed by a pediatric clinician. Do not give to children without medical advice.
For best effect, take 15–30 minutes before meals. Swallow tablets whole with water. If swallowing is difficult, ask about an oral suspension available in some regions; do not crush or split unless your pharmacist confirms it is safe for your specific product.
Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, erythromycin, ritonavir, diltiazem, verapamil, grapefruit) can raise domperidone levels and are contraindicated in many labels. Combining with other QT‑prolonging drugs (e.g., certain antiarrhythmics, antipsychotics, methadone, some SSRIs) increases arrhythmia risk. Always review interactions with your pharmacist or clinician.
For acute nausea/vomiting, many authorities recommend no more than 7 days. Chronic or recurrent symptoms require reassessment of the underlying cause and specialist guidance, using the lowest effective dose and monitoring cardiac risk factors.
Yes. Motilium is a brand name for domperidone. Depending on your country, domperidone may be available under other brand names or as generics with the same active ingredient.
It’s better to avoid combining domperidone with alcohol. Alcohol can worsen dizziness and may contribute to electrolyte disturbances that increase arrhythmia risk. For hangover nausea, focus on hydration and rest; seek medical advice if vomiting is severe, prolonged, or if you have red-flag symptoms (confusion, chest pain, black stools).
Safety data in pregnancy are limited. It is generally avoided unless the expected benefit outweighs potential risk. For nausea and vomiting of pregnancy, first-line options like doxylamine-pyridoxine and lifestyle changes are preferred. Discuss with your obstetric clinician before use.
Domperidone appears in breast milk in low amounts, but maternal cardiac risks and regulatory advisories mean it is not routinely recommended as a galactagogue. For mothers needing domperidone for GI issues, a personalized risk–benefit discussion with a clinician is essential, with attention to cardiac history and interactions.
Postoperative nausea is often treated with agents like ondansetron or dexamethasone. Domperidone may be considered in some cases, but it should not be used if there is suspected GI obstruction, perforation, or bleeding. Post-surgery use must be guided by your surgical/anaesthesia team.
People over 60 have a higher baseline risk of QT prolongation and arrhythmias. If prescribed, use the lowest effective dose for the shortest duration and monitor for cardiac symptoms. Review other QT‑prolonging drugs and correct electrolytes.
Domperidone is contraindicated in moderate to severe hepatic impairment. In severe renal impairment, dosing frequency may need to be reduced. Discuss your lab results and comorbidities with your clinician before use.
If you have a history of arrhythmias, heart failure, prolonged QT, or you take medications that prolong QT or inhibit CYP3A4, domperidone may not be appropriate. An ECG and medication review are advisable before considering therapy.
Both are effective for nausea and vomiting. Metoclopramide crosses the blood–brain barrier and is more likely to cause central nervous system side effects (drowsiness, agitation) and movement disorders. Domperidone has fewer neurologic effects but carries a clearer signal for QT-related cardiac risk, especially at higher doses or with interacting drugs. Choice depends on your risk profile and the cause of nausea.
For short-term use, domperidone tends to cause fewer extrapyramidal symptoms (restlessness, dystonia) and less sedation. Metoclopramide, especially with longer use, carries a known risk of tardive dyskinesia. Domperidone, however, has a stronger warning for cardiac arrhythmias in at-risk patients. Discuss individualized risks with your clinician.
Ondansetron (a 5‑HT3 antagonist) is often first-line for chemotherapy-, radiation-, and postoperative nausea/vomiting. It does not improve gastric motility but generally has a favorable neurologic side-effect profile. Both drugs can prolong QT. Domperidone adds prokinetic benefits and may be preferred when delayed gastric emptying contributes to symptoms.
Both are prokinetics. Domperidone is a D2 antagonist with antiemetic action. Itopride combines D2 antagonism with acetylcholinesterase inhibition, which may enhance motility without significant QT prolongation in available data. Evidence bases and availability differ by region; head-to-head trials are limited.
Levosulpiride is a D2 antagonist with additional serotonergic activity; some studies suggest benefit in functional dyspepsia and gastroparesis. However, it may be more prone to central effects and endocrine adverse events (hyperprolactinemia). Domperidone often has fewer CNS effects but carries cardiac cautions. Choice should be individualized.
Prochlorperazine (a phenothiazine) is effective for nausea, particularly migraine-related, but commonly causes sedation, orthostatic hypotension, and extrapyramidal symptoms. Domperidone is less sedating and better for motility symptoms, yet has QT risks. The safer option depends on your comorbidities and concomitant drugs.
Haloperidol is used off-label in palliative care for refractory nausea and can be effective at low doses, but it is more likely to cause sedation, extrapyramidal symptoms, and QT prolongation. Domperidone is typically preferred for GI-related nausea with motility issues, provided cardiac risks are addressed.
Erythromycin (a motilin receptor agonist) can rapidly accelerate gastric emptying but often loses effect over days to weeks (tachyphylaxis) and has many interactions, including QT prolongation and CYP3A4 inhibition. Domperidone provides steadier prokinetic and antiemetic effects, with fewer GI antibiotic-related side effects, but still requires cardiac caution.
No. Prucalopride is a selective 5‑HT4 agonist approved mainly for chronic constipation; it enhances colonic motility and has little antiemetic effect. Domperidone treats nausea/vomiting and upper GI motility symptoms. They target different problems, though a specialist may combine or sequence them in select cases.
Cisapride, a 5‑HT4 agonist, was withdrawn or severely restricted in many countries due to serious QT prolongation and fatal arrhythmias. Domperidone also carries QT risk but is considered safer when used appropriately at low doses and without interacting drugs. Neither should be combined with QT-prolonging or strong CYP3A4-inhibiting agents.
Mosapride (5‑HT4 agonist) enhances gastric emptying and has a lower reported risk of QT issues than cisapride. It lacks antiemetic dopamine-blocking activity. If nausea and vomiting are prominent, domperidone may be preferred; if motility symptoms dominate without much nausea, mosapride can be considered where available.
Clebopride and bromopride are D2 antagonists like domperidone, used in some regions. They may penetrate the CNS more, increasing the risk of sedation and extrapyramidal effects. Domperidone tends to spare the CNS but requires attention to cardiac risk and interactions.
Meclizine and dimenhydrinate (antihistamines) are better for motion sickness because they target vestibular pathways. Domperidone is not first-line for motion sickness; it is more useful for GI-origin nausea and delayed gastric emptying. Antihistamines can be sedating; domperidone is less so but has cardiac cautions.
