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Thread: How to obtain Domperidone

  1. #1
    Join Date
    Apr 2014
    Posts
    16

    Default How to obtain Domperidone

    I'm looking for help on obtaining Domperidone here in the US. My doctor talked with me about how much better it is than Reglan but wasn't willing to prescribe it. I know a lot of people have been able to obtain it through off shore and Canada. It looks like the site I have used for another medication in the past, and the main site people have used in the past, now requires a prescription. Can anyone point me in the right direction?

  2. #2
    Join Date
    Mar 2014
    Location
    Central FL
    Posts
    1,152

    Default Re: How to obtain Domperidone

    See if you can find a compounding pharmacy in your area and if so, maybe you Dr would be willing to prescribe it then. I believe it is legal through a compounding pharmacy by prescription but it is probably NOT legal to have the non compounded drug shipped in and hence why your dr isn't willing to take that risk.

  3. #3
    Join Date
    May 2006
    Posts
    21,103

    Default Re: How to obtain Domperidone

    You might want to contact Dr. Jack Newman: http://www.breastfeedinginc.ca/conte...agename=drjack. I know he is very gung-ho about Domperidone.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4

    Default Re: How to obtain Domperidone

    Please be cautious about buying domperidone without a prescription. The European Medicines Agency recently recommended new restrictions on the sale of domperidone because of more reports of cardiac problems and deaths.

    Dr. Newman doesn't believe the data about adverse events is relevant to moms who are taking domperidone to increase milk supply, but he has also said that there hasn't been enough research done to establish what dosages are safe.

    It definitely should not be taken without a doctor's supervision.
    Karen
    Forums Admin

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  5. #5
    Join Date
    May 2014
    Posts
    17

    Default Re: How to obtain Domperidone

    I'm interested in this also. My OB does not prescribe either dom or reglan at all. It would be nice to have the option to try dom.

  6. #6
    Join Date
    Oct 2009
    Posts
    2,627

    Default Re: How to obtain Domperidone

    Dr Newman will give you the name of an online pharmacy, I'm trying to remember the name but it's not too expensive and it's under the name Vomistop.

    is the link he gives, I don't know if that's OK to post here or not so I guess I'm not too surprised if this gets deleted.
    Last edited by @llli*lllkaren; May 16th, 2014 at 05:18 AM.
    Nursed my sweet daughter 3 years, 3 mos.

  7. #7

    Default Re: How to obtain Domperidone

    Quote Originally Posted by @llli*krystine View Post
    is the link he gives, I don't know if that's OK to post here or not so I guess I'm not too surprised if this gets deleted.
    Yep.

    Please don't post online pharmacy links.
    Karen
    Forums Admin

    Find an LLL Leader or Meeting | Get one-on-one help from a Leader online | Become a Member of LLLI

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  8. #8
    Join Date
    Oct 2009
    Posts
    2,627

    Default Re: How to obtain Domperidone

    Sorry, Karen, I thought it might help Dr Newman from getting too many requests but he doesn't mind.
    Nursed my sweet daughter 3 years, 3 mos.

  9. #9
    Join Date
    Dec 2011
    Posts
    365

    Default Re: How to obtain Domperidone

    Karen, I agree that mothers should be under the supervision of a qualified medical doctor when taking prescription medications, and I appreciate your concern that mothers be armed with the most complete set of information before making prescription decisions. In the interest of completeness, I am linking two documents:

    1. This is what Dr. Newman and a group of Canadian physicians say regarding domperidone use in Canada: http://www.nbci.ca/docs/Domperidone_...ay_11_2012.pdf

    2. Here is a meta-analysis on the literature published by MotherRisk at the Hospital for Sick Kids in Toronto, Canada. The source documents are available on pubmed through the link below:
    http://www.researchgate.net/publicat...trolled_trials

    However, with respect, LLL officers have to be very cautious not to be seen to be crossing into the realm of offering medical advice. I note you have posted the EMA position twice on the site this month without offering other regional perspectives on domperidone safety, a topic that is somewhat controversial. That begs the question of whether you are expressing an official LLL position on the matter, which would be outside the scope of the LLL mandate.

    Perhaps a good feature would be to invite Dr. Newman or some of his colleagues listed in the above document, as well as the EMA study authors, for an interview on the website to discuss the EMA release and the consensus statement Dr. Newman and colleagues issued. They could touch on what issues mothers should address with their physicians when all non-pharmaceutical interventions are exhausted.
    Last edited by @llli*alphawoman; May 17th, 2014 at 12:49 AM.

  10. #10

    Default Re: How to obtain Domperidone

    I posted the EMA position because it's the newest information that has come out about domperidone, but LLLI's position on all galactagogues, including domperidone, is basically to defer to the Academy of Breastfeeding Medicine:

    Academy of Breastfeeding Medicine Protocol on the Use of Galactogogues in Initiating or Augmenting the Rate of Maternal Milk Secretion

    Prior to the use of a galactogogue, thorough evaluation should be performed of the entire feeding process by a lactation expert. Reassurance may be offered, if appropriate.

    When intervention is indicated for the dyad, modifiable factors should be addressed: comfort and relaxation for the mother, frequency and thoroughness of milk removal, and underlying medical conditions. Medication should never replace evaluation and counseling on modifiable factors.

    As new evidence has emerged regarding various interventions to increase milk secretion in lactating women, the case for using pharmaceutical galactogogues has grown weaker. There remain selected indications for which some of these agents may be useful, but the data are insufficient to make definitive recommendations.

    One high-quality study has found domperidone useful in mothers of babies less than 31 weeks' gestation in the neonatal intensive care unit (see the Appendix).

    Herbal galactogogues are problematic because of lack of regulation of preparations and insufficient evidence of efficacy and safety.

    Clinicians should prescribe galactogogues with appropriate caution in regards to drug-to-drug (or drug-to-herb) interactions as well as an overall risk-to-benefit approach and complete informed consent.

    Close follow-up of both mother and baby is essential to monitor the status of lactation as well as any adverse effects of the drug(s) on mother or infant.
    Protocol Appendix information about domperidone:

    Chemical class or properties Dopamine antagonist
    Level of evidence I [good quality] (one study); other studies have inadequate methodology or excessive dropout rates
    Suggested dosage 10 mg, orally, 3 times/day in the Level I study; higher doses have not been studied in this context.
    Length/duration of therapy Started between 3 and 4 weeks postpartum and given for 14 days in the Level I study. In various other studies the range was considerable: Domperidone was started between 16 to 117 days postpartum and given for 2–14 days.
    Effects on lactation Increased rate of milk secretion for pump-dependent mothers of premature infants less than 31 weeks' gestation in neonatal intensive care unit
    Untoward effects Maternal: Dry mouth, headache (resolved with decreased dosage), and abdominal cramps. Although not reported in studies of lactation, cardiac arrhythmias due to prolonged QTc interval are a concern and are occasionally fatal. This may occur with either oral or intravenous administration and particularly with high doses, or concurrent use of drugs that inhibit domperidone's metabolism (see Interactions, immediately below). Neonatal: Very low levels in milk and no QTc prolongation in premature infants who had ingested breastmilk of mothers on domperidone
    Interactions Increased blood levels of domperidone when combined with some substrates metabolized by CYP3A4 enzyme inhibitors, e.g., fluconazole, grapefruit juice, ketoconozole, macrolide antibiotics, and others
    Comments a. Do not advise exceeding maximum recommended dosage; no increased efficacy but increased untoward effects.

    b. Generally licensed for use as drug for gastrointestinal dismotility (not in the United States), where for this indication in some regions it is accepted that if no response at the initial dose may increase the dose. Some areas use as drug of choice when prolactin stimulation is felt to be needed. However, there are no studies of the safety or efficacy of this practice in lactating women.

    c. In the United States, the FDA has issued an advisory against the use of domperidone in lactating women
    Last edited by @llli*lllkaren; May 18th, 2014 at 04:57 PM.
    Karen
    Forums Admin

    Find an LLL Leader or Meeting | Get one-on-one help from a Leader online | Become a Member of LLLI

    Feel like you need professional help? ¿Es usted necesita ayuda profesional? --> Find an International Board Certified Lactation Consultant (IBCLC) <--

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