Vomistop

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Domperidone vs metoclopramide — the practical difference

Both are D2 antagonists, but the central nervous system penetration is fundamentally different.

Γιατί να παραγγείλετε από τη MedsBase

Vomistop is supplied from a πιστοποιημένο από τη WHO-GMP κατασκευαστή. Every order ships discreetly worldwide and is covered by our Πολιτική Εγγύησης Επαναποστολής — if it does not arrive within 20 business days, we reship at no cost. Domperidone is the antiemetic of choice for nausea driven by gastric stasis and regurgitation, particularly in patients in whom metoclopramide-induced extrapyramidal reactions are a concern.

Μηχανισμός δράσης

Domperidone is a benzimidazole derivative that selectively blocks peripheral D2 dopamine receptors. Two clinically important effects flow from this:

• Prokinetic action in the gut: increases lower-oesophageal sphincter tone, accelerates gastric emptying, and improves antroduodenal coordination — useful in gastroparesis, GERD with regurgitation, and post-vagotomy syndrome.
• Antiemetic action at the chemoreceptor trigger zone: the area postrema sits outside the blood-brain barrier, so domperidone reaches it despite poor BBB penetration elsewhere — this gives antiemetic efficacy without central D2 blockade in the basal ganglia (no EPS).

It is metabolised primarily by CYP3A4, which underlies the major drug interactions.

Ενδείξεις

• Functional dyspepsia with nausea, postprandial fullness, early satiety
• Gastroparesis — diabetic, post-surgical, idiopathic; specialist supervision
• GERD with regurgitation — usually as adjunct to a PPI
• Levodopa-induced nausea in Parkinson’s disease (peripheral D2 only)
• Symptomatic nausea/vomiting from various causes (short course)
• Lactation support (off-label, jurisdiction-dependent) — via prolactin elevation

Δόση

Παρενέργειες

• Συχνές: dry mouth, headache, abdominal cramps, diarrhoea
• On prolonged use: hyperprolactinaemia → galactorrhoea, gynaecomastia, menstrual disturbance, sexual dysfunction
• Λιγότερο συχνές: drowsiness, rash, asthenia
• Σπάνιες αλλά σοβαρές: QT prolongation/torsades, severe arrhythmia (especially with dose > 30 mg/day, age > 60, electrolyte disturbance, or strong CYP3A4 inhibitors)
• Very rare: extrapyramidal reactions (more likely in children, neonates, and at high doses)

Αλληλεπιδράσεις φαρμάκων

• Φάρμακα που επιμηκύνουν το QT (azithromycin, fluoroquinolones, citalopram, escitalopram, methadone, ondansetron, antipsychotics, hydroxychloroquine): avoid combination.
• Ισχυροί αναστολείς CYP3A4 (clarithromycin, ketoconazole, itraconazole, ritonavir, grapefruit juice): increase domperidone exposure 4–8 fold — avoid.
• Levodopa, dopamine agonists: peripheral D2 antagonism is intentional in Parkinson’s nausea; central effect is minimal at standard doses but caution in advanced disease.
• Anticholinergics (atropine, hyoscine, oxybutynin): may antagonise the prokinetic effect.
• Bromocriptine, cabergoline: domperidone may reduce the prolactin-lowering effect via competing peripheral D2 blockade.

Συχνές Ερωτήσεις

How quickly does Vomistop work?

Onset is typically 30–60 minutes after a dose taken before meals. The prokinetic effect (faster gastric emptying) often comes within an hour of the first dose; full antiemetic effect after 1–2 days of regular dosing.

Why is Vomistop restricted to 7 days?

Following a 2014 European review of cardiac safety data, the EMA restricted domperidone to short-course symptomatic treatment of nausea/vomiting (max 7 days, 30 mg/day) due to a small but real risk of QT prolongation and serious arrhythmia, particularly in older adults and patients on QT-prolonging or CYP3A4-inhibiting drugs. Longer courses (gastroparesis, GERD) require specialist review and ECG monitoring.

Can I take Vomistop in pregnancy?

Limited human data. First-line for nausea-vomiting of pregnancy is doxylamine + B6 (Doxinate, Pregnidoxin NU). Domperidone is not first-line and should be discussed with a clinician.

Does Vomistop cause sedation?

Sedation is uncommon at standard doses because domperidone does not cross the blood-brain barrier appreciably. This is its main advantage over metoclopramide.

Is Vomistop safe for breastfeeding?

Some clinicians use domperidone off-label as a galactagogue (milk-supply support) via its prolactin-elevating effect. This use is jurisdiction-dependent and not approved by the FDA. Discuss with a lactation specialist.

Can I take Vomistop for chemotherapy nausea?

5-HT3 antagonists (ondansetron, granisetron) ± dexamethasone ± aprepitant are first-line for CINV. Domperidone is sometimes used as a breakthrough agent but is not the primary choice.

Why is Vomistop avoided in Parkinson’s disease?

All D2 antagonists can worsen Parkinson’s motor symptoms by blocking the dopaminergic pathways of the nigrostriatal system. Domperidone has the lowest central penetration of the D2 antiemetics, so a low dose can sometimes be used to control levodopa-induced nausea — under specialist supervision only.

Τι γίνεται αν χάσω μια δόση;

Take the next dose at the next planned time before a meal — do not double up. Doses are typically tied to meal times (15–30 minutes before).

Can I drink alcohol with Vomistop?

Occasional small amounts are unlikely to interact pharmacologically. Heavy alcohol can worsen reflux, gastritis, and nausea, and may increase QT prolongation risk — avoid during the course.

How is Vomistop stored?

Store tablets at room temperature (below 30°C), protected from light and moisture. Keep out of reach of children. Do not use after the expiry date printed on the carton.

Other Nausea Treatments

• Dompewal Tablet (domperidone — alternative brand)
• Metopar (paracetamol + metoclopramide — migraine nausea)
• Ondem (ondansetron — serotonin-driven nausea)
• Stemetil MD (prochlorperazine ODT — vestibular)
• Doxinate (doxylamine + B6 — pregnancy nausea)
• Browse all Nausea Treatments

More options in Nausea Treatment

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Κιτ Ιατρικής Έκτακτης Ανάγκης

US$189.00 – US$1,020.00Prijsbereik: US$189.00 tot US$1,020.00

Doxinate

US$11.00 – US$117.00Prijsbereik: US$11.00 tot US$117.00

Granicip

US$11.20 – US$32.00Prijsbereik: US$11.20 tot US$32.00

Dompewal Tablet

US$14.00 – US$62.00Prijsbereik: US$14.00 tot US$62.00