Enarei

Domperidone

Domperidone is a nausea medication that is most commonly used by trans people to cause lactation (the secretion of breast milk), for example to breastfeed a baby.

Domperidone can be used by any trans person who has breasts, regardless of sex assigned at birth. It is usually combined with other hormonal and physical interventions (such as breast pumps), for example as a part of the Zil Goldstein protocol (Trautner, McCool-Myers, & Joyner, 2020; Reisman & Goldstein, 2018).

Key points

  • Used to induce lactation
  • May increase the risk of heart problems while used
  • May increase the risk of psychological problems when stopped
  • Intended for short-term use; may have further negative health effects if used long-term

Dosing

Domperidone is most commonly a pill that is swallowed. It is most commonly used at a dose of 10 mg three to four times daily. In some cases, much higher dosages, such as 20-30 mg three to four times daily have been used. Domperidone is usually used only temporarily, for several weeks-months. (Wan et al., 2008; Knoppert et al., 2013)

Risks & management

Conflicting evidence suggests domperidone could increase the risk of several heart problems, including fatal heart attacks. Caution is advisable in people who have known heart problems (Leelakanok, Holcombe & Schweizer, 2016; Buffery & Strother, 2015).

Domperidone may cause psychiatric side effects like difficulty sleeping and depression when stopped (Majdinasab et al., 2022).

Domperidone is usually used temporarily, for several weeks-months. Using it longer may have several negative health effects as a result of hyperprolactinemia (Yun et al., 2024).

Most commonly, domperidone has only mild side effects, including dry mouth and temporary breast pain, tenderness, and enlargement that go away when the medication is stopped (Henderson, 2003).

Interactions

Domperidone may interact dangerously with various antibiotics, antifungal medications and epilepsy medications, as well as grapefruit and green tea extract (Chen & Hsiao, 2015). A partial list can found here.

Other information

Domperidone is expected to significantly increase prolactin levels while used (Reddymasu, Soykan, & McCallum, 2007; Henderson, 2003).

Domperidone cannot be prescribed for lactation in the United States because it is not approved by the FDA.

Domperidone is also called "Domstal", "Domton", "Molax-M", "Motilak", "Motilium", "Vomistop", "Passagex", or simply "domp".

See also

References

  • Buffery, P. J., & Strother, R. M. (2015). Domperidone safety: a mini-review of the science of QT prolongation and clinical implications of recent global regulatory recommendations. The New Zealand medical journal, 128(1416), 66–74. [PubMed]
  • Chen, H. L., & Hsiao, F. Y. (2015). Domperidone, cytochrome P450 3A4 isoenzyme inhibitors and ventricular arrhythmia: a nationwide case-crossover study. Pharmacoepidemiology and drug safety, 24(8), 841–848. [DOI:10.1002/pds.3814]
  • Henderson A. (2003). Domperidone. Discovering new choices for lactating mothers. AWHONN lifelines, 7(1), 54–60. [DOI:10.1177/1091592303251726]
  • Knoppert, D. C., Page, A., Warren, J., Seabrook, J. A., Carr, M., Angelini, M., Killick, D., & Dasilva, O. P. (2013). The effect of two different domperidone doses on maternal milk production. Journal of human lactation : official journal of International Lactation Consultant Association, 29(1), 38–44. [DOI:10.1177/0890334412438961]
  • Leelakanok, N., Holcombe, A., & Schweizer, M. L. (2016). Domperidone and Risk of Ventricular Arrhythmia and Cardiac Death: A Systematic Review and Meta-analysis. Clinical drug investigation, 36(2), 97–107. [DOI:10.1007/s40261-015-0360-0]
  • Majdinasab, E., Haque, S., Stark, A., Krutsch, K., & Hale, T. W. (2022). Psychiatric Manifestations of Withdrawal Following Domperidone Used as a Galactagogue. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 17(12), 1018–1024. [DOI:10.1089/bfm.2022.0190]
  • Reddymasu, S. C., Soykan, I., & McCallum, R. W. (2007). Domperidone: review of pharmacology and clinical applications in gastroenterology. The American journal of gastroenterology, 102(9), 2036–2045. [DOI:10.1111/j.1572-0241.2007.01255.x]
  • Reisman, T., & Goldstein, Z. (2018). Case Report: Induced Lactation in a Transgender Woman. Transgender health, 3(1), 24–26. [DOI:10.1089/trgh.2017.0044]
  • Trautner, E., McCool-Myers, M., & Joyner, A. B. (2020). Knowledge and practice of induction of lactation in trans women among professionals working in trans health. International breastfeeding journal, 15(1), 63. [DOI:10.1186/s13006-020-00308-6]
  • Wan, E. W., Davey, K., Page-Sharp, M., Hartmann, P. E., Simmer, K., & Ilett, K. F. (2008). Dose-effect study of domperidone as a galactagogue in preterm mothers with insufficient milk supply, and its transfer into milk. British journal of clinical pharmacology, 66(2), 283–289. [DOI:10.1111/j.1365-2125.2008.03207.x]
  • Yun, S. J., Sang, H., Park, S. Y., & Chin, S. O. (2024). Effect of Hyperprolactinemia on Bone Metabolism: Focusing on Osteopenia/Osteoporosis. International journal of molecular sciences, 25(3), 1474. [DOI:10.3390/ijms25031474]