Omeprazole + Domperidone
Indications
Omeprazole + Domperidone is used for:
Dyspepsia, Gastro-oesophageal reflux disease
Adult Dose
Oral
Dyspepsia, Gastro-oesophageal reflux disease
Adult: 1 cap bid or as directed by the physician.
Child Dose
Renal Dose
Administration
Contra Indications
Pregnancy. Domperidone is contraindicated in conditions associated with rise in prolactin level. Omeprazole is contraindicated in hypersensitive patients.
Precautions
Domperidone can cause a rise in serum prolactin level resulting in galactorrhoea in females and less frequently gynaecomastia in males. Hypertensive crisis may occur in patients with phaeochromocytoma. Renal impairment or those at risk of fluid retention. Hepatic impairment; elderly. Exclude the possibility of malignancy if gastric ulcer is suspected, before initiating treatment with omeprazole, it may mask symptoms and delay diagnosis. Monitor patients on warfarin or phenytoin therapy, reduce dose if necessary.
Pregnancy-Lactation
Interactions
Anticholinergics may antagonize beneficial effects of domperidone in reflux oesophagitis and dyspepsia. Decreased bioavailability of domperidone after prior admin of cimetidine or Na bicarbonate. Delayed elimination of diazepam, phenytoin and warfarin with omeprazole.
Adverse Effects
Side effects of Omeprazole + Domperidone :
Domperidone: Dry mouth, transient skin rash, itching, headache, diarrhoea and rarely nervousness. Omeprazole: Anaemia, eosinopaenia, urinary tract infection, skin rash, urticaria and pruritus, diarrhoea, headache, constipation, nausea, vomiting, flatulence and abdominal pain, dizziness and lightheadedness, somnolence, insomnia and vertigo, reversible confusion, agitation, depression and hallucinations, arthritic and myalgic symptoms.
Mechanism of Action
Domperidone is a peripheral dopamine D2-receptor antagonist, which regulates the motility of gastric and small intestinal smooth muscle. It increases the duration of antral and duodenal contractions and also LES resting pressure, thus stimulating gastric emptying and is also effective in relief of symptoms of reflux esophagitis. Antiemetic activity is due to the blockade of dopamine receptors in the chemoreceptor trigger zone.
Omeprazole inhibits the secretion of gastric acid by irreversibly blocking the enzyme system of H+/K+ ATPase of the gastric parietal cell. It is activated at an acidic pH to a sulphenamide derivative that binds irreversibly to H+/K+ ATPase, an enzyme system found at the secretory surface of parietal cells. It thereby inhibits the final transport of hydrogen ions (via exchange with K ions) into the gastric lumen.