Domperidona
Domperidone
Domperidone maleate
También conocido como: Motilium · Equidone · Leisguard · Domperidonum · R-33812
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a prokinetic agent | 0.05-0.1 mg/kg PO once or twice a day | PO | q12-24h | — | 🌎 NA |
| For vomiting due to gastritis | 2-5 mg (total dose) PO two to three times a day | PO | q8-12h | — | 🌎 NA |
| Antiemetic / Prokinetic | 0.1 - 0.5 mg/kg | PO | q8h-q12h | As needed | 🌍 EU |
| Leishmaniasis (Treatment and Prevention) | 0.5 mg/kg | PO | sid | 28 days | 🌍 EU |
- As a prokinetic agent: Scant clinical experience; suggested dose based upon experimental data.
- Antiemetic / Prokinetic: Administer 15-30 minutes before feeding.
- Leishmaniasis (Treatment and Prevention): For prevention, the 28-day course can be repeated every 3-4 months depending on infection risk.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a prokinetic agent | 0.05-0.1 mg/kg PO once or twice a day | PO | q12-24h | — | 🌎 NA |
| Antiemetic / Prokinetic | 0.1 - 0.5 mg/kg | PO | q8h-q12h | As needed | 🌍 EU |
- As a prokinetic agent: Scant clinical experience; suggested dose based upon experimental data.
- Antiemetic / Prokinetic: Administer 15-30 minutes before feeding.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For fescue toxicity | 1.1 mg/kg PO once daily starting 10 to 15 days prior to Expected Foaling Date (EFD) | PO | q24h | Up to 5 days after foaling if inadequate milk | 🌎 NA |
- For fescue toxicity: Treatment may be continued for up to 5 days after foaling if mares are not producing adequate milk.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La domperidona es un antagonista de los receptores de dopamina-2 (D2) de acción periférica, utilizado principalmente como agente procinético gastrointestinal y antiemético, así como estimulante de la liberación de prolactina.
Las aplicaciones clínicas clave incluyen:
- Equinos: Prevención y tratamiento de la toxicosis por festuca alta en yeguas periparturientas, estimulación de la lactancia (agalactia) y como agente diagnóstico para la disfunción de la pars intermedia de la hipófisis equina (PPID / Cushing equino).
- Pequeños animales: Utilizado fuera de etiqueta (off-label) como procinético y antiemético, particularmente para afecciones que involucran un vaciado gástrico retardado.
Perla clínica: A diferencia de la metoclopramida, la domperidona no atraviesa fácilmente la barrera hematoencefálica. Esto reduce significativamente el riesgo de efectos secundarios en el sistema nervioso central (SNC), tales como signos extrapiramidales (temblores, espasmos), lo que la convierte en una alternativa atractiva para pacientes sensibles a los procinéticos de acción central.
Mecanismo de acción
Domperidone exerts its effects through multiple pathways:
- Dopamine-2 (D2) Receptor Antagonism in the GI tract → enhances gastric motility and accelerates gastric emptying (prokinetic effect).
- D2 Receptor Antagonism in the Chemoreceptor Trigger Zone (CRTZ) → blocks emetic signaling (antiemetic effect). Because the CRTZ lacks a complete blood-brain barrier, domperidone can act here without entering the deeper CNS.
- Alpha-2 and Beta-2 Adrenergic Receptor Antagonism → provides additional modulatory effects on stomach motility.
- Pituitary Gland Disinhibition → Dopamine normally inhibits prolactin release. By blocking dopamine receptors, domperidone → increases prolactin secretion → stimulates milk production (galactagogue effect). This directly counteracts the dopamine-mimetic alkaloids found in toxic tall fescue.
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to domperidone
- Presence or suspicion of gastrointestinal obstruction, perforation, or hemorrhage
- Pregnant mares >15 days prior to expected foaling date (unless specifically managed)
- Horses intended for human consumption
- Gastrointestinal hemorrhage
- Mechanical GI obstruction or perforation
- Prolactin-secreting pituitary tumors (prolactinomas)
- Known hypersensitivity to the drug
Efectos adversos
- Galactorrhea (inappropriate milk production)
- Gynecomastia
- Premature lactation in horses (dripping milk prior to foaling)
- Failure of passive transfer in foals
- Rarely: somnolence or dystonic reactions
- Arrhythmias (associated with withdrawn injectable human products, especially with hypokalemia or heart disease)
- Galactorrhea (milk production in females)
- Mammary gland hyperplasia
- Changes in estrus cycle
- Mild gastrointestinal upset
Precauciones
MDR1 Mutation Warning: Domperidone is potentially a neurotoxic substrate of P-glycoprotein. Use with extreme caution in herding breeds (e.g., Collies, Australian Shepherds) that may possess the MDR1 (ABCB1) gene mutation causing a nonfunctional blood-brain barrier efflux pump.
- Foal Immunity: In horses, failure of passive transfer of immunoglobulins (IgG) may occur even without visible leakage of colostrum. All foals born to treated mares must be tested for serum IgG concentrations.
- Reproductive Impact: May lead to premature birth, low birth weight, or foal morbidity if administered >15 days prior to the expected foaling date. Accurate breeding dates are essential.
- Laboratory Alterations: May increase serum prolactin, ALT, and AST. Can cause false-positive results on milk calcium tests used to predict foaling.
Interacciones farmacológicas
May increase domperidone levels due to metabolic inhibition.
May reduce the gastrointestinal prokinetic efficacy of domperidone.
Domperidone may antagonize their dopamine-agonist effects on prolactin.
May increase domperidone levels.
May reduce the gastrointestinal prokinetic efficacy of domperidone.
Domperidone may alter the absorptive characteristics of these drugs by decreasing GI transit times.
May decrease the oral absorption of domperidone
May decrease the oral absorption of domperidone due to altered gastric pH
Inhibits CYP3A4 metabolism of domperidone, potentially increasing plasma concentrations and risk of QT prolongation
Inhibits CYP3A4 metabolism of domperidone, increasing plasma concentrations.
May antagonize the gastrokinetic effects of domperidone.
Increase gastric pH, which may decrease the oral absorption of domperidone. Administer at least 2 hours apart.
Monitorización
- Clinical efficacy (resolution of vomiting, improved gastric emptying, or adequate milk production)
- Serum IgG concentrations in foals born to treated mares
- Serum prolactin levels (if indicated)
- Resolution of nausea and vomiting
- Improvement in clinical signs of Leishmaniasis (if used for this indication)
- Signs of galactorrhea, mammary enlargement, or false pregnancy in females
Farmacocinética
Vida media
Absorción
Absorbed from the GI tract, but bioavailability in dogs is low (~20%) due to a high first-pass effect. Peak serum levels occur about 2 hours after oral dosing.
Distribución
Highly bound (93%) to serum proteins. Does not readily cross the blood-brain barrier.
Metabolismo
Primarily metabolized in the liver.
Eliminación
Metabolites are excreted in the feces and urine.
Sobredosis
There is no specific antidote for a domperidone overdose.
- Employ standard gastrointestinal decontamination procedures if ingestion is recent and the patient is asymptomatic.
- Provide supportive and symptomatic care as needed. Monitor for potential neurological signs (especially in MDR1-mutant dogs) or gastrointestinal upset.
Productos disponibles
Formulaciones
- Oral gel
- Tablets
- Suppositories
- 10 mg tablet
- 1 mg/ml oral suspension
- 5 mg/ml oral suspension (veterinary)
Veterinario
- Domperidone Oral Gel 11% (110 mg/mL) in 25 mL multi-dose oral syringes (Equidone® Gel)
- Leisguard 5 mg/ml oral suspension (EU)
Etiquetado para humanos
- 10 mg oral tablets (Canada/Europe)
- Oral suspension (Europe)
- Suppositories (Europe)
- Motilium 10 mg tablets
- Motilium 1 mg/ml oral suspension
Estado regulador
Approved for veterinary use in several EU countries specifically for the management of canine leishmaniasis (e.g., Leisguard).
Human formulations (POM) are used under the prescribing cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Domperidone gel should be stored at controlled room temperature 25°C (77°F) with excursions between 15°-30°C (59°-86°F) permitted. Recap after each use. Domperidone tablets should be stored at room temperature and protected from light and moisture.
Información para el cliente
- Propósito: La domperidona se utiliza para mejorar el vaciado estomacal y reducir las náuseas en perros y gatos. En caballos, se usa para prevenir complicaciones por la ingestión de pasto festuca tóxico y para estimular la producción de leche en madres lactantes.
- Administración: Administre exactamente según las indicaciones de su veterinario.
- Advertencia de seguridad para humanos: Las mujeres embarazadas o en período de lactancia deben tener extrema precaución al manipular el producto en gel para equinos, ya que la exposición sistémica puede afectar las hormonas reproductivas humanas. Use guantes y lávese bien las manos.
- Efectos secundarios: Puede notar una producción de leche inapropiada o agrandamiento de las mamas en las mascotas. En caballos, la leche puede gotear antes de que nazca el potro. Comuníquese con su veterinario si nota letargo inusual, espasmos o cambios en el comportamiento.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.