ドンペリドン
Domperidone
Domperidone maleate
別名: Motilium · Equidone · Leisguard · Domperidonum · R-33812
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
ドンペリドンは末梢性に作用するドパミン-2 (D2) 受容体拮抗薬であり、主に消化管運動機能改善薬、制吐薬、およびプロラクチン分泌促進薬として使用されます。
主な臨床応用：
- 馬：周産期の牝馬におけるトールフェスク中毒の予防と治療、泌乳刺激（無乳症）、および馬下垂体中葉機能障害（PPID / 馬クッシング症候群）の診断薬として。
- 小動物：特に胃排空遅延を伴う疾患に対する消化管運動機能改善薬および制吐薬としての適応外使用。
臨床のポイント：メトクロプラミドとは異なり、ドンペリドンは血液脳関門を容易に通過しません。これにより、錐体外路症状（振戦、痙攣など）のような中枢神経系（CNS）の副作用リスクが大幅に軽減され、中枢作用型の運動機能改善薬に敏感な患者にとって優れた代替薬となります。
作用機序
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.
安全性・警告
禁忌
- 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
有害事象
- 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
注意事項
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.
医薬品相互作用
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.
監視
- 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
薬物動態
半減期
吸収
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.
分布
Highly bound (93%) to serum proteins. Does not readily cross the blood-brain barrier.
代謝
Primarily metabolized in the liver.
消失
Metabolites are excreted in the feces and urine.
過剰投与
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.
製品
製剤
- Oral gel
- Tablets
- Suppositories
- 10 mg tablet
- 1 mg/ml oral suspension
- 5 mg/ml oral suspension (veterinary)
動物用医薬品
- Domperidone Oral Gel 11% (110 mg/mL) in 25 mL multi-dose oral syringes (Equidone® Gel)
- Leisguard 5 mg/ml oral suspension (EU)
ヒト用医薬品
- 10 mg oral tablets (Canada/Europe)
- Oral suspension (Europe)
- Suppositories (Europe)
- Motilium 10 mg tablets
- Motilium 1 mg/ml oral suspension
規制ステータス
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.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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.
飼主向け情報
- 目的：ドンペリドンは、犬や猫の胃の排空を改善し、吐き気を軽減するために使用されます。馬では、有毒なフェスク草の摂取による合併症の予防や、授乳中の牝馬の乳汁分泌を促進するために使用されます。
- 投与方法：獣医師の指示に正確に従って投与してください。
- 人間への安全に関する警告：妊娠中および授乳中の女性は、馬用ゲル製品を取り扱う際に細心の注意を払う必要があります。全身への曝露が人間の生殖ホルモンに影響を与える可能性があります。手袋を着用し、取り扱い後は手をよく洗ってください。
- 副作用：ペットに不適切な乳汁分泌や乳房の腫れが見られることがあります。馬では、子馬が生まれる前に乳が滴り落ちることがあります。異常な無気力、痙攣、または行動の変化に気づいた場合は、獣医師に連絡してください。
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