돔페리돈
Domperidone
Domperidone maleate
다른 이름: Motilium · Equidone · Leisguard · Domperidonum · R-33812
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
돔페리돈은 말초에서 작용하는 도파민-2 (D2) 수용체 길항제로, 주로 위장관 운동 촉진제, 항구토제 및 프로락틴 분비 촉진제로 사용됩니다.
주요 임상 적용:
- 말: 분만 전후 암말의 톨 페스큐(tall fescue) 중독 예방 및 치료, 유즙 분비 촉진(무유증), 말 뇌하수체 중엽 기능 장애(PPID / 말 쿠싱 증후군)의 진단 보조제.
- 소동물: 위 배출 지연을 동반하는 질환에 위장관 운동 촉진 및 항구토 목적으로 허가 외(off-label) 사용.
임상 요점: 메토클로프라미드와 달리 돔페리돈은 혈액-뇌 장벽(BBB)을 쉽게 통과하지 못합니다. 이는 추체외로 증상(떨림, 경련)과 같은 중추신경계(CNS) 부작용 위험을 크게 줄여주어, 중추 작용성 위장관 촉진제에 민감한 환자에게 훌륭한 대안이 됩니다.
작용 기전
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.
안전성·주의사항
금기사항
- 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
부작용
- 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
주의
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.
약물 상호작용
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.
모니터링
- 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
약동학
반감기
흡수
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.
분포
Highly bound (93%) to serum proteins. Does not readily cross the blood-brain barrier.
대사
Primarily metabolized in the liver.
배설
Metabolites are excreted in the feces and urine.
과다투여
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.
제품
제형
- Oral gel
- Tablets
- Suppositories
- 10 mg tablet
- 1 mg/ml oral suspension
- 5 mg/ml oral suspension (veterinary)
동물용의약품
- Domperidone Oral Gel 11% (110 mg/mL) in 25 mL multi-dose oral syringes (Equidone® Gel)
- Leisguard 5 mg/ml oral suspension (EU)
인용의약품
- 10 mg oral tablets (Canada/Europe)
- Oral suspension (Europe)
- Suppositories (Europe)
- Motilium 10 mg tablets
- Motilium 1 mg/ml oral suspension
규제 현황
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.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
- 목적: 돔페리돈은 개와 고양이의 위 배출을 돕고 메스꺼움을 줄이는 데 사용됩니다. 말에서는 독성이 있는 페스큐 풀 섭취로 인한 합병증을 예방하고 수유 중인 암말의 젖 분비를 촉진하는 데 사용됩니다.
- 투여 방법: 수의사의 지시에 따라 정확하게 투여하십시오.
- 인체 안전 경고: 임신 및 수유 중인 여성은 말용 겔 제품을 취급할 때 각별히 주의해야 합니다. 전신 노출 시 인체의 생식 호르몬에 영향을 미칠 수 있습니다. 장갑을 착용하고 취급 후에는 손을 깨끗이 씻으십시오.
- 부작용: 반려동물에서 비정상적인 젖 분비나 유방 비대가 관찰될 수 있습니다. 말의 경우 망아지가 태어나기 전에 젖이 떨어질 수 있습니다. 비정상적인 무기력증, 경련 또는 행동 변화를 발견하면 수의사에게 연락하십시오.
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