Motilium pharmacological action
Motilium prevents the emetic effect, reduces or eliminates the hiccups and nausea. At the same it contributes to normalization of the motility of the gastrointestinal tract under the influence of dopamine, the active ingredient, blocking the digestive tract. The principle of its operation is largely similar to metoclopramide, but at the same the remedy penetrates through the blood-brain barrier that separates the tissue and bloodstream, thereby the substance has a number of advantages, because it does not lead to extrapyramidal disorders. In this case no violation of coordination of movements or shaking of the limbs take place.
The preparation has an antiemetic effect by affecting the central nervous system and blocking dopamine receptors. Preventing the vomit reflex occurs as a consequence of a combination of properties and inhibition of gastrokinetic annoying dopamine nerve endings located in the chemoreceptors of the brain. An increase of pressure in the esophagus after ingestion of the drug is observed, facilitating the emptying of the stomach cavity and the antroduodenal motility accelerated at the same time. The acceleration does not affect the cure of gastric secretion.
Domperidone is valued for its fast absorption, while its plasma concentration increases for half an hour or an hour. The first material goes through the liver cells. If there is a relatively gastrointestinal discomfort, the preparation is not recommended to be taken earlier than half an hour before meals. If there is a low acidity (gastric juice), the adsorption of the drug is broken. If taken simultaneously with cimetidine and sodium bicarbonate, the first effect is reduced, while the complete absorption of the drug takes more time. The remedy gets in contact with plasma protein, it is distributed in organs and tissues; it can penetrate into breast milk, but at the same time, the blood-brain barrier represents a solid obstacle. This substance is metabolized in the gut and the liver cells. The remedy is derived from the gut within seven or nine hours.
The medication should be taken fifteen or twenty minutes before meals with plenty of water. It is not desirable to replace the water by a tea or milk, as well as carbonated beverages, because of potential reduction of the effect. Adults and children whose weight does not exceed thirty-five pounds, can take one or two tablets three or four times a day. The largest dose of the substance must not exceed 80 mg per day, while the course of the drug must not exceed one month. At the same time, the physician may continue the therapy indicated. Patients with renal insufficiency should not take the medicine more than twice a day, in some cases – not more than once.
According to reviews of, the use of the drug is rarely complicated by the development of side effects, but sometimes during the treatment may occur spastic pain in the abdominal area, as well as allergic reactions and extrapyramidal disorders.
In some cases, domperidone became the cause of such disorders as:
• increase the level of prolactin in blood plasma;
• dryness of the oral mucosa;
• menstrual irregularities;
• decreased libido.
Domperidone is not recommended for persons with individual intolerance to the components that go into tablets.
Domperidone is not applicable in the treatment of patients with intestinal obstruction, a marked reduction in the kidneys and liver, prolactinoma, as well as a treatment for gastric perforation and active gastrointestinal bleeding. It is also not recommended to use Motilium for the prevention and treatment of postoperative vomiting.