Okay, actually, two questions. The first one is, “Are there any Canadian doctor Dopers?”
Here’s a lead-in to question #2. Please understand that it is not intended to be taken as a request for medical advice.
kaylasmom, who has type-2 diabetes, is suffering from gastroparesis as a result of diabetic neuropathy. Her gastroenterologists have tried relieving her symptoms with, first, erythromycin; and second, metoclopramide (trade-named Reglan). The general idea is that these drugs have the effect of increasing gastric motility. However, they have not proven to be effective in kaylasmom’s case.
Last month, she went to see another GE, with the hope that since these drugs have not worked as desired, she could be evaluated for implantation of a gastric pacemeker. The GE came into the office and regretfully informed her that the facility we were using has no program for the use of this device, but she did sugggest that if erythromycin and Reglan were ineffective, she might try domperidone. She wrote kaylasmom a prescription for one 10mg tablet daily, and advised us on how to find an online pharmacy that would fill the scrip.
The meds arrived in the mail yesterday, and the patient information sheet with them gave a radically different suggestion for the dosage (one pill, 3X daily, half an hour preprandial). The sheet indicated that this was for “chronic conditions (mainly dyspepsia)”.
So my question to the Canadian M.D.s is: What is the standard adult dose for treating gastroparesis (as opposed to dyspepsia) with domperidone? Was our American doctor prescribing according to the manufacturer’s recommendation for this drug, or is it likely that she was simply being extra cautious about a medication that she has little experience with?
I’ve placed a call to her in the clinic, by the way, but she has not yet responded. We will, of course be basing our actions on our local doctor’s recommendations, but it would be nice to hear what the Canadian medicos do with this stuff.
Thanks in advance for any replies.