Gastroparesis and Domperidone

[MikeF]

Any of you Dopers suffer from GP and use this drug? How’d it go? Its not available in the U.S. unless your doc uses an “investigative” loophole. As an unapproved drug, I assume this means insurance doesn’t cover it. How much does it cost? My adult daughter has GP and, apparently, her doc told her to not consider this drug as it can lead to neurological issues. The little I’ve read seems to say that this is not the case. In fact, the lack of this side effect is why its used in place of metoclopramide. It may cause cardiac arrhythmias which is a concern as she is on a low dose of Lopressor for idiopathic tachycardia. This is a very frustrating disease to deal with.

[ZipperJJ]

I’ve got GP but don’t have it bad enough to take pills for it. I have a bottle of metoclopramide but I read the possible side effects and decided it just wasn’t worth it, so I’ve never taken it. Lucky for me I can use non-drug methods to make myself feel better, like chewing gum, drinking pineapple juice or just eating less.

I’ve read about how GP is for people who have it worse than me. It must be a constant struggle for your daughter, I can sympathize that she wants more relief. Sorry I don’t have any insight on Domperidone.

[Qadgop_the_Mercotan]

The studies on domperidone have been small and have been considered to be somewhat flawed methodologically. (A systematic review of the efficacy of domperidone for the treatment of diabetic gastroparesis - PubMed), hence the lack of approval in the US thus far.

CONCLUSIONS Overall, our assessment is that there is level 3 evidence for the efficacy of domperidone in diabetic gastroparesis, leading to a grade C recommendation for its use in this condition. These results need to be interpreted very cautiously because of significant methodologic limitations of these studies, including the fact that most positive studies lacked a control arm. It is clear that larger and better-designed studies are needed to further validate the use of this drug in diabetic gastroparesis.

Since studies are ongoing, I’d wait for more info before prescribing it, or taking it myself. Current evidence indicates lots of interactions with other meds along with potential cardiac conductivity issues.

I’d consider metoclopramide (reglan) to be less risky, based on the info available. It’s true that tardive dyskinesias are a concern, but they’re a relatively low risk. I’d consider a trial of reglan to be an acceptable risk for someone with gastroparesis symptoms severe enough to disrupt their daily functioning. But that’s just me, each patient needs to decide on the risks they want to take.

Good luck!