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Herzl Family Practice Centre, Goldfarb Breastfeeding Clinic © February 2023

Herzl Family Practice Centre, Goldfarb Breastfeeding Clinic

Domperidone

Patient Handout

What is domperidone?

 Domperidone is a pill that can increase breastmilk by increasing your levels of prolactin (the

hormone responsible for milk production).

 This pill was originally developed for stomach problems such as reflux and nausea. However, it

is also used widely in breastfeeding mothers to improve breastmilk production.

 It is used “off label” when used for lactation.

Who needs it?

1. Domperidone is not for everyone. There are specific indications for this medication.

2. If you feel you do not have enough milk, you should first see a lactation consultant and/or doctor.

3. It is important to try other ways of increasing milk production first (without pills).

4. Other medical problems may need to be treated first.

Is domperidone safe?

 Domperidone has been studied and shown to be safe and effective.

 It has been used safely for many years in Canada, Australia and Europe.

 Domperidone has been approved by Health Canada for use in children and adults for stomach

problems. In fact, the dose received by the infant through breastmilk is far less than the dose

given to children.

Herzl Family Practice Centre, Goldfarb Breastfeeding Clinic © February 2023

What to be careful about when taking domperidone:

Domperidone, like all medicine, may have side effects and risks.

Domperidone is one of the many medications that can affect the electrical conduction of the heart. In

2012, Health Canada endorsed an update on domperidone noting again the extremely rare risk of cardiac

side effects (arrhythmia or cardiac arrest) in patients taking higher doses of domperidone. There has

never been a documented case of cardiac problems associated with domperidone use in our

Breastfeeding Clinic. However, if you experience chest pain or palpitations stop the medication and

contact the breastfeeding clinic. If the symptoms persist see a doctor immediately. If you have had any

of the following conditions, you should discuss this with a doctor before starting domperidone:

 History of bowel or colon surgery.

 Gastrointestinal conditions causing problems with digestion or absorption.

 Heart conditions causing chest pain, shortness of breath, palpitations, fainting or dizzy spells or

if you have been diagnosed with having long QT waves.

 A family history of heart problems, unexplained fainting or sudden death.

 History of heart surgery.

 A brain tumor (prolactinoma) causing increased prolactin.

 Any mental health disease or psychiatric history.

Domperidone can interact with other medication. It is important that you tell your doctor or pharmacy

you are taking domperidone before you are given any medication.

Medications that may interact with domperidone:

 Cisapride (Propulsid)

 Medications used to treat fungal infections or thrush, i.e. fluconazole (Diflucan)

 Some antibiotics, i.e. ciprofloxacin (Cipro), levofloxacin (Levaquin), erythromycin, and

azythromycine (Zithromax).

 Grapefruit and its juice (and possibly grapefruit seed extract).

 Some antidepressants, i.e. amitriptyline (Elavil), nortriptyline (Aventyl), fluoxetine

(Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and flovoxamine

(Luvox).

 Lithium (absolute contraindication).

 Some HIV medication (such as ritonavir (Norvir/Kaletra ))

 Some antipsychotics (such as thioridazine (Mellaril) and mesoridazine (Serentil)).

Herzl Family Practice Centre, Goldfarb Breastfeeding Clinic © February 2023

 Some anti-arrhythmics: Class IA (quinidine, procainamide, disopyramide/Rythmodan), class II and class

III (solatol/Sotacor, amiodarone/Cordarone, bretylium/Bretylate).

 Other medications not on this list may also potentially interact with domperidone.

How to take domperidone:

 Usually, you will be asked to start domperidone at a dose of 10 mg (or 1 pill) 3 times a day. The

dose may be increased based on your case.

 Domperidone does not have to be taken before meals when used for milk production. It can be

taken with meals or at any other time.

 You may feel an increase in milk production anywhere from 2 -3 days to 2-3 weeks after starting

domperidone.

 Domperidone is a long-term medication. You have to take it continuously for at least 3 to 8 weeks

for it to have its full effect. Most mothers take it for a few months, and then decrease and stop

it gradually after discussing with their health professional. You will be followed at the

Breastfeeding Clinic regularly while you are taking domperidone.

 It is important to continue pumping and putting the baby to the breast as often as possible while

on domperidone. Domperidone does not act alone. It is helped by breast stimulation. If the

breasts are not stimulated, domperidone will not be able to work as well.

 You may continue taking herbs along with domperidone, if you feel herbs are helping as well.

 Domperidone should be stopped gradually and not suddenly, even if you have stopped

breastfeeding, to avoid any withdrawal effects, including rare psychological symptoms.

Side effects:

The following side effects are not very common, and usually improve after a week:

 Headache ▪ Fatigue

 Dry mouth ▪ Weight gain

 Dizziness ▪ Increased appetite

 Diarrhea (or change in bowel movements) ▪ Abdominal cramps

The information contained in this patient handout is a suggestion only and is not a substitute for consultation with a health professional or lactation specialist.

This handout is the property of the author(s) and the Goldfarb Breastfeeding Clinic. No part of this handout can be changed or modified without permission

from the author and the Goldfarb Breastfeeding Clinic. This handout may be copied and distributed without further permission on the condition that it is not

used in any context in which the International Code for the Marketing of Breastmilk Substitutes is violated. For more information, please contact the Herzl-