26/01/2018
Domperidone and heart rhythm disturbances
Infant reflux can be treated with medication in four ways:
• Thickeners
• H2-blockers such as Ranitidine
• Proton pump inhibitors such as omeprazole, esoprazole and lansoprazole
• Prokinetic agents – domperidone
Domperidone is infrequently used because of concerns about prolongation of the heart electrical circuits which might predispose to life-threatening cardiac rhythm disturbances – something seen in older adult patients with concomitant other illnesses and on multiple other medications. No one knows whether this domperidone effect on the heart occurs in otherwise healthy young infants, but just in case it might this useful, effective drug is hardly now prescribed for infants with reflux.
Doctors in Thailand have therefore examined electrocardiograms before and after giving domperidone to a group of infants with reflux. The answer: domperidone given alone did not affect the ECG, whereas domperidone given with lansoprazole did lengthen the heart’s electrical impulses in a minority.
Conclusion: domperidone is safe to use on it’s own in infants, and probably is safe if the baby is taking other medication, but best to check an ECG if baby is taking it with other drugs.
Pediatr Neonatol. 2016 Feb;57(1):60-4. doi: 10.1016/j.pedneo.2015.03.015. Epub 2015 Jun 4. Research Support, Non-U.S. Gov't