Abstract
Purpose
Domperidone is thought to accelerate gastric emptying via D2 receptor antagonism at the gastro-oesophageal and gastro-duodenal junctions. Listed in the BNF as a prokinetic anti-emetic, it has been used in video capsule endoscopy (VCE) to accelerate capsule delivery to the small intestine. We audited VCEs performed at UHCW from 2011, when as standard practice, domperidone was given pre-VCE, to 2012, after its discontinuation due to doubts about its effectiveness.
Methods
Thirty-one patients received oral domperidone 20 mg pre-VCE. Thirty-three patients underwent VCE without domperidone pre-treatment. After 2 h, if the capsule remained intra-gastric, gastroscopy-assisted duodenal delivery was performed. Data was analysed using Mann-Whitney testing.
Results
Median oro-duodenal transit was 13 and 30 min in the untreated and domperidone groups, respectively (p = 0.01). Median oro-caecal transit was 242 and 267 min in the untreated and domperidone groups, respectively (p = 0.02). No difference in duodenal-caecal transit was seen (p = 0.60). Six percent of untreated and 13% of domperidone VCEs required gastroscopy-assisted duodenal capsule delivery (p = 0.65).
Conclusions
Unexpectedly domperidone delayed VCE gastric transit. Most studies on domperidone prokinetic effects have been in diabetic gastroparesis, demonstrating that domperidone can achieve good symptomatic relief, but with mixed results for gastric emptying. Our study suggests that any antiemetic effects of domperidone are not mediated through accelerated gastric transit.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sneader W (2006) Drug discovery—a history. John Wiley & Sons, Hoboken
Ahmad N, Keith-Ferris J, Gooden E, Abell T (2006) Making a case for domperidone in the treatment of gastrointestinal motility disorders. Curr Opin Pharmacol 6(6):571–576. https://doi.org/10.1016/j.coph.2006.07.004
Niemegeers CJ, Schellekens KH, Janssen PA (1980) The antiemetic effects of domperidone, a novel potent gastrokinetic. Arch Int Pharmacodyn Ther 244(1):130–140
Shuto K, Shiozaki Z, Kojima T, Tanaka M (1980) Antagonism of KW-5338 (domperidone) against emesis and depression of intestinal motility induced by L-DOPA. Aust J Pharm 3(12):709–714
Brogden RN, Carmine AA, Heel RC, Speight TM, Avery GS (1982) Domperidone. A review of its pharmacological activity, pharmacokinetics and therapeutic efficacy in the symptomatic treatment of chronic dyspepsia and as an antiemetic. Drugs 24(5):360–400. https://doi.org/10.2165/00003495-198224050-00002
Schuurkes JA, Van Nueten JM (1984) Control of gastroduodenal coordination: dopaminergic and cholinergic pathways. Scand J Gastroenterol Suppl 92:8–12
Joint Formulary Committee (2016) British National Formulary. BMJ Group and Pharmaceutical Press, London
Lee A (2013) Gastroparesis: what is the current state-of-the-art for evaluation and medical management? What are the results? J Gastrointest Surg 17(9):1553–1556. https://doi.org/10.1007/s11605-013-2254-x
McAlindon ME, Ching HL, Yung D, Sidhu R, Koulaouzidis A (2016) Capsule endoscopy of the small bowel. Ann Transl Med 4(19):369. https://doi.org/10.21037/atm.2016.09.18
Sugumar A, Singh A, Pasricha PJ (2008) A systematic review of the efficacy of domperidone for the treatment of diabetic gastroparesis. Clin Gastroenterol Hepatol 6(7):726–733. https://doi.org/10.1016/j.cgh.2008.02.065
Bateman DN, Gooptu D, Whittingham TA (1982) The effects of domperidone on gastric emptying of liquid in man. Br J Clin Pharmacol 13(5):675–678. https://doi.org/10.1111/j.1365-2125.1982.tb01435.x
Broekaert A (1979) Effect of domperidone on gastric emptying and secretion. Postgrad Med J 55(Suppl 1):11–14
Baeyens R, van de Velde E, De Schepper A, Wollaert F, Reyntjens A (1979) Effects of intravenous and oral domperidone on the motor function of the stomach and small intestine. Postgrad Med J 55(Suppl 1):19–23
Sanger GJ, Broad J, Andrews PL (2013) The relationship between gastric motility and nausea: gastric prokinetic agents as treatments. Eur J Pharmacol 715(1–3):10–14. https://doi.org/10.1016/j.ejphar.2013.06.031
Tonini M, Cipollina L, Poluzzi E, Crema F, Corazza GR, De Ponti F (2004) Review article: clinical implications of enteric and central D2 receptor blockade by antidopaminergic gastrointestinal prokinetics. Aliment Pharmacol Ther 19(4):379–390. https://doi.org/10.1111/j.1365-2036.2004.01867.x
Sweetser S, Ravi K (2013) Gastrointestinal motility. In: DeCross AJ (ed) DDSEP7 Digestive Diseases Self-Education Program. AGA, Bethesda, pp 53–85
Author information
Authors and Affiliations
Contributions
MM: Analysed the data and wrote the manuscript
BL: Collected the data
CN: Wrote the manuscript and project oversight
Corresponding author
Ethics declarations
Competing interests
The authors declare that they have no competing interests.
Rights and permissions
About this article
Cite this article
Mcfarlane, M., Liu, B. & Nwokolo, C. Domperidone prolongs oral to duodenal transit time in video capsule endoscopy. Eur J Clin Pharmacol 74, 521–524 (2018). https://doi.org/10.1007/s00228-017-2399-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00228-017-2399-8