Cardiac Arrhythmias during Cytotoxic Chemotherapy: Role of Domperidone

Abstract

<jats:p> 1 Four patients receiving platinum-containing chemotherapy were treated with domperidone (20 mg) by slow intravenous injection followed by a continuous infusion for 24 h at a dose of 10 mg 24 h<jats:sup>-1</jats:sup> kg<jats:sup>-1</jats:sup>. Cardiac monitoring and plasma potassium and domperidone concentration measurements were performed. Severe cardiac arrhythmias occurred in two patients. </jats:p><jats:p> 2 A control group of 14 patients treated with similar chemotherapy, without domperidone, also underwent cardiac and plasma potassium monitoring. No significant arrhythmias were seen. </jats:p><jats:p> 3 The electrophysiologic effects of domperidone are discussed. </jats:p><jats:p> 4 It is concluded that treatment with intravenous domperidone is associated with the occurrence of cardiac arrhythmias. </jats:p>

Effects of domperidone on augmentation of lactation following cesarean delivery at full term

“…The pharmacologic actions of domperidone are similar to those of metoclopramide, but the former has a high molecular weight and does not readily cross the bloodbrain barrier, thus producing fewer extrapyramidal adverse effects [11,12]. Domperidone is not currently available in the USA [13] because the Food and Drug Administration withheld approval on the basis of reported cardiac arrhythmias [14] and heart attacks [15] in patients undergoing chemotherapy who were also receiving domperidone intravenously. Outside the USA, oral domperidone has been used since 1978, with relatively few reports of significant adverse effects.…”

Domperidone-Associated Sudden Cardiac Death in the General Population and Implications for Use in Patients Undergoing Hemodialysis: A Literature Review

“…13,14 The adult literature is limited to case reports, [15][16][17] case-control studies, and case series of cardiotoxicity secondary to IV domperidone, a formulation that is no longer available. 18 QTc prolongation secondary to domperidone use has also been demonstrated in animal studies and in vitro models.…”

Prokinetic Agents and QT Prolongation: A Familiar Scene with New Actors

“…Due to the proarrhytmic risk of cisapride, domperidone has been felt to be a safer alternative to cisapride, because its apparent favorable safety profile. However, QT prolongation, life-thretening ventricular tachyarrhytmias and cardiac arrest have been reported after the use of intravenous domperidone [75][76][77][78][79][80][81][82]. Underlying electrolyte disturbances such as hypokalemia and not a drug specific effect were assumed as the physiopathologic mechanism involved in cardiac domperidone-related adverse events.…”