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Domperidone's Usage and Discontinuation in the UK: A Comprehensive Analysis

Domperidone, widely known under the brand name Motilium 10, has been a cornerstone in the treatment of short-term nausea and vomiting for adults over the age of 16 in the United Kingdom. However, since September 2014, this medication, which contains the active ingredient domperidone, has been discontinued in the UK due to safety concerns. The decision to remove Motilium 10 from the market raises questions about the balance between the therapeutic benefits of a medication and its potential risks.

Domperidone functions by blocking dopamine receptors in the upper part of the digestive system. This mechanism of action facilitates the faster movement of food through the stomach, thereby reducing feelings of sickness, bloating, fullness, and the likelihood of reflux. Furthermore, by blocking dopamine receptors in the chemoreceptor trigger zone (CTZ) in the brain, domperidone effectively prevents nausea by stopping messages from being sent to the vomiting center of the brain.

Traditionally, the usage of Motilium tablets involved the consumption of one tablet up to three times a day, before meals, to prevent short-term symptoms of sickness and vomiting. The guidelines stipulated that the treatment should not exceed 48 hours and not more than three tablets should be taken within any 24-hour window. If symptoms persisted, consulting a medical professional was advised.

Despite its effectiveness, the suspension of domperidone's distribution was prompted by research indicating a slight increase in the risk of serious heart-related side effects. Consequently, healthcare providers were guided to prescribe domperidone solely for the short-term management of nausea and vomiting, with a reduced maximum daily dosage of 30mg. This adjustment necessitated individuals, especially those with pre-existing heart conditions, to consult their doctors regarding the use of domperidone for other health concerns.

Responsible for several contraindications, domperidone is not suitable for children under the age of 16, individuals with a history of pituitary gland cancer (which can lead to excessive prolactin production), and those with any form of bleeding, abnormal openings or blockages in the stomach or intestines. Furthermore, individuals suffering from reduced liver or kidney function, heart disease, prolonged QT intervals on an ECG, pregnancy, or lactose intolerance were advised against its use.

The side effects associated with domperidone, though often mild, could include dry mouth, diarrhea, decreased sex drive, anxiety, sleepiness, headache, rash or itching, feeling weak, breast pain or tenderness, and even the unexpected production of breast milk. Such side effects underscored the need for careful consideration and monitoring during treatment with domperidone.

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