Domperidone (brand name Motilium) is a prescription galactogogue, similar to Reglan but with fewer side effects. Since it is a prescription drug, it should only be used as a last resort after it has been determined that you really do have a low milk supply or failure to thrive (FTT) situation. While it is generally considered safe, most people discuss using it with their family doctor, ob/gyn, or pediatrician before resorting to using this drug.
The best info on this drug is found on the kelly mom site and includes info on usage, dosage, politics behind its use and non-use, legality, medical journal articles about its use, etc.
More info is found on the BFAR site .
Domperidone can be obtained in the US from compounding pharmacies, or on the internet without prescription from:
http://www.inhousepharmacy.com/general/motilium.html
I'm going to be asking that this thread be stickied, so if anyone else wants to add info here please do so.
Edited to remove the globaldrug link. Apparently it is no longer in business.
Edited to add information from Thomas Hale, Ph.D., "Medications and Mother's Milk."
"It is also known to produce significant increases in prolactin levels and has proven useful as a galactagogue. Serum prolactin levels have been found to increase from 8.1 ng/mL to 124.1 ng/mL in non-lactating women after one 20 mg dose (Brouwers JR et al. Plasma prolactin levels after acute and subchronic oral administration of domperidone and of metoclopramide: a cross-over study in healthy volunteers. Clin Endocrinol (Oxf) 1980; 12(5):435-440.) Concentrations of domperidone reported
in milk vary according to dose. But following a dose of 10 mg three time daily, the average concentration in milk was only 2.5 micrograms/L (Hofmeyr GJ et al. Domperidone: secretion in breast milk and effect on
puerperal prolactin levels. Br J Obstet Gynaecol 1985 Feb;92(2):141-4)"
"Recently the US FDA issued a warning on this product stating that it could induce arrhythmias in patients. These claims were derived from data many years old where domperidone was used intravenously as an antiemetic during cancer chemotherapy (20 mg stat followed by 10 mg/kg/24 h). Many of these patients were undergoing extensive chemotherapy and were extremely ill, and hypokalemic to begin with.
Further, intravenous domperidone produced plasma levels many times higher than oral use. Thus far, we do not have any recently published data suggesting that domperidone used orally in breastfeeding mothers
is arrhythmogenic."
"Lactation Risk Category: L1 (the safest level)
Pediatric Concerns: None reported. Considered the ideal galactagogue."
Just as a point of reference, Ibuprofen is an L2, and Naproxen is an L3.
Here's a listing of its availability internationally:
Classification status in other countries:
•Australia: prescription medicine
•UK: over the counter (OTC)
•USA: not marketed
•Canada: prescription medicine
•Belgium: OTC
•Ireland: OTC
•Italy: OTC
•Japan: OTC
•Netherlands: OTC
•South Africa: OTC
•Switzerland: OTC
HTTP://WWW.MEDSAFE.GOVT.NZ/DOWNLOADS...OMPERIDONE.DOC
More sources of where you can get it, US and worldwide:
http://www.breastfeedingonline.com/d...onewhere.shtml
ETA
Link to package insert, including contraindications and possible drug interactions:
http://www.medsafe.govt.nz/Profs/Dat...otiliumtab.htm
ETA: PLEASE NOTE that offering to buy/sell Domperidone on MDC forums is against the User Agreement. Please don't discuss this here -- or this thread might be deleted.
The best info on this drug is found on the kelly mom site and includes info on usage, dosage, politics behind its use and non-use, legality, medical journal articles about its use, etc.
More info is found on the BFAR site .
Domperidone can be obtained in the US from compounding pharmacies, or on the internet without prescription from:
http://www.inhousepharmacy.com/general/motilium.html
I'm going to be asking that this thread be stickied, so if anyone else wants to add info here please do so.
Edited to remove the globaldrug link. Apparently it is no longer in business.
Edited to add information from Thomas Hale, Ph.D., "Medications and Mother's Milk."
"It is also known to produce significant increases in prolactin levels and has proven useful as a galactagogue. Serum prolactin levels have been found to increase from 8.1 ng/mL to 124.1 ng/mL in non-lactating women after one 20 mg dose (Brouwers JR et al. Plasma prolactin levels after acute and subchronic oral administration of domperidone and of metoclopramide: a cross-over study in healthy volunteers. Clin Endocrinol (Oxf) 1980; 12(5):435-440.) Concentrations of domperidone reported
in milk vary according to dose. But following a dose of 10 mg three time daily, the average concentration in milk was only 2.5 micrograms/L (Hofmeyr GJ et al. Domperidone: secretion in breast milk and effect on
puerperal prolactin levels. Br J Obstet Gynaecol 1985 Feb;92(2):141-4)"
"Recently the US FDA issued a warning on this product stating that it could induce arrhythmias in patients. These claims were derived from data many years old where domperidone was used intravenously as an antiemetic during cancer chemotherapy (20 mg stat followed by 10 mg/kg/24 h). Many of these patients were undergoing extensive chemotherapy and were extremely ill, and hypokalemic to begin with.
Further, intravenous domperidone produced plasma levels many times higher than oral use. Thus far, we do not have any recently published data suggesting that domperidone used orally in breastfeeding mothers
is arrhythmogenic."
"Lactation Risk Category: L1 (the safest level)
Pediatric Concerns: None reported. Considered the ideal galactagogue."
Just as a point of reference, Ibuprofen is an L2, and Naproxen is an L3.
Here's a listing of its availability internationally:
Classification status in other countries:
•Australia: prescription medicine
•UK: over the counter (OTC)
•USA: not marketed
•Canada: prescription medicine
•Belgium: OTC
•Ireland: OTC
•Italy: OTC
•Japan: OTC
•Netherlands: OTC
•South Africa: OTC
•Switzerland: OTC
HTTP://WWW.MEDSAFE.GOVT.NZ/DOWNLOADS...OMPERIDONE.DOC
More sources of where you can get it, US and worldwide:
http://www.breastfeedingonline.com/d...onewhere.shtml
ETA
Link to package insert, including contraindications and possible drug interactions:
http://www.medsafe.govt.nz/Profs/Dat...otiliumtab.htm
ETA: PLEASE NOTE that offering to buy/sell Domperidone on MDC forums is against the User Agreement. Please don't discuss this here -- or this thread might be deleted.