Domperidone proven to be safe in the treatment of nausea associated with dihydroergotamine infusion and headache

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Domperidone proven to be safe in the treatment of nausea associated with dihydroergotamine infusion and headache

Dihydroergotamine (DHE)as an injection is used to treat migraine and cluster headaches. It acts by activating certain receptors in the brain that makes the brain vessels narrow, thus relieving the migraine symptoms.

Domperidone is a less expensive alternative which is well tolerated in headache. It is a peripherally acting dopamine antagonist which is widely used for decades to treat gastric motility disorders and nausea. An audit was conducted to determine the safety of domperidone in the treatment of nausea associated the DHE infusion and headache. While auditing, the use of domperidone for the inpatient management of nausea, safety concerns, specially of potential cardiac arrhythmias were focused.

In this analysis, 103 consecutive admissions of 90 patients admitted for IV DHE by infusion were done. Most of patients with chronic migraine were treated domperidone. Out of 103, 85 patients were encountered and DHE was found to be well-tolerated at doses up to 80 mg/day. However, a significant side effect, akathisia was observed in one patient. Further,  baseline ECG was corrected and electrocardiograph (ECG) was repeated after administering domperidone in 21 patients. Electrocardiograph was interpreted blindly by a cardiac electrophysiologist. It was observed that, QTc did not differ before and after the administration of domperidone. Although, in combination with the other antiemetics, domperidone was effective in treating the nausea and no patients had severe refractory nausea that demands restricting the DHE dose.

To summarize, domperidone has proven to be a safe in the treatment of nausea associated with inpatient DHE infusion and headache. While the larger prospective trials were necessary to confirm these results, and assessed efficacy.

Source:

Neurology

Link to the source:

http://www.neurology.org/content/87/24/2522.long

Original title of article:

Safety of domperidone in treating nausea associated with dihydroergotamine infusion and headache

Authors:

Nathaniel M. Robbins, MD, Hiroyuki Ito, MD, Melvin M. Scheinman, MD and Peter J. Goadsby, MD, PhD

 

Neurology
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