Drugs in focus: Domperidone.

Domperidone is a peripheral dopamine D2 receptor antagonist with prokinetic and antiemetic properties. Its prokinetic effects are mainly manifest in the upper gastrointestinal (GI) tract. Currently its use is restricted to relief of nausea and vomiting in children older than 12 years for a short period of time. However, among (paediatric) gastroenterologists, domperidone is also used outside its authorised indication ("off label") for treatment of symptoms associated with gastro-oesophageal reflux disease, dyspepsia and gastroparesis. Little is known about its efficacy in the treatment of GI motility disorders in children and controversial data have emerged in the paediatric literature. As its use is off label, appropriate knowledge of its efficacy is helpful to support an "off label/on evidence" prescription. Based on this, the purpose of this review is to summarise all evidence on the efficacy of domperidone for the treatment of GI disorders in infants and children and to report an overview of its pharmacological properties and safety profile.