Motilac - instructions for use, reviews, analogs and formulations (10 mg tablets, including for resorption, suspension or syrup) of the drug for the treatment of nausea, vomiting and heartburn in adults, children and pregnancy

In this article, you can read the instructions for using the drug Motilac. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Motilak in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Motilak with available structural analogues. Use for the treatment of nausea, vomiting and heartburn in adults, children, as well as during pregnancy and lactation.

Motilac - antiemetic drug. The mechanism of action is due to a combination of peripheral action and antagonism to dopamine receptors in the trigger zone of the chemoreceptors.

Motilac increases the duration of peristaltic contractions of the Antral part of the stomach and duodenum, accelerates the emptying of the stomach in case of slowing of this process, increases the tone of the lower esophageal sphincter, eliminates the development of nausea and vomiting.

Domperidone (the active ingredient of the preparation Motilac) poorly penetrates the BBB, therefore, the use of Motilac is rarely accompanied by extrapyramidal side effects, especially in adults, but Domperidone stimulates the secretion of prolactin by the pituitary gland that is outside the blood-brain barrier (BBB).

Domperidone has no effect on gastric secretion.

Composition

Domperidone + auxiliary substances.

Pharmacokinetics

After taking the drug inside domperidone is rapidly absorbed from the digestive tract. Bioavailability is low - about 15%. The decreased acidity of the gastric contents reduces the absorption of domperidone. Binding to plasma proteins is 91-93%. Domperidone is widely distributed in the tissues of the body.In the brain tissues, the concentration of domperidone is small. It is subjected to intensive metabolism in the wall of the intestine and in the liver. It is excreted through the intestine (66%) and kidneys (33%), incl. in unchanged form 10% and 1% respectively.

Indications

A complex of dyspeptic symptoms, often associated with delayed emptying of the stomach, gastroesophageal reflux, esophagitis:

• a feeling of overflow in the epigastrium, a sensation of bloating, pain in the upper abdomen;
• eructation, flatulence;
• heartburn with casting or without casting the contents of the stomach into the mouth.

Nausea and vomiting of any etiology, incl. functional, organic, infectious origin, caused by radiotherapy, drug therapy, intoxication or disruption of the diet, and against the background of dopamine agonists when used in Parkinson's disease (such as levodopa and bromocriptine).

Forms of release

The tablets covered with a cover of 10 mg.

Tablets for resorption of 10 mg.

Other dosage forms, be it a suspension or syrup, do not exist.

Instructions for use and dosing regimen

For chronic dyspeptic symptoms, adults are prescribed 10 mg (1 tablet) 3 times a day and, if necessary, additionally before bedtime.

In case of insufficient effect, this dose is doubled.

Children over 5 years of age are prescribed 2.5 mg / 10 kg body weight 3 times a day and, if necessary, additionally before bedtime.

In acute and subacute conditions, especially with nausea and vomiting, adults are prescribed 20 mg (2 tablets) 3-4 times during the day and, if necessary, additionally before bedtime.

Children older than 5 years are prescribed 5 mg per 10 kg body weight 3-4 times during the day and, if necessary, additionally before bedtime.

When taking the drug after a meal, absorption is somewhat slowed down.

With continued use (for chronic symptoms), it is preferable to take the drug inside 15-30 minutes before meals.

With renal failure, depending on the degree of severity, it is recommended to reduce the frequency of taking the drug to 1-2 times per day.

Side effect

• transient intestinal spasms;
• extrapyramidal symptoms in children and with increased permeability of the BBB (completely reversible and spontaneously disappear after discontinuation of therapy);
• galactorrhea;
• gynecomastia;
• dysmenorrhea due to hyperprolactinaemia;
• rash;
• hives.

Contraindications

• prolactinoma;
• children under 5 years;
• increased sensitivity to domperidone.

Application in pregnancy and lactation

The use of the drug in the first trimester of pregnancy is possible only in cases where the expected benefit of therapy for the mother exceeds the potential risk to the fetus. To date, there is no evidence of an increased risk of human developmental malformations.

In women, the concentration of domperidone in breast milk is 4 times lower than the corresponding concentration in the plasma. It is not known whether domperidone in this concentration has a negative effect on the newborn. Therefore, during lactation (breastfeeding) the use of Motilac is not recommended, except when the expected benefit of therapy for the mother exceeds the potential risk for the infant.

Use in children

The drug is contraindicated for children under 5 years.

special instructions

Since domperidone is metabolized in the liver, caution should be given to patients with hepatic insufficiency.

Because a very small amount of the drug is excreted by the kidneys unchanged, patients with renal insufficiency do not practically need a single dose adjustment. However, with a re-appointment, the frequency of taking the drug should be reduced depending on the severity of the kidney failure,a dose reduction may also be required. With prolonged therapy, patients with impaired renal function require regular monitoring.

Do not apply Motilac when stimulation of gastric motility is unacceptable, i.e. with gastrointestinal bleeding, mechanical obstruction or perforation.

When appointing Motilac with antacid or antisecretory drugs, they should not be taken simultaneously with Motilac.

Impact on the ability to drive vehicles and manage mechanisms

Motilac does not interfere with the speed of psychomotor reactions.

Drug Interactions

With simultaneous use of anticholinergic drugs can neutralize the effect of Motilac.

With simultaneous use of antacids and inhibitors of gastric secretion reduce the bioavailability of Motilac.

On the basis of studies suggest that while the use of drugs Motilak significantly inhibiting the isozyme CYP3A4 (azole antifungals group of macrolide antibiotics, inhibitors of HIV protease, an antidepressant nefazodone), there may be an increase in plasma levels of domperidone.

Domperidone does not affect the level of Paracetamol and Digoxin in the blood.

It is possible that Motilac may affect the absorption of concomitantly administered drugs with sustained release of the active substance or coated with an enteric coating.

Analogs of the drug Motilac

Structural analogs for the active substance:

• Damelyum;
• Domet;
• Domperidone;
• Domstal;
• Motigect;
• Motilium;
• The monotonous;
• Motion;
• The passenger.

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