This letter was sent to my department manager from one of our perinatologists.

18 months ago I addressed the issue of prescribing and "compounding"
the lactating promoting drug known as domperidone (motillium) in
response to MFM patients, especially those that have delivered early,
being directed by "lactation consultants" to ask for prescriptions for
this drug.  At the time, the FDA issued a warning/advisory stating
unequivocally that this drug should not be used by lactating mothers
secondary to reports of cardiac arrythmias, cardiac arrests, and sudden
deaths in the users of this drug. They further advised that any pharmacy
caught compounding this drug would be prosecuted.  In addition the FDA
requested  that any physician who desires to use this medication only do
so under the investigational drug protocol.  Unfortunately we are again
being asked by our patients about this medication available through
internet ordering via Canada.   Often times a Canadian paper is cited as
proof of safety.  This study contains only 7 patients and no conclusions
in regards to saftety can be made. We are  being  told that they are
getting this information through the lactation consultants. I would like
us to remind those who counsel in regards to domperidone that the FDA
advisory is still in effect. The safety of this drug has not been
confirmed by United States standards and until evidence of safety is
available, and as long as the FDA advisory is in effect, I would caution
against recommending its use in these mothers.

My department Mgr. is willing to support her LC's if we can provide her with strong evidence.
If you have something I can use, please forward it to me so I can build  a case for 
domperidone use.  As it so happens, there are a couple physician residents who have used it 
with excellent results.  I know they will support me too.

Ok, off to the archives......

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