Re: Domperidone(Motilium)  and metoclopramide(Reglan)

        The elegant post by Dr. Gross on domperidone needs no futher
explanation.  Domperidone and metoclopramide both presumably increase the
release of prolactin from the pituitary,  hence their use in lactation.

>He also wants to know where the FDA is on this use of reglan.  The point here
>being that we can't do a formal QA study on something that is not approved for
>the particular use in question.

       There is a common misconception concerning the use of drugs for
various syndromes.  The FDA requirements, as I understand it,  only preclude
the pharmaceutical company from "advertising"  the use of a specific
medication for non-FDA approved indications.    On the other hand, the FDA
laws do not ban a physician from using a medication for any indication
he/she so wishes.  A physician can study anything for any use as long as
they pass muster with the Institutional Review Board.

"BINGO"
 As per the mother who was using  labetalol(Trandate, Normodyne) and noted
her infant resisted taking the milk.  This was a really interesting
observation.  Labetalol is a typical beta blocker used for hypertension.
Although only a small amount is transferred to milk(0.004% of dose),  1% of
patients report a "Taste Distortion" effect,  which means,  that food tastes
funny to them.  This is a great little pearl of information.




***********************************
T.W. Hale, Ph.D.
Associate Professor of Pediatrics
Texas Tech University School of Medicine

***********************************