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Subject:
From:
Nikki Lee <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 10 Dec 2015 10:54:41 -0500
Content-Type:
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Dear Lactnet Friends:

Someone will have to check out the whole article. If, as the abstract
suggests, the risk of cardiac events is so much increased, even in young
healthy women, we need to be careful about this drug.

Clin Drug Investig. 2015 Dec 9. [Epub ahead of print]
Domperidone and Risk of Ventricular Arrhythmia and Cardiac Death: A
Systematic Review and Meta-analysis.
Leelakanok N1, Holcombe A2, Schweizer ML2,3,4.
Author information


Abstract
BACKGROUND AND OBJECTIVE:
Domperidone is a drug used globally for relieving nausea and vomiting and
stimulating breast milk production. Several case reports and studies linked
domperidone usage with major cardiovascular adverse events (cardiac
arrhythmia and sudden cardiac death). However, multiple randomized
controlled efficacy studies failed to detect such adverse events. Our
objectives were to systematically review and meta-analyze the association
between current domperidone exposure and cardiovascular adverse events.


METHODS:
The first author performed EMBASE, PubMed and Scopus searches to identify
human studies assessing the association between current domperidone
exposure and cardiac arrhythmia or sudden death. Thirteen related articles
were identified and the first and second authors independently reviewed the
articles. Six studies were included in the final analysis. Meta-analysis
was performed with a random effect model using the inverse variance
approach. Heterogeneity was evaluated using the Q statistic and I 2 test.


RESULTS:
Five case-control studies and one case-crossover study were included in
this meta-analysis. Pooled risk estimates demonstrated that the current use
of domperidone increased the risk of ventricular arrhythmia and sudden
cardiac death (pooled adjusted odds ratio = 1.70; 95 % confidence interval
1.47-1.97; I 2 = 0 %). The I 2 test showed that the underlying population
was homogeneous.


CONCLUSIONS:
Evidence from this meta-analysis suggests that current domperidone use
increases the risk of cardiac arrhythmia and sudden cardiac death by 70 %.
Domperidone usage in older populations should be discouraged. Larger
observational studies or randomized controlled trials are needed to confirm
the findings of this analysis.

warmly,
-- 
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
Author:* Complementary and Alternative Medicine in Breastfeeding Therapy*
www.nikkileehealth.com
https://www.facebook.com/nikkileehealth

*Get my FREE webinar series*

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