Dear Lactnetters
I am reposting this message as the bulletin I posted it in last night has
been posted back to me as garbled with seven messages running into one.

I urgently need some information on Domperidone.  The doctors at the
hospital I work at are still comfortable prescribing Domperidone in certain
situations. From my experience it is a superior galactogue to Maxalon and is
well tolerated if mums of premature babies need to use it for a number of
weeks.

I have been involved with writing a guideline relating to "Breastfeeding
Sick and Premature Babies Guidline" for hospitals within the zone and have
been challenged regarding the suitability of using Domperidome in the light
of the FDAs warning.  I have a copy  of Thomas Hales reply and a copy of an
articile he wrote in the September issue of  Clinical Obstetrics and
Gynecology "Maternal Medications During Breastfeeding" in which he supports
the use of Domperidome. I am also aware it is still currently recommended on
the Australian Breastfeeding Associations website in an article by Wendy
Brobidd. Can anyone tell me if any peak bodies recomend its use?  Apart from
the da Silva study there appears to be a dearth of current studies on it.
Is anyone aware of any more recent studies?

Does anyone know the status of TGA  (therapeutic goods administration)
classification in Australia?  It is currently legal to prescribe it
Australia. When I did a search  for "domperidone" and "Australia" I came up
with a site http:msdforgps.com.au/comte/tgc/plg/5a58609/htm which listed
Domperidone as category B2--compatible for short-term use in stimulating
lactation.  On another page
http://msdforgps.com.au/complete/tgc/plg/5a57ea5.htm titled "Australian
categorisaton of drugs in pregnancy" it refers to "Medicines in Pregnancy
Working Party of the Australian Drug Evaluation Committee. Prescribing
medicines in  pregancy. An Australian categorisation of risk of drug use in
pregnancy. 4th edn. Canberra: Commonwealth of Australia".  However the web
site they reference www.health.gov.au/tga/docs/html/mip/medicine.htm is not
working.  From the look of the  msdfogps...  website (current at July 2004)
it appears the TGA in Australia approved the use of Domperidome for short
term use in stimulating lactation at least in 1999. But my searches draw a
blank with current status in Australia.  Does anyone know  the current
status or does anyone know what organisation is behind the GP prescribing
information site I have listed above?

Also I am keen to know of other hospitals in Australia are still currently
using it or have a guideline supporting Domperidone's continued use.  You
may email me privately if you do not wish to disclose the hospitals name on
the Lactnet and I will provide a summary of the replies (hospital names
omitted).

Any information would be greatly appreciated
Thanks in advance
Marian Rigney RN IBCLC Neonatal Nurse

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