Domperidone

Domperidone is a dopamine D2-receptor antagonist with peripheral gastrointestinal and endocrine effects. Its most established veterinary role is prevention or treatment of fescue-associated reproductive dysfunction and agalactia in mares. Additional uses include selected lactation-support protocols and, in some markets, immunomodulatory management related to canine leishmaniosis.

Group

Dopamine antagonist

Mechanism of Action

Domperidone blocks dopamine D2 receptors with relatively limited penetration into the brain. At pituitary lactotrophs, removal of dopamine-mediated inhibition increases prolactin secretion and can support mammary development and milk production. Peripheral dopamine antagonism can alter upper gastrointestinal motility. Prolactin-associated modulation of cellular immunity is proposed to contribute to its use in canine leishmaniosis.

Dose Rates

Dog

Use / stage	Dose	Route	Schedule	Instructions
Gastroparesis adjunct	2–5 mg/animal	PO	Every 8–12 h
Leishmaniasis adjunct	1 mg/kg	PO	Every 12 h	Up to 30 days
Lactation support	2.2 mg/kg	PO		Up to 21 days; During nursing for 1–3 weeks; dosing frequency not specified.
Prokinetic therapy	0.05–0.1 mg/kg	PO	Every 12–24 h	Suggested from experimental data; limited clinical experience.
Gastritis-associated vomiting	2–5 mg	PO	Every 8–12 h

Cat

Use / stage	Dose	Route	Schedule	Instructions
Gastroparesis adjunct	2 mg/animal	PO	Every 8–12 h
Lactation support	1.5–2 mg/kg	PO		Up to 21 days; During nursing for 1–3 weeks; dosing frequency not specified.
Prokinetic therapy	0.05–0.1 mg/kg	PO	Every 12–24 h	Suggested from experimental data; limited clinical experience.

Horse

Use / stage	Dose	Route	Schedule	Instructions
Fescue toxicosis or agalactia	1.1 mg/kg	PO	Every 24 h	Start 10 days before expected foaling; continue through foaling and for up to 5 additional days if milk remains inadequate.
Laminitis adjunct	1.1 mg/kg	PO		Clinical efficacy not established.
PPID diagnostic challenge	5 mg/kg	PO	Once	Measure endogenous ACTH at baseline, 2 and 4 hours; interpret using the laboratory protocol.

Indications

Prevention or treatment of fescue-toxicosis-associated agalactia and related periparturient reproductive dysfunction in mares.
Induction or support of lactation in selected mares within a reproductive management protocol.
Extra-label support of milk production in selected lactating dogs or cats; veterinary efficacy evidence is limited.
Adjunctive management of selected gastrointestinal hypomotility or gastroparesis, with limited species-specific clinical evidence.
Immunomodulatory management or risk reduction of canine leishmaniosis where included in a locally authorized program; evidence and patient selection are indication-specific.

Contraindications

Gastrointestinal obstruction

Interactions

Antacids and acid-suppressing drugs may impair oral absorption.

Adverse effects

Endocrine changes including increased prolactin and ACTH
Potential cardiac rhythm concerns

Preparations

Preparation	Form	Strength	Route
Domperidone 10 mg	Tablet	10 mg / tablet	PO
Equidone oral gel 110 mg/mL	Oral Gel	110 mg / mL	PO

Monitoring and Administration

Assess milk production and gastrointestinal response. Equine oral prokinetic efficacy and clinical benefit in laminitis are uncertain.

Experimental equine IV 0.2 mg/kg improved motility, but no commercial IV formulation is supplied.