Interaction charts on this desk are for reading, not for writing a prescription or filling a bottle. Open the orbit disclaimer
Orbit · Orbit · GI / wake-adjacent
Last reviewed · 13 min read · Updated
Orbit card
| Onset | Antiemetic effect within an hour classically |
|---|---|
| Duration | t½ ~7-9 h; short courses preferred |
| Food | Often before meals when used as a prokinetic |
| Alcohol | Adds variability; not a QT antidote |
Orbit · domperidone (Motilium 10 mg). QT desk at Laugavegur 28 - not a US pharmacy and not an importer.
EU SmPCs contraindicate potent CYP3A4 inhibitors with domperidone - azole antifungals, HIV protease inhibitors, and macrolides such as clarithromycin and telithromycin. Those pairs raise levels and QT risk together.
A small increased risk of serious ventricular arrhythmia and sudden death showed up in the EMA review, higher over age 60, over 30 mg oral per day, and with QT or CYP3A4 partners. Adult oral maps were cut to 10 mg up to three times daily, generally not longer than a week for the kept nausea indication.
If emptying claims are the question, the GI orbit is that lane. The QT trace is the cardiac companion.
EU SmPCs contraindicate potent CYP3A4 inhibitors with domperidone - azole antifungals, HIV protease inhibitors, clarithromycin, telithromycin. Oral ketoconazole for nails plus Motilium 10 for azole nausea is the failure mode. Do not treat azole nausea with domperidone.
A small increased risk of serious ventricular arrhythmia and sudden death showed up in the EMA review, higher over age 60, over 30 mg oral per day, and with QT or CYP3A4 partners. Adult oral maps were cut to 10 mg up to three times daily, generally not longer than a week for the kept nausea indication.
Other QT drugs are a contraindication pattern. Ondansetron dissolving tablets plus Motilium 10 for the same nausea day is a stack. Do not pair them from a drawer. A narrow apomorphine exception in some texts does not generalize to a sinus macrolide.
Azithromycin is a caution macrolide in some SmPCs because it prolongs QT even when it is not the strongest CYP3A4 inhibitor. Recite it. See the azithromycin orbit when both names land.
Known long QT, heart failure, and significant electrolyte disturbance close the door. A short week is not a waiver. Potassium-wasting diuretics belong on the spoken list.
Moderate-severe hepatic impairment is contraindicated on current SmPCs.
Mechanical obstruction, perforation, or GI bleed are reasons not to force motility.
Not a routine US retail NDC. No invented Motilium dollar. Costco quotes are literacy. Caelum does not import.
Lactation off-label galactagogue use does not retire the ECG or the CYP wall. A midwife abroad writing 10 mg TID for milk without an ECG still sits inside the cardiac sketch. This desk will not write an import recipe.
Age 72 plus a secret third week because reflux returned is how risk accumulates. Book a review rather than restarting 10 mg TID quietly.
Pediatric maps are mg/kg. Giving a 10 mg adult tablet to a 20 kg child because she vomited is not math. Seek pediatric advice.
Metoclopramide is a different CNS and tardive story. Do not stack. A swap is a clinician call.
Ketoconazole cream is a different exposure than oral ketoconazole. Name the exact product and body area. When unsure, pause Motilium until someone reads both labels. Do not add oral azole.
Peer-pass starts with QT history, not emptying poetry. Ingrid peer-passes literacy only.
Sources stay EMA/CMDh referral text, EU SmPC contraindication lists, and FDA non-approval context for the missing dollar. Syncope or palpitations: 112. Reviewed 21 August 2026.
After the referral, adults and adolescents ≥35 kg were held to 10 mg orally up to three times daily. Suppository maps exist in some countries. Pediatric weight maps use mg/kg - never adult foil math.
Duration language after the review is short - often not more than one week for the nausea indication that remained. A secret lactation month is off-label in many places and still sits inside the QT wall.
Mechanical obstruction, perforation, or GI bleed are reasons not to force motility. Domperidone is a peripheral D2 blocker at the gut and CTZ - less central than metoclopramide, not 'no CNS ever,' and not a tardive-risk-free twin you stack.
| Absorption | Oral uptake; often before meals for prokinetic intent. |
|---|---|
| Distribution | Peripheral D2; CTZ sits outside the classic BBB story. |
| Metabolism | CYP3A4 is the level hinge - inhibitors raise exposure and QT risk. |
| Excretion | Hepatic impairment is a contraindication band on current SmPCs. |
Contraindication territory on current EU-style labels includes significant conduction disease, heart failure, important electrolyte disturbance, moderate-severe hepatic impairment, and co-use of QT-prolonging drugs (with a narrow apomorphine exception in some texts).
Azithromycin appears as a caution macrolide in some SmPCs because it prolongs QT even when it is not the strongest CYP3A4 inhibitor. See azithromycin when both names land on one med list.
Potassium-wasting diuretics belong on the spoken list. A 'short nausea week' does not waive an ECG history.
| Partner | Stance | Desk move |
|---|---|---|
| Clarithromycin / ketoconazole / ritonavir-class | Contraindicated CYP3A4 | Do not pair |
| Other QT drugs | Contraindicated pattern | Recite the full list |
| Azithromycin | QT caution | Joined cardiac review |
| Age >60 / >30 mg/day | Higher cardiac signal | Stay at 10 mg TID cap |
Potassium-wasting diuretics belong on the spoken list. Hypokalemia plus a QT drug is a bad week.
Metoclopramide is a different CNS and tardive story. Do not stack. A swap is a clinician call.
Pediatric maps are mg/kg. Never copy adult 10 mg foil onto a child.
Suppository maps exist in some countries. They are not a US cash board.
Laugavegur peer-pass starts with QT history, not with emptying poetry.
Sources stay EMA/CMDh referral text and EU SmPC contraindication lists. FDA non-approval context explains the missing US dollar.
Metoclopramide is a different CNS and tardive story. Do not stack. A swap is a clinician call.
Pediatric maps are mg/kg. Never copy adult 10 mg foil onto a child.
Suppository maps exist in some countries. They are not a US cash board.
Peer-pass starts with QT history, not emptying poetry.
Sources stay EMA/CMDh referral text, EU SmPC lists, and FDA non-approval context for the missing dollar.
| Item | Note |
|---|---|
| Metoclopramide is a different CNS and ta | chart |
| Pediatric maps are mg/kg. Never copy adu | till |
Off-label galactagogue use circulates. It does not create a US cash board and it does not waive CYP3A4 or QT contraindications.
People over sixty on other QT drugs are the EMA high-risk sketch. A newborn-at-home story does not erase that sketch.
Personal sourcing decisions stay with the clinician who can see an ECG and the full med list. This desk will not write an import recipe.
Domperidone chips
Moderate-severe hepatic impairment is contraindicated on current SmPCs.
Mechanical obstruction, perforation, or GI bleed are reasons not to force motility.
Not a routine US retail NDC. No invented Motilium dollar. Caelum does not import.
Lactation off-label use does not retire the ECG or the CYP wall.
A sourced blister still owes an electrolyte and med-list review. Potassium-wasting diuretics belong on the spoken list.
Oral ketoconazole plus Motilium 10 for the nausea the azole caused is the contraindicated CYP3A4 and QT pair. Call the prescriber. Do not treat azole nausea with domperidone. People who treat a labeled contraindication as a courtesy antiemetic invent a syncope week. This desk will not write an import recipe. No US dollar.
Ondansetron ODT plus Motilium 10 the same afternoon is two QT-active antiemetics from a drawer. Do not pair them. Syncope is 112. Postoperative nausea kits that leave both in a bag are how this orbit fails after discharge.
Age 72 plus week three of 10 mg three times daily because reflux returned is a secret extra week in the higher-risk age band. Book a review. EMA duration language is why this orbit exists. Do not invent a chronic 10 mg habit because a holiday meal sat badly.
A 10 mg adult tablet given to a 20 kg child is not pediatric mg/kg math. Seek pediatric advice. Adult foils are not a household pool. Cardiac risk and dose math both fail when someone 'just gives one.'
No-ECG lactation 10 mg TID from a clinic abroad still sits inside QT and CYP walls. This desk will not write an import recipe or a brand dollar. Ask the clinician who would own an ECG if this were a licensed path. Caelum does not import.
Peer-pass starts with QT history. Syncope: 112. Reviewed 21 August 2026. Sources stay EMA/CMDh and EU SmPC lists. Educational only. Azithromycin still gets recited when both names land. See that orbit.
Erythromycin plus Motilium 10 is another CYP3A4 and QT pair. Do not treat macrolide nausea with domperidone. Call. The 10 mg lock is enough.
A new citalopram or other QT-active psychiatric week deserves a named clinician before anyone adds 10 mg for reflux. Two QT stories on one slip are a hold.
Icelandic holiday weeks empty 10 mg foils and people invent leftover TID maps. Call. Do not stretch a seven-day EMA-style course into a buffet month.
Ingrid charts. She does not import Motilium by thread. If syncope already happened, 112. Bring the foil so the locum sees 10 mg, not a mystery antiemetic.
The fill block is a four-chain ledger that says the same thing four ways: not a routine US NDC, no invented coupon, Health Canada / EMA labels, QT counseling if a tablet was sourced abroad. Caelum does not import.
| Pharmacy | Strength / count | Orbit note | Official page |
|---|---|---|---|
| Costco | Ask Motilium 10 mg | Not a routine US retail NDC | Costco pharmacy |
| Giant Food | Ask Motilium 10 mg | No invented Motilium coupon | Giant Food pharmacy |
| Albertsons | Ask Motilium 10 mg | Health Canada / EMA labels, not a US cash board | Albertsons pharmacy |
| Publix | Ask Motilium 10 mg | QT counseling still applies if sourced abroad | Publix pharmacy |
The review kept nausea and vomiting, cut the dose, and shortened the usual course. Adult oral 10 mg up to three times daily, generally not more than a week for that kept indication.
Potent CYP3A4 inhibitors are contraindicated - ketoconazole, ritonavir-class, clarithromycin, telithromycin.
Other QT drugs are a contraindication pattern. Do not generalize a narrow apomorphine exception to a sinus macrolide.
Azithromycin is a caution macrolide in some SmPCs. Recite it anyway.
Heart failure, known long QT, and important electrolyte disturbance close the door. A short week is not a waiver.
The review kept nausea and vomiting, cut the dose, and shortened the usual course. Adult oral 10 mg up to three times daily, generally not more than a week for that kept indication.
Potent CYP3A4 inhibitors are contraindicated regardless of their own QT story - ketoconazole, ritonavir-class, clarithromycin, telithromycin.
Other QT drugs are a contraindication pattern. Apomorphine has a narrow exception in some texts. Do not generalize that exception to a sinus macrolide.
Azithromycin is a caution macrolide in some SmPCs. Recite it anyway.
Heart failure, known long QT, and important electrolyte disturbance close the door. A short week is not a waiver.
Moderate-severe hepatic impairment is contraindicated on current SmPCs.
Mechanical obstruction, perforation, or GI bleed are reasons not to force motility.
Not a routine US retail NDC. No invented Motilium dollar. Caelum does not import.
Lactation off-label use does not retire the ECG or the CYP wall.
| EMA sketch | Action |
|---|---|
| >60 y | Extra caution |
| >30 mg oral/day | Stay at 10 mg TID cap |
| CYP3A4 inhibitor | Do not pair |
| QT drug | Do not pair |
QT first. No US dollar. No clarithromycin. EMA week-scale caps. Lactation talk does not rewrite cardiac rows.
Companions: QT, GI, azithromycin when macrolide names collide.
Checked against the current label and reviewed by Dr. Ingrid Bergsson. See Lift, Chart, Peer-pass, Publish.
Domperidone QT and CYP3A4 thread at Laugavegur, peer-passed by Dr. Ingrid Bergsson. No US cash row. Educational only. Syncope: 112.
Runa J., macrolide Motilium 10 mg plus clarithromycin for a sinus week?
No. EMA-style labels contraindicate potent CYP3A4 inhibitors with domperidone, and many macrolides also prolong QT. Clarithromycin is a classic hard pair. Azithromycin is a caution macrolide in some SmPCs. This is a cardiac conversation, not a nausea convenience. See the QT trace. Confirm with your clinician. Icelandic emergency: 112.
Valgerdur S., keto Oral ketoconazole plus Motilium 10 for azole nausea.
Contraindicated pair. Do not treat azole nausea with domperidone. Call the prescriber. Icelandic emergency: 112. Syncope or a racing irregular pulse is urgent. Bring both bottles. No US dollar belongs on this orbit.
Ida M., Costco Need a Motilium coupon for a US window.
This desk will not invent a US dollar. The fill block is literacy. Caelum does not import.
Petur A., heart Known long QT. 10 mg three times daily for a week OK?
Known conduction disease, heart failure, and significant electrolyte disturbance are contraindication territory on EU SmPCs. A 'short week' is not a waiver. Ask cardiology before any sourced tablet.
Tomas E., ODT Ondansetron ODT plus Motilium 10 the same afternoon.
Two QT-active antiemetics are a stack. Do not pair them from a drawer. Call. Syncope: 112.
Jonas M., US window Costco quote for Motilium 10?
Domperidone is not a routine US retail NDC. This desk will not invent a Motilium dollar. Official pharmacy links are literacy only. Caelum does not import. The orbit fill block says that in caption form.
Stefan P., child Gave my 10 mg tablet to a 20 kg child because she vomited.
Adult foil is not pediatric mg/kg math. Seek pediatric advice. Do not repeat it.
Olafur B., child Gave my 10 mg tablet to a 20 kg child who vomited.
Adult foil is not pediatric mg/kg. Seek pediatric advice. Do not repeat it.
Lara H., keto Oral ketoconazole for nails plus Motilium 10 for nausea from the azole.
That pair is a contraindicated CYP3A4 stack and a QT stack. Do not treat nausea from the azole with domperidone. Call the prescriber. This is the failure mode the EMA list exists for.
Helgi P., ODT Ondansetron ODT plus Motilium 10 the same afternoon.
Do not pair two QT antiemetics from a drawer. Call. Syncope: 112. Postoperative kits that leave both in a bag are how this orbit fails. Stop the pair. Ask which single agent the clinician wants.
Helga R., metoclopramide Swap to metoclopramide because Motilium is hard to find?
Different CNS penetration and tardive-dyskinesia story. A swap is a clinician call, not a till substitution. Do not stack both.
Kristjan D., 72 Age 72, week three of 10 mg three times daily because holiday reflux returned.
Book a review. That is a secret extra week in the higher-risk age band. EMA duration language is why this orbit exists. Do not invent a chronic habit. Syncope: 112. Bring the foil.
Sara L., azole Ketoconazole cream plus oral Motilium?
Systemic azoles are potent CYP3A4 inhibitors and are contraindicated pairs. A tiny cream is a different exposure than oral ketoconazole - name the exact product. When in doubt, pause and ask. Do not add oral itraconazole 'for the same fungus.'
Pia N., 72 Age 72, 10 mg TID week three because reflux returned on stop.
Secret extra weeks accumulate risk over sixty. Book a review. Recite every QT drug.
Nanna L., child Gave a 10 mg tablet to a 20 kg child who vomited.
Adult foil is not pediatric math. Seek pediatric advice. Do not repeat it. Cardiac risk and mg/kg both fail. If the child looks unwell, 112. Do not give a second adult tablet.
Gudrun F., keto Oral ketoconazole plus Motilium 10 for the nausea the azole caused.
That pair is contraindicated CYP3A4 and QT. Do not treat azole nausea with domperidone. Call the prescriber. Icelandic emergency: 112.
Olaug K., week3 Nausea returned day ten. Restart 10 mg TID another week without telling anyone.
Secret second weeks accumulate risk, especially over sixty. Book a review. Recite every QT drug.
Jon P., age 72 10 mg TID for three weeks because reflux returned when I stopped.
Duration after the review is short for the kept indication. Age over 60 was a higher cardiac signal. Book a review rather than a secret third week. Recite every QT drug including ondansetron.
Elin S., lactation 10 mg to make more milk - GP in another country wrote it.
Lactation use is off-label in many maps and sits inside the same QT and CYP3A4 walls. EMA dose caps were written after cardiac review, not after a forum. The GI orbit is emptying claims, not a lactation clinic.
Anna S., lactation Midwife abroad wrote 10 mg TID for milk. ECG never done.
Off-label galactagogue use still sits inside QT and CYP walls. Ask a clinician who can see an ECG and the full med list before any sourced tablet. This desk will not write an import recipe.
Svana M., milk No ECG, 10 mg TID for milk from a clinic abroad.
Off-label galactagogue use still sits inside QT and CYP walls. Ask a clinician who can see an ECG and the full med list before any sourced tablet. This desk will not write an import recipe.
Magnus T., duration Feel better day three. Keep 10 mg for a month just in case?
EMA recommendations after the cardiac review: lowest dose, shortest time - adult oral 10 mg up to three times daily, generally not longer than one week for the nausea indication they kept. A secret month is how risk accumulates in people over sixty and on other QT drugs.
Niels V., ondansetron Ondansetron dissolving tablets plus Motilium 10 for the same nausea day.
Two QT-active antiemetics are a stack the EMA list worries about. Do not pair them from a drawer. Call the prescriber. Syncope: 112.
Ragnar T., keto cream Only using ketoconazole cream. Oral Motilium 10 for reflux. Fine?
Systemic azoles are the hard CYP3A4 pair. A cream is a different exposure - name the exact product and body area to a pharmacist. Do not add oral ketoconazole. When unsure, pause Motilium until someone reads both labels.
Desk note What belongs on a sourced-tablet review?
ECG/QT history, electrolytes, full list of macrolides/azoles/other QT drugs, age over 60, daily milligram total, duration so far, lactation intent. Caelum does not import. Ingrid peer-passes literacy only. Confirm with your clinician. Syncope or palpitations: 112.