Domperidone and Heart Attacks: Should You Be Worried?

By Blake Eligh

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Photography from iStockphoto.com

Are you a nursing mum taking domperidone to boost your milk supply? Did you see Health Canada’s recent advisory on the drug?

No need to panic, we’ve got the low-down from breastfeeding guru Dr. Jack Newman.

On March 2, Health Canada issued an advisory for domperidone, citing the drug for causing heart arrhythmias and heart attacks. The drug, which is officially used to treat gastric disorders, is often used off-label to increase milk supply for nursing mothers. (The FDA issued a related advisory in 2004.)

It’s a lot of fuss over nothing, says Dr. Newman of the International Breastfeeding Centre in Toronto.

“What has this to do with breastfeeding mothers who are rarely older than 45 years, and are usually in reasonably good health?” he asks.

Dr. Newman takes issue with the Belgian study that spurred the advisory, noting that the average age of those who experienced problems with the drug were 75. Health Canada’s advisory highlights problems with patients taking more than 30mg daily, and who were older than 60 years of age.

Dr. Newman points to a number of problems with the supporting studies, saying that misdiagnosis may have contributed to problems experienced by those taking domperidone for gastric issues. He notes that patients in the studies were being treated for reflux, which has symptoms similar to heart disease. Further, domperidone is available without prescription in some European countries, meaning that people may have run into problems by self-diagnosing and self-medicating.

“It does not mean that domperidone kills,” Dr. Newman says, adding that he will continue to prescribe the drug at his clinic.

“I have treated many thousands of women with it, with only minor side effects,” he says. “It would be a pity that mothers and babies not benefit from domperidone when used in conjunction with our Protocol to Manage Breast Milk.”

Used as a lactation aid, domperidone is prescribed at dosages ranging from 30 mg tid (three tablets taken three times per day) to 40 mg qid (four tablets taken four times per day). Potential side effects can include mild headaches, occasional menstrual irregularities, or mild abdominal cramping.

Nursing mothers can also take natural supplements to increase milk production. Fenugreek and blessed thistle supplements, available at health food stores, can increase supply and help with milk flow. The dosage (3 capsules taken three times daily) should work within 24 to 72 hours.

For more breastfeeding advice, see these tips from lactation consultant Edith Kernerman, or visit the International Breastfeeding Centre’s website for downloadable multilingual information sheets, video instruction and more.

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