Domperidone, the Milk Making Medicine

on April 16, 2014 in Breastfeeding, Domperidone

While you may have never heard of Domperidone, it is well known among lactation professionals.   Domperidone is primarily used by those suffering with gastric reflux, but it has an interesting side-effect; it increases prolactin levels, the hormone that increases milk production.  Increasing prolactin levels can be very helpful for mothers who are struggling with low milk supply. Prolactin levels are normally high in mothers who are breastfeeding.

For mothers who are not producing enough milk for their baby, other herbal remedies are often suggested.  Fenugreek, a fragrant seed and eaten by mothers around the world has long been known to stimulate more milk.  It can be purchased in capsule form from nearly any health food store.  If you use pancake syrup, you have already taken fenugreek. It is the ingredient used to flavor of the syrup to be similar to taste of real maple syrup.  The typical lactation dose of fenugreek is 3 capsules taken three times a day.  A bottle of fenugreek costs about $10.00.

There are other herbs that can increase milk production like Blessed thistle, nettle, fennel seed and Goat’s rue.  “More Milk Plus” from Motherlove Herbals contains most of these herbs.  Mothers with Insufficient Glandular Tissue, those with a history of breast surgery, or those mothers who are adopting a baby may find that Motherlove’s “More Milk Special Blend” which contains the same herbs, plus Goat’s Rue, often find this product helpful.

Newer on the market is GoLacta, a product made from the leaves of the Malunggay tree (moringa oleifera), is another milk stimulating product for mothers who have low milk production.

One medication, metoclopramide (Reglan) also used for the treatment of reflux, was found to increase prolactin levels and therefore milk supply, is available by prescription.  But despite the increase in milk production, this medication has proven to have side effects that make its use problematic, causing fatigue and depression as well as other rare and serious effects.

Some mothers find that despite using these herbs or herbal combination products, they continue to be plagued by low milk production.  Using the medication Domperidone can be very helpful.  This medication is not distributed in the U.S. but is available through compounding pharmacies and in all other countries around the world. Domperidone does not pass into the brain and cause the side effects seen with metoclopromide.  You should know that in 2004, the U.S. Federal Drug Administration put out a warning about Domperidone for possible cardiac side effects that were reported when this medication was given intravenously.  But these side effects have never been reported when the medication is taken by mouth.

If you are considering using Domperidone, there are a few things that you should know.  Probably one of the best resources on using Domperidone is Dr. Jack Newman, a Canadian Pediatrician and lactation professional who has used this medication for more than 25 years. You can visit his website for a great deal of breastfeeding information, including information about Domperidone.  It is best to make sure that your breasts are being well drained by either a vigorous nursing baby and/or an effective breast pump.  The most common side effect of taking Domperidone is increased milk production.  Know that if you want to try Domperidone, there are a few uncommon side effects like headaches for the first couple of days, and more unusual, dry mouth, abdominal cramps.  Coming off of Domperidone “cold turkey” can suffer with anxiety, sleeplessness, and loss of appetite.  There are no concerns about the safety of taking for the baby, and has been given directly to infants that suffer with reflux.  The amount received by the baby through breastmilk is very small.

The initial dosing is usually 30 milligrams three times a day.  The dose can be increased up to 40 milligrams four times a day. Ideally taking the medication every 8 hours is suggested but this is not critical.  Domperidone is absorbed best when taken on an empty stomach.  Many mothers take the medication for one to two months, but some may need to take it longer or even as long as they are nursing.  This may be true for mothers who are nursing an adopted baby.

Often an increase in milk production is seen within a few days, but some mothers may need a few weeks to see a maximum effect.  It should be taken for 4-6 weeks before deciding that it isn’t helping.

The most difficult part may be getting a prescription from a doctor because they are unfamiliar with it or they are fearful of the side effects that they have heard about when it is given by IV.

If you cannot get a prescription or find a compounding pharmacy that can make the medication for you, there is another option.  You can purchase Domperidone on-line from a reputable pharmacy, “Inhouse Pharmacy” in Vanuatu, off the coast of New Zealand.  They sell Domperidone and will ship it to you without a prescription. They offer three different brands of  Domperidone; Motilium 10 milligrams, Domperon 10 milligrams, and Vomistop 10 milligrams.  Motilium is the most expensive and the two generics are less expensive with Vomistop being the least expensive.

You can visit their website at inhousepharmacy.biz and order it on-line or call them to order it. You can speak with one of their pharmacists by calling 1-800-868-9064.  Their hours are daily from 6 p.m. to midnight (EST) or 3 p.m.to 9 p.m. (PST). Shipping to the U.S. is free and takes about 10 to 14 days.  Orders can be paid for with Visa, MasterCard, or American Express.

The minimum order for Motilium manufactured by Janseen Cilag, is 100 pills.  Domperon  manufactured by Cadila has a minimum order of 200 pills and Vomistop manufactured by Cipla Pharmaceutiucals and has a minimum order of 500 tablets.  The minimums of each of these products is because of the package size of each brand.

The pricing is as follows;

MOTILIUM made by Janseen Cilag (Domperidone):

Motilium 10mg 100 tabs   $36.05

Motilium 10mg 200 tabs   $64.86

Motilium 10mg 300 tabs   $81.07

Motilium 10mg 600 tabs   $129.37

Motilium 10mg 900 tabs   $183.28

Motilium 10mg 1200 tabs $226.41

Motilium 10mg 1800 tabs $306.45

 

Domperon made by Cadila (generic Domperidone):

Domperon 10mg 200 tabs  $43.70

Domperon 10mg 400 tabs  $69.18

Domperon 10mg 600 tabs  $86.48

Domperon 10mg 800 tabs  $107.81

Domperon 10mg 1000 tabs $129.37

Domperon 10mg 1200 tabs $150.94

Domperon 10mg 1800 tabs $204.84

 

Vomistop made by Cipla Pharmaceutiucals (generic Domperidone)

Vomistop 10mg 500 tablets  $64.86

Vomistop 10mg 1000 tablets $113.20

Vomistop 10mg 1500 tablets $161.72

Vomistop 10mg 2000 tablets $183.28