Domperidone + Paracetamol

Oral
Migraine

Hypersensitivity. GI haemorrhage, obstruction and perforation, patients with prolactin releasing pituitary hormone or chronic admin or for prophylaxis of postoperative nausea and vomiting.

Phaeochromocytoma; children, elderly; renal or hepatic impairment, risk of cardiac arrhythmias and hypokalaemia if administered IV. Pregnancy, lactation and alcohol-dependent patients.

Drowsiness, extrapyramidal reactions, galactorrhoea, gynaecomastia; constipation or diarrhoea, lassitude, decreased libido, nausea, allergic reactions, skin rashes, acute renal tubular necrosis.
Potentially Fatal: Domperidone: convulsions, arrhythmias and cardiac arrest, dysrhythmias in patients with CV disease or hypokalaemia, patients on cancer chemotherapy. Seizures, hypertensive crisis in patients with pheochromocytoma are seen.
Paracetamol, very rare, blood dyscrasias (eg, thrombocytopaenia, leucopaenia, neutropaenia, agranulocytosis); liver damage are seen.

Domperidone reduces absorption of oral digoxin, increases absorption of aspirin and oral diazepam. Enhances CNS depression by phenothiazines. Antimuscarinic agents and opioids antagonise GI effects of domperidone.
Paracetamol reduced absorption of cholestyramine within 1 hr of admin and accelerates absorption of metoclopramide.
Potentially Fatal: Paracetamol increases the risk of liver damage in chronic alcoholics. Increased risk of toxicity with other hepatotoxic drugs or drugs which induce microsomal enzymes.

Delayed absorption of domperidone but higher bioavailability due to reduced first-pass metabolism in gut wall. Decreased rate of absorption of paracetamol with food.

Description:
Mechanism of Action: Domperidone is a dopamine antagonist which works to prevent vomiting (symptom of migraine). Domperidone is given with paracetamol, an analgesic, for relief of migraine.

Antimigraine Preparations