MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Motility stimulants

Please note: Metoclopramide and domperidone are not licensed for the treatment of gut motility problems including managment of oesophageal reflux, gastroparesis and in some patients with non-ulcer dyspepsia. Benefit no longer outweighs risk. Please see the link to safety information below.

 Due to the risk of neurological adverse effects metoclopramide should only be prescribed for short term use (up to 5 days) and the maximum dose in 24 hours is 30mg (or 0.5mg/kg body weight). For more information see Drug Safety Update, August 2013

Domperidone is associated with a small increased risk of serious cardiac side effects. Domperidone is contraindicated in people with underlying cardiac conditions, receiving other drugs known to prolong the QT interval or potent CYP3A4 inhibitors and those with severe hepatic impairment. For adults and adolescents weighing >35kg, the maximum recommended oral dose in 24 hours is 30mg, (10mg three times daily), and for suppositories 60mg in 24 hours, (30mg twice daily). The maximum treatment duration should not usually exceed 1 week. For more information please see Drug Safety Update, May 2014.

 Motility stimulants were used in the management of oesophageal reflux, gastroparesis, nausea and in some patients with non-ulcer dyspepsia.

Erythromycin suspension 125mg three times a day before meals is sometimes used to stimulate gastric motility (unlicensed indication). Please see NICE evidence review for an unlicensed or off-label medicine. ESUOM13 Gastroparesis in adults - oral erythromycin, June 2013.