Reglan and Domperidone

[Lanene]

I have been using Reglan for 2.5 months and would like to switch to domperidone. Do I need to taper off of Reglan first, or can I simply switch? If I do need to taper, how do I do that without affecting my supply?

[cpride]

Dear Lanene,

You do not have to taper off Reglan before switching to domperidone.
Finish your Reglan dose for the day, then the following day start
domperidone. Start the domperidone with the lowest dose 10 mg three times
per day. You may increase up to 20 mg four times per day if needed. You
should not go above 20 mg four times daily. You should not take domperidone
if you have a history of heart problems. Observe for any heart
palpitations. This reaction is rare, but you should stop the medication
and seek medical care if palpitations occur. You may stay on domperidone
until you are ready to wean your infant as it does not cross the blood
brain barrier; therefore, doesn't cause the depression and muscle
twitching that long term use of Reglan may cause. Let me know if you have
further questions.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center