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37yo G7P2, term baby is 8 weeks, tongue tie, torticollis, plagiocephaly, having frenotomy next week. Mother pumping 20oz and gives 4-6oz formula daily. already tried moringa and goat's rue without success, wants to try domperidone. Takes trazodone hs for anxiety and sleep. I know that both trazodone and domperidone can prolong QT intervals so best not taken together but mother says she can switch to lorazepam instead of trazodone. Any contraindications of using domperidone and lorazepam together?
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Hi Annie,
I've never heard of lorazepam prolonging QT intervals, but I'd still promote caution in this patient. Domperidone may cause or worsen depression, anxiety, and intrusive thoughts upon discontinuation (or taper). In a patient with a history of anxiety, it is worth further evaluation of risk vs benefit. Lower doses (30-60 mg per day) are probably safer for lactation, and if mom has anxiety problems when tapering the issues are more short-lived.
Kaytlin Krutsch, PharmD -
Hi Kaytlin,
To clarify it was the trazadone, not lorazepam that could prolong QT intervals. Mother could switch to Lorazepam instead of trazadone. Are they any interactions with lorazepam and domperidone? I will certainly talk about the chance of increase of PMAD symptoms with domperidone withdrawal with her.
Thank you,
Annie Brown, FNP, IBCLCComment
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No interactions with lorazepam and domperidone that I am aware of.
KKComment
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Many thanks,
AnnieComment
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