Article Text

PDF
Survey of the use of domperidone and the association with QTc prolongation in general practice
  1. Adam Ioannou1,
  2. Alka Jain2,
  3. George Kassianos3,
  4. Constantinos Missouris4,5
  1. 1University College London, London, UK
  2. 2Wrafton House Surgery, Hatfield, UK
  3. 3Ringmead Medical Practice, Birch Hill Medical Centre, Bracknell, UK
  4. 4Cardiology, Frimley Health NHS Foundation Trust, London, UK
  5. 5International Centre for Circulatory Health, NHLI, Imperial College, London, UK
  1. Correspondence to Dr Constantinos Missouris, Frimley Health NHS Foundation Trust, Wexham Street, Slough SL2 4HL, UK; dinos.missouris{at}fhft.nhs.uk

Abstract

Purpose of the study Domperidone is associated with QTc prolongation, predisposing to the development of ventricular arrhythmias. In 2014, The Medicines and Healthcare Regulatory Agency (MHRA) recommended restricting its use. We assessed whether these recommendations have been implemented in a general practice.

Study design We conducted a prospective study using the general practitioner (GP) computer database on patients who had at least one repeat prescription for domperidone in 12 months. Data were presented to the doctors and the survey was repeated 7 months later.

Results Sixty-four patients (mean age 61.3±16.4 years) were identified who had received at least one repeat prescription of domperidone. Twenty patients were being prescribed over the recommended daily dose. Nineteen patients were coprescribed medications known to prolong the QTc interval and two CYP3A4 inhibitors. The repeat survey performed 7 months later demonstrated a 70% reduction in the number of patients prescribed domperidone to a total of 19 (three patients prescribed above the recommended dose) none of which had a history of cardiac disease or were being coprescribed drugs known to prolong the QTc interval.

Conclusions Following the publication of the MHRA recommendations and presentation of our initial survey, there has been a significant reduction in the number of patients treated with domperidone and those coprescribed drugs known to prolong the QTc interval. We suggest that regular review of GP practice database should be performed to identify those patients prescribed domperidone and at risk of life-threatening arrhythmias and measures taken to use alternative pharmacological agents.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.