Motilium: indispensable for poisoning and stomach disorders

Compound

Regardless of the form of release, the medicine contains domperidone as an active substance.
Motilium suspension contains the following additional components: sodium saccharinate, sodium carboxymethylcellulose, methyl parahydroxybenzoate, sodium hydroxide, water, MCC, sorbitol , propyl parahydroxybenzoate, polysorbate.

Excipients of lozenges: gelatin, aspartame, poloxamer 188, mannitol, mint essence.

Coated Motilium tablets contain lactose, microcrystalline cellulose, polyvidone, hydrogenated vegetable oil, hypromelose, corn starch, gelatinized potato starch, magnesium stearate, sodium lauryl sulfate.

Assessing the effectiveness of drugs

According to medical literature, domperidone in Motilium and Motilak is one of the most popular drugs for the treatment of stomach diseases associated with impaired motility. Clinical studies show that the drug is effective in mild to moderate gastroesophageal reflux disease. It stops reflux and relieves associated symptoms - nausea, belching, abdominal discomfort. There is evidence that domperidone should be considered as a safe alternative to another prokinetic agent, metoclopramide.

Pharmacodynamics and pharmacokinetics

The medicine inhibits dopamine receptors . This property, in combination with the gastrokinetic effect, determines the antiemetic effect of the drug.

When used internally, Motilium increases the pressure of the lower esophageal sphincter , accelerates gastric emptying and helps improve antroduodenal motility .

After taking on an empty stomach, the active substance of the drug is absorbed from the gastrointestinal tract in a short time. The degree of absorption of domperidone is reduced due to a decrease in the acidity of gastric juice. plasma concentration is observed after approximately 0.5-1 hour. In people with moderate liver dysfunction it can be 1.5 times higher than in healthy people.

Absolute bioavailability is about 15%. When using the medicine after meals, the maximum concentration is reached later. In healthy people, bioavailability increases when taken after meals. If you have problems with the gastrointestinal tract, you should use the drug 15-30 minutes before meals.

The degree of binding of the active substance to plasma proteins is 91-93%. Once in the body, it undergoes rapid and active biotransformation in the liver through hydroxylation and N-dealkylation.

The drug is excreted 31% in urine and 66% in feces. About 11% of the active substance is excreted unchanged.

The plasma half-life after a single dose is 7-9 hours. In people with severe renal impairment, the half-life increases to 20.8 hours and plasma concentrations decrease. Only about 1% is excreted unchanged through the kidneys. In people with impaired liver function, the half-life is 15-23 hours.

Therapeutic effect

Motilium has the ability to eliminate nausea, stop vomiting, and gently activate intestinal motility. The active component of the drug, domperidone, exhibits some properties of an antipsychotic, suppressing sensitivity to dopamine. Unlike other inhibitors, it is more neutral: it does not cause dystonia, tremor, or nervous tics.

The drug increases the tone of muscle fibers and enhances contractions of the esophageal sphincter in its lower part. Thanks to this, the evacuation function of the stomach is normalized, signs of dyspepsia, indigestion, and other motility disorders and diseases of the gastrointestinal tract are eliminated.

The drug is absorbed by the mucous membranes within a few minutes and actively binds to blood proteins. Transformed by liver cells. It is excreted from the body by the kidneys and with intestinal contents within 0.5–1 days after administration.

Domperidone stimulates the release of prolactin. The secretion of gastric juice and its acidity are not affected. When consumed during or immediately after a meal, the effect of Motilium may slow down somewhat.

Indications for use of Motilium

Indications for the use of Motilium: vomiting, hiccups, nausea, atony and hypotension , cholecystitis , reflux esophagitis , peptic ulcers , the need to accelerate peristalsis before X-ray studies of the gastrointestinal tract, biliary dyskinesia cholangitis , flatulence .

As a component of complex treatment, the drug is taken for exacerbation of gastric and duodenal ulcers .

Indications for the use of Motilium for children: gastroesophageal reflux , cyclic vomiting, regurgitation syndrome .

How can I replace Motilium?

The most famous analogues and generics of the drug:

• Domrid;
• Domidon;
• Domperidone Hexal;
• Motinorm;
• Motoricum;
• Motilak;
• Peridonium.

You should not change the medicine to an alternative one on your own. In addition to differences in dosage, some of them have a wider list of contraindications; not all are approved for use in pediatrics.

Contraindications

The medicine has the following contraindications:

• bleeding in the gastrointestinal tract, perforation , mechanical obstruction ;
• prolactinoma;
• negative reaction of the body to the components of the drug;
• severe or moderate liver dysfunction

The drug should be taken with caution in case of kidney dysfunction , as well as cardiac and disorders .

It is advisable to consult a specialist about possible contraindications to the use of the medicine.

When is Motilium contraindicated?

It is prohibited to use the medicine:

• in case of danger of perforation of a gastric ulcer, development of internal bleeding;
• in case of intestinal obstruction;
• in case of dysfunction, neoplasms in the pituitary gland;
• prolactinoma;
• severe kidney or liver damage;
• individual intolerance to any of the components of the drug.

If you are allergic to Motilium, itching, hyperemia, rash, lacrimation, and swelling of the mucous membranes are likely to occur. In such cases, discontinuation of therapy and replacement of the drug with another is required.

Side effects

The following side effects are possible when taking this medicine:

• endocrine system: amenorrhea , hyperprolactinemia (in rare cases can cause galactorrhea ), gynecomastia ;
• Gastrointestinal tract: spasms in the intestines;
• allergies : urticaria , rash;
• nervous system: extrapyramidal disorders .

Negative effects are observed only in extremely rare cases.

Side effects and interactions

When treating with Motilium, caution should be exercised when using antacids and agents that reduce secretory activity. It is recommended to separate them by time.

The simultaneous use of antifungal drugs, some drugs against HIV infection and macrolides contributes to the prolonged presence of Motilium in the blood. This is important to consider for people with impaired liver and endocrine system functions.

Most patients tolerate therapy well. In rare cases, the drug may cause menstrual irregularities or gynemastia due to changes in prolactin levels in women.

In case of an overdose, spasms in the intestinal area, loss of appetite, drowsiness, and an unpleasant taste in the mouth are likely to occur.

Instructions for use of Motilium (Method and dosage)

The instructions for use of Motilium indicate that the dosage regimen may vary depending on whether the tablets or suspension are used in each specific case.

In case of chronic dyspepsia, adults need to take the medicine 10 mg (1 tablet) on an empty stomach 3 times a day. If necessary, you can use the drug before bedtime. For those who use Motilium suspension and tablets, the instructions for use do not recommend exceeding the daily dosage of 80 mg.

Children are given syrup in a dosage of 2.5 ml of medicine per 10 kg of weight. This should be done 3 times a day on an empty stomach. If necessary, take the medicine before bedtime.

Instructions for use of Motilium for children over 1 year of age also indicate that, if necessary, the dose can be increased by 2 times. The maximum dosage per day is 2.4 mg/kg, but not more than 80 mg.

In case of nausea and vomiting, take syrup in a dosage of 20 ml or 2 tablets. This should be done 3-4 times a day on an empty stomach and before bedtime. Daily dosage – no more than 80 mg.

Suspension for children is given at the rate of 5 ml of product per 10 kg of weight. The medicine is taken 3-4 times a day on an empty stomach and before bedtime. The maximum daily dosage is 2.4 mg/kg, but not more than 80 mg.

Tablets can only be given to adults and children weighing over 35 kg. If your body weight is less, you need to use the so-called children's Motilium in the form of syrup.

Before use, the bottle of suspension must be shaken well. To open it, you need to press on the plastic cover and turn it. Next, remove the cap containing the Motilium suspension; the instructions for use indicate that it should only be drawn up using a special pipette that comes with the drug.

Motilium

Motilium ®

(lat.
Motilium
®) is a second generation prokinetic agent intended for the treatment of diseases of the upper digestive tract, accompanied by a decrease in motor-evacuation function, as well as an antiemetic drug.
Dosage forms of Motilium:

• lozenges
• film-coated tablets
• suspension for oral administration

Active substance:
domperidone. One lozenge or film-coated tablet contains 10 mg of domperidone. The oral suspension contains 1 mg of domperidone per 1 ml.

Excipients:

• lozenges - gelatin, aspartame, mannitol, mint essence, polyxamer 188
• film-coated tablets - lactose, pre-gelatinized potato starch, corn starch, hydrogenated vegetable oil, microcrystalline cellulose, magnesium stearate, polyvidone, hypromelose, sodium lauryl sulfate
• oral suspension - sodium saccharinate, sorbitol, microcrystalline cellulose, sodium carboxymethylcellulose, methyl parahydroxybenzoate, propyl parahydroxybenzoate, sodium hydroxide, polysorbate, purified water

Appearance:

• lozenges - white or almost white round tablets
• film-coated tablets - round, biconvex, white to pale cream in color, labeled "Janssen"
• oral suspension - homogeneous white suspension

Pharmacotherapeutic group
- antiemetic, central dopamine receptor blocker. According to the pharmacological index, motilium belongs to the group “Gastrointestinal motility stimulants, including emetics.” For ATC - to the group “Gastrointestinal motility stimulants”, code A03FA03.

Motilium blocks dopamine D2 receptors and thus eliminates dopamine inhibition of the motor activity of the digestive system. Increases the duration of gastric antrum and duodenal peristalsis, prevents slow gastric emptying, and increases the tone of the lower esophageal sphincter.

The antiemetic effect of motilium is due to a combination of gastrokinetic action and blockade of chemoreceptors of the trigger zone of the vomiting center. Motilium prevents the development or reduces the severity of vomiting and nausea.

After oral administration, motilium is quickly absorbed from the gastrointestinal tract. Food or low acidity of gastric juice slows down and reduces absorption. The maximum concentration in the blood is reached after 0.5–1 hour. Motilium is found in small amounts in breast milk. It is subjected to intensive metabolism in the intestinal wall and liver with the formation of hydroxydomperidone and 2,3-dihydro-2-oxo-1-H-benzimidazole-1-propionic acid, respectively. The half-life after a single dose is 7 hours and increases in chronic renal failure. 31% is excreted by the kidneys, of which 1% is excreted unchanged and 66% is excreted by the intestines (10% unchanged). Domperidone may accumulate in patients with liver disease.

Motilium belongs to the second generation prokinetics and, unlike the first generation prokinetics: cerucal, raglan and others (the active substance metoclopramide) does not penetrate the blood-brain barrier (BBB) ​​well. Therefore, Motilium does not cause extrapyramidal disorders: spasms of the facial muscles, trismus, rhythmic protrusion of the tongue, bulbar type of speech, spasms of extraocular muscles, spastic torticollis, opisthotonus, muscle hypertonicity and others. Motilium does not cause parkinsonism: hyperkinesis, muscle rigidity. Motilium less frequently and to a lesser extent than Cerucal and Raglan causes side effects such as drowsiness, fatigue, tiredness, weakness, headaches, increased anxiety, confusion, and tinnitus.

Compared to Coordinax and other prokinetics with the active ingredient cisapride, motilium has a less effective effect on the motility of the digestive tract, but it is completely devoid of the serious cardiac side effects of cisapride - prolongation of the QT interval and ventricular arrhythmias, including ventricular fibrillation.

Since the pituitary gland is located outside the blood-brain barrier, motilium increases the level of prolactin in the blood.

Indications for use of Motilium

In adults, Motilium is indicated for nausea and vomiting, including due to diet disorders, radiation therapy, infections, toxemia, during endoscopic and radiopaque studies of the digestive tract, hiccups, postoperative or other atony of the stomach and intestines;
with a feeling of bloating, fullness in the epigastrium, pain in the upper abdominal cavity, belching, flatulence, heartburn, pharyngolaryngeal reflux (reflux of stomach contents into the pharynx, larynx and oral cavity). In children, Motilium is indicated for regurgitation syndrome, cyclic vomiting, gastroesophageal reflux and other motility disorders of the upper digestive tract. Motilium is used in the treatment of many gastrointestinal diseases, usually in combination with antisecretory and other drugs and much less often as a single drug. It is most often prescribed for:

• gastroesophageal reflux disease
• achalasia cardia
• duodenogastric reflux
• chronic gastritis with decreased motor-evacuation function of the stomach
• gastroptosis
• gastric ulcer with normal and low acidity and weakening of muscle tone and peristalsis
• atony and hypotension of the stomach and duodenum that developed in the postoperative period (gastroparesis)
• hypokinetic type of biliary dyskinesia

Method of application of motilium and dose

• Chronic dyspepsia.
  Adults: 1 tablet or 10 ml of motilium suspension 3 times a day, 15–30 minutes before meals and, if necessary, before bedtime. Per day, a total of no more than 8 tablets or 80 ml of suspension (80 mg of domperidone). Children: 25 ml of suspension per 1 kg of body weight 3 times a day before meals and, if necessary, before bedtime. If necessary, for children over 1 year of age, the indicated dose can be doubled. The maximum daily dose of motilium is 2.4 ml per 1 kg of child’s body weight, but not more than 80 ml.
• Nausea and vomiting.
  Adults: 2 tablets or 20 ml of motilium suspension 3-4 times a day before meals and before bed. Per day, a total of no more than 8 tablets or 80 ml of suspension (80 mg of domperidone). Children: 0.5 ml of suspension per 1 kg of body weight, 3-4 times a day before meals and before bedtime. The maximum daily dose of motilium is 2.4 ml per 1 kg of child’s body weight, but not more than 80 ml (Instructions for use).

For children under 5 years of age
(according to*
, 10 mg film-coated tablets - up to 12 years)
and weighing less than 35 kg, taking Motilium tablets is not recommended. Such children should take motilium in the form of a suspension.

In case of renal failure, it is recommended to reduce the frequency of taking motilium.

At the beginning of 2015, the Russian Ministry of Health* proposed making changes

In the instructions for film-coated tablets, 10 mg: dosage regimen - one tablet 3 times a day, maximum daily dose - 3 tablets (30 mg).

The use of motilium in children suffering from GERD

Among prokinetics, the most effective antireflux drugs currently used in the treatment of children are blockers of dopamine receptors, both central (at the level of the chemoreceptor zone of the brain) and peripheral. These include cerucal and motilium. The pharmacological effect of these drugs is to enhance antropyloric motility, which leads to accelerated evacuation of gastric contents and increased tone of the lower esophageal sphincter. However, when cerucal is prescribed, especially in young children at a dose of 0.1 mg/kg 3-4 times a day, extrapyramidal reactions and, less commonly, allergic reactions in the form of swelling of the tongue and agranulocytosis may be observed. In childhood, treatment with a dopamine receptor antagonist, domperidone (Motilium), is preferable. Motilium has a pronounced antireflux effect. When it is used, there are practically no extrapyramidal reactions in children. Motilium also has a positive effect on constipation in children: it leads to normalization of the bowel movement process. Motilium cannot be combined with antacids, since its absorption requires an acidic environment and with anticholinergic drugs that neutralize the effect of motilium (Khavkin A.I., Privorotsky V.F.).

Motilium therapy taking into account electrogastrographic studies

When studying the motor-evacuation function of the stomach using electrogastrography, 5 main types of impaired motility of the stomach and duodenum are determined (Rachkova N.S., Khavkin A.I.):

• irritable stomach (type 1) - characterized by normal or reduced electrical activity of the stomach on an empty stomach with a subsequent increase in its electrical activity after eating by more than 1.5-2 times

• lazy stomach
  (type 2) - characterized by normal electrical activity of the stomach on an empty stomach and a decrease in it after eating
• asthenic stomach
  (type 3) - characterized by a high level of electrical activity of the stomach on an empty stomach and a decrease in it after eating
• duodenal hypertension, option I
  (type 4) - characterized by an increased level of electrical activity of the duodenum on an empty stomach and after meals
• duodenal hypertension, variant II
  (type 5) - characterized by an increase in the electrical activity of the duodenum on an empty stomach and normalizing after eating.

The figure on the right (Rachkova N.S., Khavkin A.I.) shows the electrical activity of the stomach before and after treatment with Motilium for the listed 3 types of gastric motility disorders. Motilium is also recommended for type 5 disorders (duodenal hypertension, II). At the same time, in type 4 disorders (duodenal hypertension, I), treatment with motilium has no effect and the use of antispasmodics is recommended.

Professional medical publications addressing the effects of motilium on the gastrointestinal tract

• Erdes S.I., Mukhametova E.M., Petukhova E.V., Matsukatova B.O. Differentiated approach to the treatment of children with motor and secretory disorders of the upper digestive tract // RMZh. Mother and Child. – 2010. – T. 18. – No. 10.
• Rachkova N.S., Khavkin A.I. Assessment and principles of differential treatment of gastric and duodenal motility disorders in patients with functional dyspepsia // Bulletin of pediatric pharmacology and nutrition. – 2007. – T. 4. – No. 5. – p. 25–29.
• Rebrov V.G., Loginov A.F., Kalinin A.V. Changes in the electrical activity of the stomach and intestines under the influence of motilium / Russian Journal of Gastroenterology, Hepatology, Coloproctology. –1997. – No. 4. - With. 42–45.
• Khavkin A.I., Privorotsky V.F. Gastroesophageal reflux disease. In the book. Acid-dependent conditions in children / Ed. acad. RAMS V.A. Tabolina. – M. – 1999. – 112 p.

On the website in the literature catalog there is a section “Prokinetics”, containing articles on the use of prokinetics in the treatment of diseases of the gastrointestinal tract.

Contraindications for the use of motilium

Hypersensitivity to motilium, bleeding in the stomach or intestines, perforation of the stomach or intestines, intestinal obstruction, hyperprolactinemia, prolactinoma, epilepsy, glaucoma, breast cancer, pheochromocytoma, pregnancy (first trimester - see below
), simultaneous use of oral forms of ketoconazole.

Part of the active substance of motilium, domperidone, penetrates into mother's milk, so motilium is not recommended during breastfeeding.

At the beginning of 2015, the Russian Ministry of Health* proposed changes

In the instructions for film-coated tablets, 10 mg, in particular, a list of contraindications for use has been added: moderate and severe liver failure, pregnancy, breastfeeding, children under 12 years of age or body weight up to 35 kg, simultaneous use of medications increasing the QT interval and inhibitors of the CYP34A isoenzyme.

Side effects of Motilium

• digestive system
  : rarely - gastrointestinal disorders, very rarely - transient intestinal spasms
• nervous system
  : very rarely - extrapyramidal phenomena (spasms of the facial muscles, trismus, rhythmic protrusion of the tongue, bulbar type of speech, spasms of extraocular muscles, spastic torticollis, opisthotonus, muscle hypertonicity) and disappear after stopping Motilium.
• immune system:
  very rarely - allergic reactions
• endocrine system
  : hyperprolactinemia; very rarely - galactorrhea, gynecomastia and amenorrhea
• integumentary system:
  urticaria, itching

At the beginning of 2015, the Russian Ministry of Health* proposed changes
to the instructions for film-coated tablets, 10 mg, in particular, the list of side effects was added: very rarely - urticaria, anaphylactic shock, angioedema shock, convulsions, increased excitability and irritability, drowsiness, headache pain, changes in liver function tests; frequency unknown - ventricular tachycardia of the “pirouette” type, sudden coronary death.

Motilium overdose

Overdose is manifested by drowsiness, disorientation and extrapyramidal reactions, especially in children. In case of overdose, it is recommended to take activated charcoal and careful monitoring, as well as anticholinergic drugs used to treat parkinsonism and antihistamines.

Interaction of motilium with other drugs

Anticholinergic drugs may counteract the effects of motilium.
The oral bioavailability of motilium is reduced after previous administration of cimetidine or sodium bicarbonate. Antacids and antisecretory drugs, when taken simultaneously with motilium, reduce its bioavailability. Antifungal drugs of the azole group, antibiotics of the macrolide group, HIV protease inhibitors can block the metabolism of domperidone and increase its level in plasma, so their combined use with motilium requires caution. Motilium may also be combined with:

• paracetamol
• digoxin
• neuroleptics, the effect of which it does not enhance
• agonists of dopaminergic receptors: bromocriptine, levodopa, the undesirable effects of which are indigestion, vomiting, nausea, without affecting their basic qualities, it suppresses

Special instructions for Motilium therapy

When using motilium with antacid or antisecretory drugs, the latter are not recommended to be taken simultaneously with motilium.
In this case, antacids or antisecretory drugs are taken after meals. The drug should be given to infants, as well as to patients of any age with liver disease, very carefully and under medical supervision.

In severe renal failure, the elimination time of the active substance of motilium, domperidone, increased by approximately 3.5 times, but drug concentrations in plasma were lower than in healthy volunteers. There is no need to adjust a single dose in patients with renal failure, however, when re-administered, the frequency of administration should be reduced to once or twice a day, depending on the severity of the failure, and it may also be necessary to reduce the dose. During long-term therapy, such patients should be under medical supervision.

Manufacturers of Motilium

• lozenges - Cardinal Health UK 416 (UK)
• film-coated tablets - Janssen-Cilag (France)
• suspension for oral administration – Janssen Pharmaceutica (Belgium)

general information

Motilium does not affect the ability to drive a car or use other mechanisms ( according to* when taking 10 mg film-coated tablets, caution must be exercised when driving vehicles and similar activities
).
Motilium is an over-the-counter product
(
letter* suggests converting 10 mg film-coated tablets to prescription status
).

Trade names of other drugs containing active ingredients

Domperidone
: Damelium, Domet, Domperidone, Domperidone Hexal, Domstal, Motilak, Motinorm, Motonium, Passazhix.
* Letter from the Director of the Department of State Regulation of Medicines of the Ministry of Health of the Russian Federation A.G. Tsyndymeev No. 20-3/162 dated 03/05/2015

Motilium has contraindications, side effects and application features; consultation with a specialist is necessary.

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Overdose

Overdose symptoms: drowsiness , extrapyramidal reactions , disorientation .

special antidote . In case of overdose, it is advisable to rinse the patient’s stomach and give activated carbon . It is necessary to monitor the patient's condition and carry out supportive measures.

In case of extrapyramidal reactions, anticholinergic and antihistamine drugs may be effective

For what diseases is Motilium needed?

The medicine helps restore well-being in the following pathologies:

• stomach ulcer;
• atonic bowel dysfunction;
• flatulence;
• hypokinetic dyskinesia of the gallbladder;
• epigastric pain;
• nausea, vomiting due to food or chemical intoxication;
• digestive disorders due to taking medications, radiation therapy;
• spontaneous constipation;
• frequent regurgitation in children.

The drug moderately stimulates intestinal peristalsis, normalizing gastric functions and eliminating signs of dyspepsia. Domperidone suppresses dopamine activity, producing a mild antipsychotic effect. But, unlike other drugs, it does not lead to autonomic disorders.

The medicine quickly penetrates the blood through the mucous membranes and interacts with its proteins. After administration, Motilium cleanses the stomach cavity, intestinal lumen, binds and neutralizes toxic substances. It is completely excreted from the body with intestinal contents after 12–24 hours, without accumulating in tissues.

Interaction

Anticholinergics may block the action of Motilium. Antifungal drugs of the azole group, HIV protease inhibitors and antibiotics belonging to the macrolide group can inhibit the biotransformation of domperidone and increase its content in the blood plasma , so this combination should be prescribed with caution.

The simultaneous use of Motilium and Ketoconazole in oral form, as well as Erythromycin and strong inhibitors of the CYP3A4 isoenzyme , which cause prolongation of the QT interval .

Special instructions for the use of the drug Motilium

When taken in combination with antacids or antisecretory drugs, it should be taken after meals and not at the same time. Motilium should not be prescribed to patients with lactose intolerance, galactosemia and glucose malabsorption. In case of liver diseases , prescribe with caution due to the high level of metabolism of the drug in the liver. For kidney diseases in patients with severe renal failure, when Motilium is re-administered, the frequency of administration is reduced to 1-2 times a day, depending on the severity of the condition. During long-term therapy, the patient must remain under constant supervision. During pregnancy and breastfeeding. Motilium should be prescribed only when the expectation of a therapeutic effect is justified and the risk is eliminated. During breastfeeding, the use of Motilium is not recommended. In therapeutic doses, Motilium does not affect the ability to drive vehicles or operate machinery.

Analogues of Motilium

Level 4 ATX code matches:
Passazhix

Motinorm

Domrid

Itomed

Metoclopramide

Domperidone

Motilak

Ganaton

Cerucal

The following analogues of Motilium are known:

• Domrid;
• Brulium Lingvatabs;
• Motinol;
• Gastropom-Apo;
• Motinorm;
• Domidon;
• Domperidone Hexal;
• Domperidone Sandoz;
• Domperidone-Credopharm;
• Domperidone-Ostoma;
• Domrid Sr;
• Motilak;
• Motoricum;
• Peridonium;
• Nausilium;
• Motorix;
• Peridon;
• Perilium.

Some analogues are cheaper than Motilium. These include, for example, Nausilium , Motorix , Motinorm , Domrid , Domidon .

Before taking Motilium analogues, you need to carefully study the instructions. Some of them are not suitable for children.

What is better - Motilium or Motilak?

find out which is better Motilium or Motilak only by experience. The active ingredient of both drugs is domperidone . Motilium is available in tablets and suspension form, while Motilak is available only in tablet form. The composition of the auxiliary components of the drugs is different, so if you have an individual intolerance to any of them, only one drug will do.

Both drugs normalize and prolong gastrointestinal motility , relieve vomiting and nausea. In addition, they help eliminate heartburn , flatulence and belching .

The difference between them is also the cost. Motilium costs 2-3 times more than Motilak . People who have taken both drugs claim that there is no qualitative difference between them.

What is Motilium

The active component of the drug is domperidone, a substance that can quickly suppress nausea, normalize peristalsis, stool, and relieve signs of indigestion. The product is produced in several pharmaceutical forms:

• film-coated tablets: white, biconvex, containing 10 mg of domperidone, packaged in blisters;
• non-coated sublingual tablets with mint flavor;
• syrup for children: a sweetish, thick, white, water-based liquid with a dosage of domperidone 1 mg per 1 ml, sold in glass bottles with a measuring syringe.

The tablet medicine contains auxiliary compounds: starch, povidone, stabilizers.

During pregnancy (and lactation)

data on the effect of the drug during pregnancy . There is no information about the risk to the fetus. However, it is advisable to allow the drug during pregnancy only if the benefit of treatment is greater than the potential threat to the fetus.

When breastfeeding, the concentration of the active substance of the drug is 10-50% of its level in the blood . It is not known whether the drug has negative effects on newborns. Taking the drug is also possible only if the benefit to the mother is greater than the possible risk to the baby.

Description of Motilak

Motilak is an antiemetic drug based on domperidone. Produced by Veropharm in Russia. Available in tablet form. Affects the peristalsis of the stomach and duodenum. Increases the tone of the esophageal sphincter. Prevents the occurrence of nausea and vomiting. Improves stomach function, speeding up emptying.

Domperidone is a prokinetic agent. It is a dopamine receptor antagonist. Domperidone accelerates the peristalsis of the stomach and intestines and provokes the release of prolactin. The substance is used to normalize the function of the gastrointestinal tract.

Contraindications

Motilak is contraindicated if intolerance to the active ingredient, namely domperidone, has previously been established. It is also not used when there is an allergy or hypersensitivity to the excipients in the composition.

It is not recommended to use the medicine when stimulation of gastric motility may worsen the condition. The drug is contraindicated in case of gastric bleeding, perforation and organ obstruction. Also, it should not be used when there is prolactinoma.

Animal studies have shown that domperidone is not teratogenic. Motilak can be used in the first trimester of pregnancy, when the expected benefits outweigh the possible risks. During lactation, it is unknown whether the concentration of domperidone that enters the milk has a negative effect on the child. It is recommended to temporarily stop breastfeeding when there is a need to undergo treatment with Motilac.

Side effects

Motilak is well tolerated. In rare cases, intestinal spasms have been reported. Extrapyramidal effects may appear in adults, but are temporary and disappear completely after treatment is stopped. Motilac can lead to an increase in plasma prolactin levels. This phenomenon can already provoke gynecomastia and galactorrhea.

There is a possibility of allergic manifestations. Cases of urticaria and rash were recorded.

Dosage

Motilak is taken before meals. For nausea and vomiting – 20 mg 3-4 times. For frequently recurring symptoms of dyspepsia - 10 mg 3-4 times. The dose may be doubled. For kidney disease, the medicine is taken no more than 2 times a day with a possible reduction in dosage.

In case of overdose, extrapyramidal reactions, drowsiness, and spatial disorientation are observed. Activated carbon is prescribed for treatment. Anticholinergics may be effective for extrapyramidal reactions.

In case of renal failure, the drug is prescribed with caution. During long-term treatment, you need to be regularly examined by a doctor and be monitored.

Who is it suitable for?

Motilak is prescribed for dyspeptic symptoms associated with slow gastric emptying, esophagitis, and reflux. The drug helps with heaviness in the stomach, a feeling of fullness, and pain in the epigastric zone. Also indicated for heartburn with or without reflux.

Effective for vomiting of organic, functional, infectious origin. A special indication is the treatment of Parkinson's disease with dopamine antagonists, which leads to nausea and vomiting.

Reviews about Motilium

Reviews of Motilium characterize the drug as a highly effective, fast-acting remedy. It is very popular among consumers. Reviews of Motilium for children are also mostly positive. This remedy is often recommended by pediatricians, but not for infants. In the latter case, the effect of the drug has not been studied. In addition, the medicine is rarely used by nursing mothers, since its harm to lactation has not been studied.

Among the negative aspects, those who took Motilium note only a slightly inflated cost.

Which drug is better

Motilak and Motilium are analogues. They have the same indications. Side effects and contraindications differ, so you need to carefully read the instructions for each drug. Both drugs can be prescribed for the shortest possible course.

Motilium is more suitable for children, as is the case for women during pregnancy. The suspension can even be used to treat infants.

Motilak costs almost twice as much, as it is produced in Russia. Motilium is a Belgian drug.

When you need to quickly relieve nausea, you can use Motilak dissolving tablets. If the symptoms of dyspepsia are constant, you need to be examined by a doctor who will select the most effective and safe medications for your particular case.

Motilium price, where to buy

The price of Motilium suspension is on average 540 rubles. This form of release is mainly used for children. The average price of Motilium in lozenges is 530 rubles. You can buy the product in this form of release in many pharmacies; as a rule, it is purchased for adults. In addition, coated tablets are popular. The price of Motilium in this form of release is 620 rubles.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Motilium tablets p.p.o.
  10 mg 30 pcs JANSSEN CILAG 844 RUR order
• Motilium Susp. for internal approx. 1mg/ml 100mlJanssen Pharmaceuticals N.V.

  RUR 943 order

Pharmacy Dialogue

• Motilium bottle 1mg/ml 100mlJanssen Pharmaceutica

  RUB 959 order

• Motilium tablets 10 mg No. 30Janssen-Cilag

  RUB 818 order

• Motilium Express lozenges No. 30Janssen-Cilag

  RUB 858 order

• Motilium Express lozenges No. 10Janssen-Cilag

  RUR 596 order

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Pharmacy24

• Motilium 10 mg No. 10 tablets Janssen-Cilag S.A., France
  65 UAH. order
• Motilium 10 mg No. 30 tablets Janssen-Cilag S.A., France

  135 UAH order

PaniPharmacy

• Motilium tablets Motilium tablets. 10mg No. 30 France, Janssen-Cilag

  163 UAH order

• Motilium tablets Motilium tablets. 10 mg No. 10 France, Janssen-Cilag

  80 UAH order

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Interactions of the drug Motilium

Anticholinergic drugs may counteract the effects of Motilium. Antacid and antisecretory drugs, when taken simultaneously with Motilium, reduce its bioavailability. When used simultaneously with ketoconazole (a cytochrome P450 inhibitor), which inhibits the primary metabolism of domperidone, there is a 3-fold increase in the maximum concentration of domperidone and an increase in AUC in the plateau phase. As a result, it is not recommended to prescribe azole drugs, macrolides, HIV protease inhibitors, and nefazodone simultaneously with domperidone. Also, when used with ketoconazole, an increase in the QT by 10-20 ms may be observed. Digoxin and paracetamol, when used simultaneously with domperidone, do not affect the level of these drugs. Motilium mezhet combines with: • neuroleptics, enhances their effect. • dopamine agonists (levodopa, bromocriptine).