Motilium instructions for use lozenges. Motilium tablets: instructions for use. Indications for use

Active substance

Domperidone (domperidone)

Release form, composition and packaging

Suspension for oral administration uniform, white.

Excipients: microcrystalline cellulose and sodium carmellose - 12 mg, non-crystallized liquid sorbitol 70% - 455.4 mg, methyl parahydroxybenzoate - 1.8 mg, propyl parahydroxybenzoate - 0.2 mg, sodium saccharinate - 0.2 mg, polysorbate 20 - 0.1 mg, sodium hydroxide - about 10 mcg ( from 0 to 30 mcg), water - up to 1 ml.

100 ml - dark glass bottles with a screw cap, protected from accidental opening by children (1) complete with dosing syringe - packs of cardboard.

Lozenges white or almost white, round.

	1 tab.
domperidone	10 mg

Excipients: gelatin - 5.513 mg, - 4.136 mg, aspartame - 0.75 mg, mint essence - 0.3 mg, poloxamer 188 - 1.125 mg.

10 pieces. - blisters (1) - packs of cardboard.
10 pieces. - blisters (3) - packs of cardboard.

pharmachologic effect

When taking the drug after a meal, it takes longer to reach C max, and the AUC increases slightly.

Distribution

When taken orally, domperidone does not accumulate and does not induce its own metabolism. After taking domperidone orally for 2 weeks at a dose of 30 mg/day, Cmax in blood plasma after 90 minutes was 21 ng/ml and was almost the same as after taking the first dose (18 ng/ml).

Plasma protein binding - 91-93%.

Distribution studies of the radioactively labeled drug in animals have shown broad tissue distribution but low concentrations in the brain. Small amounts of the drug cross the placental barrier in rats.

Metabolism

Domperidone undergoes rapid and extensive metabolism by hydroxylation and N-dealkylation. In vitro metabolism studies with diagnostic inhibitors have shown that the CYP3A4 isoenzyme is the main form of cytochrome P450 involved in the N-dealkylation of domperidone, while CYP3A4, CYP1A2 and CYP2E1 are involved in the aromatic hydroxylation of domperidone.

breeding

Excretion by the kidneys and intestines is 31% and 66% of the oral dose, respectively. The proportion of the drug excreted unchanged is small (10% in feces and approximately 1% in urine). Plasma T 1/2 after a single oral dose is 7-9 hours in healthy volunteers, but increases in patients with severe renal insufficiency.

Pharmacokinetics in special clinical situations

In patients with severe renal insufficiency (serum creatinine > 6 mg / 100 ml, i.e. > 0.6 mmol / l), T 1/2 domperidone increases from 7.4 to 20.8 hours, but plasma concentrations of the drug are lower than in patients with normal kidney function. A small amount of unchanged drug (about 1%) is excreted by the kidneys.

In patients with moderate hepatic impairment (Child-Pugh score 7-9), AUC and Cmax of domperidone were 2.9 and 1.5 times higher than in healthy volunteers, respectively. The proportion of unbound fraction increased by 25%, and T 1/2 increased from 15 to 23 hours. In patients with mild hepatic impairment, there were slightly reduced systemic levels of the drug compared to those in healthy volunteers based on C max and AUC without changes in binding to proteins or T 1/2. Patients with severe hepatic impairment have not been studied.

Indications

- a complex of dyspeptic symptoms, often associated with delayed gastric emptying, gastroesophageal reflux, esophagitis (a feeling of fullness in the epigastrium, a feeling of bloating, pain in the upper abdomen, belching with or without gastric contents, flatulence, nausea, vomiting, heartburn);

- nausea and vomiting of functional, organic, infectious origin, as well as those caused by radiotherapy, drug therapy or dietary disorders;

- Nausea and vomiting caused by dopamine agonists when used in Parkinson's disease (such as levodopa and bromocriptine).

Contraindications

- hypersensitivity to domperidone or any of the components of the drug;

- prolactinoma;

- simultaneous use of oral forms of ketoconazole, erythromycin or other potent inhibitors of the CYP3A4 isoenzyme, causing a prolongation of the QTc interval, such as clarithromycin, itraconazole, fluconazole, posaconazole, ritonavir, saquinavir, amiodarone, telithromycin, telaprevir and voriconazole;

- gastrointestinal bleeding, mechanical obstruction or perforation (i.e., when stimulation of the motor function of the stomach can be dangerous);

- liver failure of moderate and severe severity;

- body weight less than 35 kg (for lozenges);

- children's age up to 12 years with a body weight of less than 35 kg (for lozenges);

- phenylketonuria (for lozenges);

- pregnancy;

- period of breastfeeding.

Carefully: impaired renal function; violation of the rhythm and conduction of the heart (including prolongation of the QT interval), electrolyte imbalance, congestive heart failure.

Dosage

In patients of all age categories, usually for the treatment of acute nausea and vomiting, the maximum duration of continuous administration of the drug should not exceed 1 week. If nausea and vomiting persist for more than 1 week, the patient should re-consult their physician. For other indications, the duration of therapy is 4 weeks. If the symptoms do not disappear within 4 weeks, it is necessary to re-examine the patient and evaluate the need for continued therapy.

Suspension

Adults and adolescents over 12 years of age and children weighing ≥35 kg- 10 ml 3 times / day. The maximum daily dose is 30 ml (30 mg).

Infants and children under 12 years of age who weigh<35 кг - 0.25 mg per 1 kg of body weight 3-4 times / day. The maximum daily dose is 30 ml (30 mg).

Motilium suspension should be used at the lowest effective dose.

To determine the dose, use the child's body weight scale "0-20 kg" on the syringe.

The dose should be determined very carefully, taking into account body weight, not exceeding the recommended maximum daily dosage. In children, an overdose can cause disorders of the nervous system.

Suspension instructions

Before use, mix the contents of the vial by gently shaking it to avoid foaming.

The suspension is supplied in a package protected from accidental opening by children. The bottle should be opened as follows:

Press on top of the plastic cap of the vial while turning it counterclockwise;

Remove screwed cover.

Place the syringe into the vial. While holding the bottom ring in place, raise the top ring to the mark corresponding to the child's weight in kg.

Holding the lower ring, remove the filled syringe from the vial.

Empty the syringe. Close the vial. Rinse the syringe with water.

Lozenges

Adults and children over 12 years of age and weighing ≥35 kg- 10 mg (1 tab.) 3 times / day. The maximum daily dose is 30 mg (3 tablets).

Children under 12 years of age and weighing ≥35 kg- 10 mg (1 tab.) 3 times / day. The maximum daily dose is not more than 30 mg (3 tablets).

IN children's practice in general, Motilium suspension should be used.

Directions for use

Since the lozenges are rather fragile, they should not be forced through the foil to avoid damage.

In order to get a tablet from a blister, you need the following:

Take the foil by the edge and completely remove it from the cell in which the tablet is located;

Press gently from below;

Take the tablet out of the package.

Put the tablet on the tongue. Within a few seconds, it will disintegrate on the surface of the tongue, it can be swallowed with saliva without drinking water.

Special patient groups

Since T 1/2 domperidone at severe renal failure(with serum creatinine > 6 mg / 100 ml, i.e. > 0.6 mmol / l) increases, the frequency of taking the drug Motilium should be reduced to 1 or 2 times / day, depending on the severity of the insufficiency. Patients with severe renal insufficiency should be monitored regularly.

The use of the drug is contraindicated in patients with moderate (7–9 points according to the Child-Pugh classification) or severe (Child-Pugh score >9) liver failure. At patients with mild (Child-Pugh score 5-6) liver failure dose adjustment of the drug is not required.

Side effects

According to clinical studies

Adverse reactions observed in ≥1% of patients treated with Motilium: depression, anxiety, decreased or absent libido, headache, drowsiness, akathisia, dry mouth, diarrhea, rash, itching, galactorrhea, gynecomastia, pain and tenderness in the mammary glands, menstrual irregularities and amenorrhea, lactation disorders, asthenia.

Adverse reactions observed in<1% пациентов, принимавших Мотилиум: hypersensitivity, urticaria, swelling and discharge from the mammary glands.

The following undesirable effects were classified as follows: very often (≥10%), often (≥1%, but<10%), нечасто (≥0.1%, но <1%), peдко (≥0.01%, но <0.1%) и очень редко (<0.01%, включая отдельные случаи).

According to spontaneous reports of adverse events identified in the post-registration period

From the immune system: very rarely - anaphylactic reactions, including anaphylactic shock.

Mental disorders: very rarely - irritability, nervousness (mainly in newborns and children).

From the nervous system: very rarely - dizziness, extrapyramidal disorders, convulsions (mainly in newborns and children).

very rarely - prolongation of the QT interval, ventricular arrhythmia *, sudden coronary death *.

very rarely - urinary retention.

very rarely - angioedema, urticaria.

From the side of laboratory indicators: very rarely - deviations in laboratory parameters of liver function, increased levels of prolactin in the blood.

Adverse reactions identified during post-registration clinical studies

From the side of the immune system: frequency unknown - anaphylactic reactions, including anaphylactic shock.

Mental disorders: infrequently - increased excitability (mainly in newborns and children), nervousness.

From the nervous system: often - dizziness; rarely - convulsions (mainly in newborns and children); the frequency is unknown - extrapyramidal disorders (mainly in newborns and children).

From the side of the cardiovascular system: frequency unknown - prolongation of the QT interval, serious ventricular arrhythmias *, sudden coronary death *.

From the side of the kidneys and urinary tract: infrequently - urinary retention.

From the skin and subcutaneous tissues: frequency unknown - angioedema.

From the side of laboratory data: infrequently - deviations of laboratory indicators of liver function; rarely - an increase in the level of prolactin in the blood.

*Some epidemiological studies have shown that the use of domperidone may be associated with an increased risk of developing serious ventricular arrhythmias or sudden death. The risk of these phenomena is more likely in patients over 60 years of age and in patients taking the drug in a daily dose of more than 30 mg. The use of domperidone at the lowest effective dose in adults and children is recommended.

Overdose

Symptoms overdoses occur most commonly in infants and older children and may include irritability, altered consciousness, convulsions, confusion, drowsiness, and extrapyramidal reactions.

Treatment: There is no specific antidote for domperidone. In case of an overdose, gastric lavage is recommended within one hour from the moment of taking the drug and the use of activated charcoal. It is recommended to closely monitor the patient's condition and conduct maintenance therapy. Anticholinergics and drugs used to treat parkinsonism may be effective in relieving extrapyramidal disorders that have arisen.

drug interaction

Anticholinergic drugs can neutralize the effect of the drug Motilium.

The oral bioavailability of the drug Motilium decreases after a previous intake of cimetidine or. You should not take antacids and antisecretory drugs at the same time as domperidone, because. they reduce its bioavailability after oral administration.

The main role in the metabolism of domperidone is played by the CYP3A4 isoenzyme. The results of in vitro studies and clinical experience show that the simultaneous use of drugs that significantly inhibit this isoenzyme can cause an increase in plasma concentrations of domperidone. Strong CYP3A4 inhibitors include azole antifungals (such as fluconazole*, itraconazole, ketoconazole*, and voriconazole*), macrolide antibiotics (such as clarithromycin* and erythromycin*), HIV protease inhibitors (such as amprenavir, atazanavir, fosamprenavir, indinavir, nelfinavir, ritonavir and saquinavir), calcium antagonists (such as diltiazem and verapamil), amiodarone*, aprepitant, nefazodone, telithromycin*. Drugs marked with an asterisk also prolong the QTc interval.

In a number of pharmacokinetic and pharmacodynamic interaction studies of domperidone with oral ketoconazole and oral erythromycin in healthy volunteers, these drugs have been shown to significantly inhibit the primary metabolism carried out by the CYP3A4 isoenzyme. With the simultaneous administration of 10 mg of domperidone 4 times / day and 200 mg of ketoconazole 2 times / day, there was an increase in the QT interval with an average of 9.8 ms during the entire observation period, at some points the changes varied from 1.2 to 17.5 ms. With the simultaneous administration of 10 mg of domperidone 4 times / day and 500 mg of erythromycin 3 times / day, there was an increase in the QT interval with an average of 9.9 ms during the entire observation period, at some points the changes varied from 1.6 to 14.3 ms. In each of these studies, C max and AUC of domperidone were approximately 3-fold increased.

It is currently unknown what contribution to the change in the QTc interval is made by elevated plasma concentrations of domperidone.

In these studies, domperidone monotherapy (10 mg 4 times/day) resulted in QT interval prolongation by 1.6 ms (ketoconazole study) and 2.5 ms (erythromycin study), while ketoconazole monotherapy (200 mg 2 times/day) and erythromycin monotherapy (500 mg 3 times / day) led to a prolongation of the QTc interval by 3.8 and 4.9 ms, respectively, during the entire observation period.

In another multiple dose study in healthy volunteers, no significant prolongation of the QTc interval was found during inpatient domperidone monotherapy (40 mg 4 times / day, total daily dose of 160 mg, which is 2 times the recommended maximum daily dose). At the same time, plasma concentrations of domperidone were similar to those in studies of the interaction of domperidone with other drugs.

The combined use of anticholinergic drugs (for example, dextromethorphan, diphenhydramine) may interfere with the development of the antidyspeptic effects of the drug Motilium in the form of a suspension.

Theoretically, since Motilium has a gastrokinetic effect, it could influence the absorption of concomitantly used oral drugs, in particular, drugs with prolonged release of the active substance or enteric-coated drugs. However, the use of domperidone in patients receiving paracetamol or digoxin did not affect the level of these drugs in the blood.

Motilium can be taken simultaneously with antipsychotics, the action of which it does not enhance; dopamine receptor agonists (bromocriptine, levodopa), whose undesirable peripheral effects, such as digestive disorders, nausea, vomiting, it suppresses without affecting their central effects.

special instructions

When Motilium is used together with antacids or antisecretory drugs, the latter should be taken after meals, and not before meals, i.e. they should not be taken concomitantly with Motilium.

Use in diseases of the cardiovascular system

Some epidemiological studies have shown that the use of domperidone may be associated with an increased risk of serious ventricular arrhythmias or sudden coronary death. The risk may be more likely in patients over 60 years of age and in patients taking the drug in daily doses of more than 30 mg. Patients over 60 years of age should use the drug with caution and consult a doctor before taking it.

The use of domperidone and other drugs that lead to prolongation of the QTc interval is not recommended in patients with existing conduction disorders, in particular prolongation of the QTc interval, and in patients with severe electrolyte imbalance (hypokalemia, hyperkalemia, hypomagnesemia) or with bradycardia, or in patients with concomitant heart disease such as congestive heart failure. As you know, against the background of electrolyte imbalance and bradycardia, the risk of arrhythmias increases.

If signs or symptoms appear that may be associated with cardiac arrhythmia, therapy with Motilium should be discontinued and a doctor should be consulted.

Use in kidney disease

Because a very small percentage of the drug is excreted by the kidneys unchanged, then adjustment of a single dose in patients with renal insufficiency is not required. However, with the repeated appointment of the drug Motilium, the frequency of use should be reduced to 1-2 times / day, depending on the severity of impaired renal function, and it may also be necessary to reduce the dose. With long-term therapy, patients should be monitored regularly.

Potential for drug interactions

The main route of metabolism of domperidone is via CYP3A4. In vitro and human data indicate that concomitant use of medicinal products that significantly inhibit this enzyme may be associated with an increase in plasma domperidone concentrations. The combined use of domperidone with potent inhibitors of CYP3A4, which, according to the data obtained, cause a prolongation of the QT interval is contraindicated.

Caution must be exercised when co-administering domperidone with potent CYP3A4 inhibitors that do not prolong the QT interval, such as indinavir; Patients should be carefully monitored for signs or symptoms of adverse reactions.

Care must be taken when co-administering domperidone with medicinal products known to prolong the QT interval; Patients should be closely monitored for signs or symptoms of cardiovascular adverse reactions.

Examples of such medicines:

Class IA antiarrhythmics (eg, disopyramide, quinidine);

Class III antiarrhythmics (eg, amiodarone, dofetilide, dronedarone, ibutilide, sotalol);

Certain antipsychotics (eg, haloperidol, pimozide, sertindole);

certain antidepressants (eg citalopram, escitalopram);

certain antibiotics (eg, levofloxacin, moxifloxacin);

Certain antifungals (eg pentamidine);

Certain antimalarials (eg halofantrine);

Certain gastrointestinal drugs (eg, dolasetron);

Certain anticancer drugs (eg, toremifene, vandetanib);

Certain other medicines (eg bepridil, methadone).

Excipients

Motilium Oral Suspension contains sorbitol and is not recommended for use in patients with sorbitol intolerance.

Motilium Express lozenges contain aspartame and should therefore not be used in patients with hyperphenylalaninemia.

Disposal of the drug

If the medicinal product has become unusable or the expiration date has expired, it should not be thrown into wastewater or into the street. It is necessary to place the drug in a bag and put it in a trash container. These measures will help protect the environment.

Pediatric use

Motilium in rare cases can cause neurological side effects. The risk of neurological side effects in young children is higher, because. metabolic functions and BBB in the first months of life are not fully developed. In this regard, you should strictly adhere to the recommended dose. Neurological side effects can be caused in children by an overdose of the drug, but other possible causes of such effects must be taken into account.

Influence on the ability to drive vehicles and control mechanisms

Care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions due to the risk of adverse reactions that may affect these abilities.

Pregnancy and lactation

Pregnancy

There are insufficient data on the use of domperidone during pregnancy.

To date, there is no evidence of an increased risk of malformations in humans. However, the drug should be prescribed during pregnancy only in cases where its use is justified by the expected therapeutic benefit.

lactation period

The amount of domperidone that can enter the baby's body with breast milk is small.

The maximum relative dose for infants (%) is estimated at about 0.1% of the dose taken by the mother, based on body weight. It is not known whether this level has a negative effect on newborns. In this regard, when using the drug during lactation, it is recommended to stop breastfeeding.

Application in childhood

Motilium Express is contraindicated in children under 12 years of age with a body weight of less than 35 kg.

In pediatric practice, Motilium suspension should mainly be used.

For impaired renal function

WITH caution

Terms and conditions of storage

Motilium suspension should be stored out of the reach of children at a temperature of 15° to 30°C. Shelf life - 3 years.

Motilium EXPRESS should be stored in its original packaging out of the reach of children, in a dry place at a temperature not exceeding 25°C. Shelf life - 2 years.

Do not use after the expiration date.

Motilium is a stimulant of intestinal peristalsis, which has an antiemetic effect. Increases tone and pressure on the sphincter located in the lower part of the esophagus, without affecting the production of gastric juice.

Relieves nausea, heartburn, vomiting, belching, bloating, heaviness in the stomach and excessive gas formation. In case of poisoning and the above conditions, it restores disturbed processes and accelerates recovery.

The active substance - domperidone, has the properties of some antipsychotics, however, unlike them, it does not provoke the occurrence of extrapyramidal side effects such as parkinsonism, tremor, dystonia, athetosis, chorea, tic, akathisia, stereotypy, myoclonus.

Additionally, it enhances the secretion of prolactin, a peptide hormone that stimulates milk production.

Indications for use

What helps Motilium? According to the instructions, the drug is prescribed in the following cases:

• abdominal pain;
• bloating;
• frequent regurgitation, cyclic vomiting;
• nausea and vomiting caused by a violation of the diet or drug therapy;
• disruption of the stomach in children;
• a complex of dyspeptic symptoms that are associated with a slowdown in gastric emptying;
• feeling of fullness in the epigastrium;
• heartburn, flatulence.

Suspension Motilium is used for gastrointestinal reflux and regurgitation in newborns.

Instructions for use Motilium, dosage

The lozenges are taken before meals. If taken after a meal, absorption may be delayed.

The duration of continuous use of the drug without a doctor's recommendation should not exceed 28 days.

Dosage of tablets according to the instructions:

Adults and children over 12 years old and weighing more than 35 kg - 10-20 mg (1-2 Motilium tablets) 3-4 times a day. The maximum daily dose is 80 mg (8 tablets).

Children aged 5 to 12 years and weighing more than 35 kg - 10 mg (1 tablet) 3-4 times a day.

The maximum daily dosage should not exceed 80 mg (8 tablets).

Suspension Motilium, instruction

Indicated for children under 5 years of age.

Dyspeptic disorders - children and adults take 15-30 minutes before meals, 10 mg \ 3 r / day. The allowable dose is 80 mg / day.

Children after 12L, adults are allowed to double the dosage if necessary.

The suspension is taken at the rate of 2.5 ml per 10 kg of the child's weight. Doubling the dosage is possible only for children after a year. Permissible dosage - 2.4 mg / kg / day, but not more than 80 mg / day.

Side effects

The instruction warns of the possibility of developing the following side effects when prescribing Motilium:

• From the digestive system: transient spasms of the intestines.
• From the nervous system: extrapyramidal disorders (in children and in persons with increased BBB permeability).
• Allergic reactions: skin rash, urticaria.
• Others: hyperprolactinemia (galactorrhea, gynecomastia).

When taken in children under the age of 1 year, in case of impaired function of the blood-brain barrier, neurological side effects may occur.

Contraindications

Motilium is contraindicated in the following cases:

• perforation of the gastrointestinal tract, its mechanical obstruction,
• with a pituitary tumor
• with gastrointestinal bleeding,
• in case of hypersensitivity to the active or excipients of the drug.

Do not use simultaneously with ketoconazole, erythromycin, voriconazole, fluconazole, amiodarone, clarithromycin, telithromycin.

It is prescribed with extreme caution during pregnancy and breastfeeding.

Overdose

With an overdose, drowsiness develops, disorientation in space is observed, and extrapyramidal reactions may develop (more often in children).

Activated charcoal is indicated; with the development of neuroleptic extrapyramidal disorders, antihistamines and anticholinergics are prescribed.

Motilium analogues, price in pharmacies

If necessary, you can replace Motilium with an analogue for the active substance - these are drugs:

1. Domperidone;
2. Passagex.

ATX code:

• domperidone,
• Motilac,
• Passagex,
• motonium,
• Domstal.

When choosing analogues, it is important to understand that the instructions for use of Motilium, the price and reviews of drugs of similar action do not apply. It is important to consult a doctor and not to make an independent replacement of the drug.

Price in Russian pharmacies: lozenges Motilium 10 mg 10 pcs. - from 346 to 409 rubles, suspension 1 mg / ml 100 ml - from 560 rubles, according to 471 pharmacies.

Lozenges should be stored in their original packaging, in a dry place out of the reach of children at a temperature not exceeding 25°C. The shelf life of tablets is 2 years, suspensions - 3 years.

Poor nutrition, side effects from taking medications, constant stress, the consequences of alcohol abuse - all this inevitably leads to an upset of the gastrointestinal tract. This condition is accompanied by unpleasant symptoms, leading to the development of diseases of the digestive system. In this case, Motilium tablets come to the rescue, the properties and indications for the use of which we will consider in this article.

Properties of the drug and general information

In case of poisoning and severe upset of the gastrointestinal tract, both vomiting and vomiting can occur, so taking a medicine called Motilium will be an excellent treatment.

Motilium refers to antiemetic drugs that have the property of blocking dopamine receptors. Due to the active active ingredient domperidone, which is part of the drug, the drug improves gastrointestinal motility, therefore it is used in the treatment of many gastric pathologies.

Motilium is available in the form of a suspension, which is also called "Motilium syrup", as well as in the form of coated tablets and lozenges.

Instructions for use describe the following properties of Motilium:

• Suppresses the activity of the vomiting center in the brain;
• Increases in the esophagus;
• Increases the duration and intensity of contractions of the duodenum and stomach;
• Accelerates the evacuation of food lumps from the stomach into the duodenum.

Such properties determine the therapeutic effect of the drug - relief of symptoms of digestive disorders (belching, vomiting, nausea, feelings of heaviness, etc.) associated with gastric pathologies, in which food stagnates in the stomach.

Important! For patients suffering from gastric pathologies, Motilium is prescribed to relieve symptoms of digestive system disorders.

The substance domperidone stimulates the contractile activity of the gastric muscles, resulting in a rapid evacuation of food lumps into the duodenum. Food does not stagnate in the stomach and does not irritate it, so the unpleasant symptoms of dyspepsia quickly disappear in a person. Thus, Motilium helps to nullify the manifestations of stomach diseases, in which food stagnates (peptic ulcer, hypotension of the stomach, etc.).

Healthy people may also experience symptoms of digestive disorders, such as malnutrition, overeating, alcohol abuse, etc. In this case, the drug helps to cope with the unpleasant sensations of fullness in the stomach.

By suppressing the vomiting center in the brain, Motilium eliminates vomiting, which can be caused by medication, an infectious disease, digestive disorders due to malnutrition, or other similar factors.

When is Motilium used?

Motilium is effective in combating symptoms such as vomiting, severe indigestion, heaviness in the stomach and many others.

Indications for use for all forms of release of Motilium (suspension, tablets) are the same:

1. Relief of symptoms that occur with, reflux esophagitis, hypotension of the stomach, gastroesophageal:

• Vomit;
• Belching;
• Heartburn;
• Feelings of heaviness, fullness, arising after eating in the stomach.

1. Vomiting and nausea caused by pathologies, infectious diseases or conditions that occur during motion sickness, improper diet, overeating.
2. Vomiting and nausea resulting from the use of certain drugs, chemotherapy, radiotherapy.
3. Vomiting and nausea accompanying certain medical procedures (for example, the insertion of a gastric tube).
4. Gastric motility disorders.
5. Regurgitation syndrome in a newborn baby.

For children

Indications for the use of Motilium in children are due to such conditions as difficult emptying, gastrointestinal, cyclic vomiting.

Important! Motilium quickly stop the unpleasant symptoms that occur when a baby is poisoned, contribute to the speedy recovery of disturbed processes and speed up recovery.

Usually, the drug is prescribed for children in the form of a suspension, because. it is more convenient for a child to take.

During pregnancy

Motilium helps the expectant mother in the early and late stages of gestation to establish intestinal motility.

Motilium relieves unpleasant manifestations of preeclampsia and - nausea, vomiting, impaired motor function of the gastrointestinal tract.

In the postpartum period, Motilium can be prescribed according to the indications of doctors to stimulate the secretion of breast milk.

For nausea

Motilium instruction initially describes the drug as an antiemetic. To prevent nausea, the drug is best taken on an empty stomach or at least two hours before a meal.

When motion sickness, Motilium can be taken half an hour before the planned trip.

For heartburn

The sensation of heartburn occurs due to the accumulation of stomach contents in the esophagus. This condition can occur after suffering stress, due to malnutrition, alcohol abuse, obesity, and an unbalanced diet.

Motilium quickly relieves an unpleasant symptom, but will not be able to get rid of heartburn forever if you do not adjust nutrition and get rid of bad habits in parallel.

From diarrhea

It usually appears due to a malfunction in the functioning of the intestine due to bacterial infections or food poisoning.

Most often, babies who put objects that may be contaminated with salmonella into their mouths, as well as tourists who love to eat exotic food, suffer from it.

Motilium, which eliminates diarrhea in a short time, will help to improve the functioning of the intestines.

How to take Motilium

When taking pills, it is necessary to strictly follow the indicated daily dose, otherwise, in case of an overdose, the symptoms that were before will only intensify and others will be added to them.

Motilium tablets are taken before meals - usually 15-30 minutes before. If necessary, the drug can also be drunk before bedtime.

The coated tablets are swallowed with plenty of water. Lozenges are placed under the tongue and wait until it turns into small particles, after which you can simply swallow them or drink about half a glass of water.

To relieve symptoms of dyspepsia the drug is taken according to the scheme - 1 tablet three times a day (for children over five years old and adults). If necessary, the dosage can be doubled (two tablets each), and such a dose can be given to children only from the age of 12.

For relief of nausea and vomiting appoint two tablets three to four times a day for adults and children over 12 years old. If the age is from 5 to 12 years, one tablet of the drug is also given three or four times a day.

Maximum daily dosage:

• ¼ tablet (2.4 mg) per kilogram of weight for the age of 5-12 years, but not more than 80 mg per day.
• No more than 8 tablets per day for adolescents over 12 years of age and adults.
• 2.5 ml per 10 kg of weight for children under 5 years of age (daily dose is calculated individually).

Note! For children under 5 years old and weighing less than 35 kg, Motilium is prohibited for use.

Exceeding the daily dose and prolonged uncontrolled use of the drug can provoke a state of overdose:

• Lethargy, weakness, drowsiness;
• Violation of motor activity;
• Excitation, changes in consciousness;
• Changes in muscle tone (muscle twitching or immobility in children).

If such symptoms appear, you should immediately consult a doctor who will prescribe the intake of sorbent and cleansing agents.

The use of Motilium is prohibited in the following diseases and conditions:

• gastrointestinal bleeding;
• prolactinoma;
• Simultaneous use of drugs containing erythromycin, ketoconazole, clarithromycin, amiodarone, erythromycin, voriconazole, telithromycin;

In women, the use of the drug can cause the absence of menstruation, in men - a two- or one-sided increase in the male mammary glands.

Analogues and reviews

The price of Motilium in tablets is about 400 rubles. for a pack of 10 pieces, and about 700 rubles. per pack of 30 tablets.

If there are contraindications for Motilium, or the person is not satisfied with how much the drug costs, cheaper substitutes can be used.

Analogues (from 40 to 180 rubles):

• Domperidone;
• Cerucal;
• Perinorm;
• Dimetpramide;
• cerulgan;
• Metoclopramide.

The use of Motilium in adults and children in most cases has positive reviews, but there are also ambiguous opinions, because. the drug has been used by people for various conditions and diseases.

So, when taking the drug to eliminate vomiting and nausea, 2/3 of the reviews note the immediate effect of the drug after the first pill taken. But 1/3 of patients noted long-term use of tablets, i.e. the result did not appear immediately, which caused people to leave negative comments.

When using Motilium for the relief of symptoms accompanying the pathology of the stomach and intestines, a quick effect was observed, therefore reviews of Motilium in this case are almost 100% positive.

Any violation of the digestive system is a reason to see a doctor. It is not worth making a decision on taking Motilium on your own, especially when it comes to diseases of the digestive system.

011655/01-050617

Tradename

Motilium® EXPRESS

International nonproprietary name (INN)

domperidone

Dosage form

lozenges

Compound

Active ingredient (for 1 tablet): domperidone 10 mg.

Excipients (per 1 tablet): gelatin 5.513 mg, mannitol 4.136 mg, aspartame 0.750 mg, mint essence 0.300 mg, poloxamer 188 1.125 mg.

Description

White or almost white round lozenges.

Pharmacotherapeutic group

antiemetic, dopamine receptor blocker central.

ATX code– A03FA03

Pharmacological properties

Pharmacodynamics

Domperidone is a dopamine antagonist with antiemetic properties. Domperidone does not penetrate well through the blood-brain barrier.

The use of domperidone is rarely accompanied by extrapyramidal side effects, especially in adults, but domperidone stimulates the release of prolactin from the pituitary gland. Its antiemetic effect may be due to a combination of peripheral (gastrokinetic) action and antagonism to dopamine receptors in the chemoreceptor trigger zone, which is outside the blood-brain barrier.

Animal studies and low concentrations of the drug detected in the brain indicate a predominantly peripheral effect of domperidone on dopamine receptors.

When administered orally, domperidone increases the duration of antral and duodenal contractions, accelerates gastric emptying, and increases lower esophageal sphincter pressure. Domperidone has no effect on gastric secretion.

Pharmacokinetics

When taken on an empty stomach, domperidone is rapidly absorbed after oral administration, peak plasma concentrations are reached within 30 to 60 minutes. The low absolute oral bioavailability of domperidone (approximately 15%) is associated with intensive first pass metabolism in the intestinal wall and liver. Domperidone should be taken 15-30 minutes before meals. A decrease in acidity in the stomach leads to a deterioration in the absorption of domperidone. Oral bioavailability is reduced by prior administration of cimetidine and sodium bicarbonate. When taking the drug after a meal, it takes longer to achieve maximum absorption, and the area under the pharmacokinetic curve (AUC) slightly increases.

When taken orally, domperidone does not accumulate and does not induce its own metabolism; the peak plasma level of 21 ng/ml 90 minutes after 2 weeks of oral administration at a dose of 30 mg per day was almost the same as the level of 18 ng/ml after the first dose. Domperidone binds to plasma proteins by 91-93%. Distribution studies of the radioactively labeled drug in animals have shown broad tissue distribution but low concentrations in the brain. Small amounts of the drug cross the placenta in rats.

Domperidone undergoes rapid and extensive metabolism by hydroxylation and N-dealkylation. In vitro metabolic studies with diagnostic inhibitors have shown that the CYP3A4 isoenzyme is the main form of cytochrome P450 involved in the N-dealkylation of domperidone, while the CYP3A4, CYP1A2 and CYP2E1 isoenzymes are involved in the aromatic hydroxylation of domperidone.

Excretion in urine and feces is 31% and 66% of the oral dose, respectively. The proportion of the drug excreted unchanged is small (10% in feces and approximately 1% in urine). The plasma half-life after a single oral dose is 7-9 hours in healthy volunteers, but is increased in patients with severe renal insufficiency.

In such patients (serum creatinine > 6 mg / 100 ml, i.e. > 0.6 mmol / l), the half-life of domperidone increases from 7.4 to 20.8 hours, but plasma concentrations of the drug are lower than in patients with normal kidney function. A small amount of unchanged drug (about 1%) is excreted by the kidneys.

In patients with moderate hepatic impairment (Child-Pugh score 7-9), AUC and Cmax of domperidone were 2.9 and 1.5 times higher than in healthy volunteers, respectively. The proportion of the unbound fraction increased by 25% and the half-life increased from 15 to 23 hours. Patients with mild hepatic impairment had slightly reduced systemic drug levels compared to healthy volunteers based on Cmax and AUC, with no change in protein binding or half-life. Patients with severe hepatic impairment have not been studied.

Indications

a) A complex of dyspeptic symptoms, often associated with delayed gastric emptying, gastroesophageal reflux, esophagitis:
- a feeling of fullness in the epigastrium, a feeling of bloating, pain in the upper abdomen;
- belching, flatulence;
- nausea, vomiting;
- heartburn, belching.
b) Nausea and vomiting of functional, organic, infectious origin, as well as those caused by radiotherapy, drug therapy or dietary disorders. A specific indication is nausea and vomiting induced by dopamine agonists when used in Parkinson's disease (such as levodopa and bromocriptine).

Contraindications

• hypersensitivity to domperidone or any of the components of the drug;
• prolactin-secreting pituitary tumor (prolactinoma);
• concomitant use of oral ketoconazole, erythromycin, or other potent CYP3A4 inhibitors that cause QTc prolongation, such as clarithromycin, itraconazole, fluconazole, posaconazole, ritonavir, saquinavir, amiodarone, telithromycin, telaprevir, and voriconazole (see sections "Special Instructions","Interaction with othersmedicines");
• gastrointestinal bleeding, mechanical obstruction or perforation (i.e., when stimulation of the motor function of the stomach can be dangerous);
• moderate and severe liver dysfunction;
• phenylketonuria;
• body weight less than 35 kg;
• children's age up to 12 years with body weight<35 кг.

Carefully

• impaired renal function;
• violation of the rhythm and conduction of the heart, including prolongation of the QT interval, electrolyte imbalance, congestive heart failure.

Use during pregnancy and during breastfeeding

Application during pregnancy

There are insufficient data on the use of domperidone during pregnancy.
To date, there is no evidence of an increased risk of malformations in humans. However, Motilium® EXPRESS should be used during pregnancy only if its use is justified by the expected therapeutic benefit.

Use during lactation

The amount of domperidone that can enter the baby's body with breast milk is small.

The maximum relative dose for infants (%) is estimated at about 0.1% of the dose taken by the mother, based on body weight. It is not known if this level has a negative effect
on newborns. In this regard, when using the drug

Dosage and administration

Adults and children over 12 years of age weighing 35 kg or more

Children under 12 years of age and weighing 35 kg or more

1 tablet (10 mg) 3 times a day, the maximum daily dose is 3 tablets (30 mg).

In pediatric practice, MOTILIUM® suspension should mainly be used.

Usually, for the treatment of acute nausea and vomiting, the maximum duration of continuous administration of the drug should not exceed one week. If nausea and vomiting persist for more than one week, the patient should re-consult their doctor. For other indications, the duration of therapy is 4 weeks. If the symptoms do not disappear within 4 weeks, it is necessary to re-examine the patient and evaluate the need for continued therapy.

Use in patients with renal insufficiency

Since the half-life of domperidone in severe renal insufficiency (serum creatinine level > 6 mg/100 ml, i.e., > 0.6 mmol/l) increases, the frequency of taking Motilium® EXPRESS, lozenges, for resorption should be reduced to 1 or 2 times a day, depending on the severity of the insufficiency.

Patients with severe renal insufficiency should be regularly evaluated (see section"Pharmacological properties").

Use in patients with hepatic impairment

The use of MOTILIUM® EXPRESS is contraindicated in patients with moderate (Child-Pugh 7 - 9) or severe (> 9 Child-Pugh) hepatic insufficiency (see section"Contraindications"). In patients with mild (Child-Pugh classification 5-6) hepatic insufficiency, dose adjustment is not required. (see section "Pharmacological properties").

INSTRUCTIONS FOR USE

Since the lozenges are rather fragile, they should not be forced through the foil to avoid damage. In order to get the tablet out of the blister, the following is necessary: ​​take the foil by the edge and completely remove it from the cell in which the tablet is located (Fig. 1);

Gently press from below (Fig.2);

Take the pill out of the package
(Fig.3).

Put the tablet on your tongue. Within a few seconds, it will disintegrate on the surface of the tongue, it can be swallowed with saliva without drinking water.

SIDE EFFECTS

According to clinical studies

unwantedreactions, seen in > 1% of patientshostedMotilium®EXPRESS: depression, anxiety, decreased or absent libido, headache, drowsiness, akathisia, dry mouth, diarrhoea, rash, pruritus, breast enlargement/gynecomastia, breast pain and tenderness, galactorrhea, menstrual irregularities and amenorrhea, lactation, asthenia.

unwantedreactions, seen in< 1% пациентов, hostedMotilium®EXPRESS: hypersensitivity, urticaria, swelling of the mammary glands, discharge from the mammary glands.

The following undesirable effects were classified as follows: Often(> 10 %), often(> 1%, but< 10 %), infrequently(> 0.1% but< 1 %), rarely(> 0.01% but< 0,1 %) и very rarely(< 0,01 %), включая отдельные случаи.

According to spontaneous reports of adverse events

Very rare: anaphylactic reactions, including anaphylactic shock.

Mental disorders.

Very rarely: irritability (mainly in newborns and children), nervousness.

Nervous disorderssystems.

Very rare: dizziness, extrapyramidal

disorders and seizures

(mainly in newborns and children).

Cardiovascular disorders
vascular system.

Very rare: QT prolongation, ventricular arrhythmia*, sudden coronary death*.

Skin disorders and
subcutaneous tissues.

Very rare: urticaria, angioedema.

Renal and urinary tract disorders.

Very rare: urinary retention.

Laboratory and instrumental
data.

Very rarely: abnormal liver function tests, increased blood prolactin levels.

Adverse reactions identified during post-registration clinical studies

Immune system disorders.

Frequency unknown: anaphylactic reactions, including anaphylactic shock.

Mental disorders.

Infrequently: irritability (mainly in newborns and children), nervousness.

Nervous disorders
systems. Often: dizziness. Rare: convulsions (mainly in newborns and children). Frequency unknown: extrapyramidal disorders (mainly in newborns and children).

Disorders of the cardiovascular system. Frequency unknown: QT prolongation, ventricular arrhythmia*, sudden coronary death*.

Skin and subcutaneous disordersfabrics.

Frequency unknown: angioedema.

Renal disorders andurinary tract.

Uncommon: urinary retention.

Laboratory and instrumental data.

Infrequently: abnormal liver function tests. Rarely: increased blood prolactin levels. *Some epidemiological studies have shown that the use of domperidone may be associated with an increased risk of developing serious ventricular arrhythmias or sudden death. The risk of these phenomena is more likely in patients over 60 years of age and in patients taking the drug in a daily dose of more than 30 mg. The use of domperidone at the lowest effective dose in adults and children is recommended.

Overdose

Symptoms

Cases of overdose have been noted mainly in infants and older children. Overdose symptoms may include irritability, altered consciousness, convulsions, confusion, drowsiness, and extrapyramidal reactions.

Treatment There is no specific antidote for domperidone. In case of an overdose, gastric lavage is recommended within one hour from the moment of taking the drug and the use of activated charcoal.

Anticholinergics and drugs used to treat parkinsonism may be effective in managing extrapyramidal reactions that have occurred.

Interaction with other drugs

Anticholinergic drugs can neutralize the effect of the drug Motilium® EXPRESS. The oral bioavailability of the drug Motilium® EXPRESS decreases after a previous intake of cimetidine or sodium bicarbonate. Antacids and antisecretory drugs should not be taken simultaneously with domperidone, as they reduce its bioavailability after oral administration. (see section"Special instructions"). The main role in the metabolism of domperidone is played by the CYP3A4 isoenzyme. The results of in vitro studies and clinical experience show that the simultaneous use of drugs that significantly inhibit this isoenzyme can cause an increase in plasma concentrations of domperidone.

Strong inhibitors of the CYP3A4 isoenzyme include:

• Azole antifungals such as fluconazole*, itraconazole, ketoconazole* and voriconazole*;
• macrolide antibiotics, such as clarithromycin* and erythromycin*;
• HIV protease inhibitors, eg amprenavir, atazanavir, fosamprenavir, indinavir, nelfinavir, ritonavir and saquinavir;
• Calcium antagonists such as diltiazem and verapamil;
• Amiodarone*;
• Aprepitant;
• Nefazodon;
• Telithromycin*.

(Drugs marked with an asterisk also prolong the QTc interval (see section "Contraindications")).
In a number of studies of pharmacokinetic and pharmacodynamic interactions of domperidone with oral ketoconazole and oral erythromycin in healthy volunteers, these drugs have been shown to significantly inhibit the primary metabolism of domperidone, carried out by the CYP3A4 isoenzyme.

With the simultaneous administration of 10 mg of domperidone 4 times a day and 200 mg of ketoconazole 2 times a day, there was an increase in the QTc interval by an average of 9.8 ms during the entire observation period, at some points the changes varied from 1.2 to 17.5 ms. With the simultaneous administration of 10 mg of domperidone 4 times a day and 500 mg of erythromycin 3 times a day, there was an increase in the QTc interval by an average of 9.9 ms during the entire observation period, at some points the changes varied from 1.6 to 14.3 ms. In each of these studies, Cmax and AUC of domperidone were approximately three-fold increased. (see section"Contraindications").

It is not currently known
what contribution to the change in the QTc interval is made by elevated plasma concentrations of domperidone. In these studies, domperidone monotherapy (10 mg four times daily) resulted in QTc prolongation of 1.6 ms (ketoconazole study) and 2.5 ms (erythromycin study), while ketoconazole monotherapy (200 mg twice daily) and erythromycin monotherapy (500 mg three times a day) led to a prolongation of the QTc interval by 3.8 and 4.9 ms, respectively, during the entire observation period.

In another multiple dose study in healthy volunteers, no significant prolongation of the QTc interval was found during inpatient domperidone monotherapy (40 mg four times a day, total daily dose of 160 mg, which is significantly higher than the recommended maximum daily dose). At the same time, plasma concentrations of domperidone were similar to those in studies of the interaction of domperidone with other drugs.

Theoretically, since Motilium® EXPRESS has a gastrokinetic effect, it could influence the absorption of concomitantly used oral drugs, in particular, drugs with prolonged release of the active substance, or enteric-coated drugs. However, the use of domperidone in patients receiving paracetamol or digoxin did not affect the level of these drugs in the blood. Motilium® EXPRESS can be taken simultaneously with:

• neuroleptics, the action of which it does not enhance;
• with dopaminergic receptor agonists (bromocriptine, levodopa), since it inhibits their undesirable peripheral effects, such as digestive disorders, nausea and vomiting, without affecting their central effects.

special instructions

When Motilium® EXPRESS is used together with antacids or antisecretory drugs, the latter should be taken after meals, and not before meals, i.e. they should not be taken simultaneously with Motilium® EXPRESS.

Motilium® EXPRESS lozenges contain aspartame and should therefore not be used in patients with hyperphenylalaninemia.

Use in children
Motilium® EXPRESS may rarely cause neurological side effects. In this regard, you should strictly adhere to the recommended dose. (See section "How to useAnddoses"). Neurological adverse effects can be caused in adolescents by an overdose of the drug, but other possible causes of such effects must be taken into account.

Use in diseases of the cardiovascular system.

Some epidemiological studies have shown that the use of domperidone may
be associated with an increased risk of serious ventricular arrhythmias or sudden coronary death
(see section "Side effects"). The risk may be more likely in patients over 60 years of age and in patients taking the drug in daily doses of more than 30 mg.

Patients over 60 years of age should take Motilium® EXPRESS with caution. The use of domperidone and other drugs that lead to a prolongation of the QTc interval is not recommended in patients with existing conduction disorders, in particular prolongation of the QTc interval, and in patients with severe electrolyte imbalance (hypokalemia, hyperkalemia, hypomagnesemia) or with bradycardia, or in patients with concomitant heart disease such as congestive heart failure. As you know, against the background of electrolyte imbalance and bradycardia, the risk of arrhythmias increases.

In the event of signs or symptoms that may be associated with cardiac arrhythmia, Motilium® EXPRESS therapy should be discontinued and a physician should be consulted.

Use in kidney disease.

Since a very small percentage of the drug is excreted by the kidneys unchanged, adjustment of a single dose in patients with renal insufficiency is not required. However, when re-appointing Motilium® EXPRESS, the frequency of use should be reduced to one or two times a day, depending on the severity of renal dysfunction. (see section "Methodapplication and dosage). With long-term therapy, patients should be monitored regularly.

Potentialmedicinal interactions

The main route of metabolism of domperidone is carried out through the CYP3A4 isoenzyme.

In vitro and human data suggest that concomitant use of medicinal products that significantly inhibit this enzyme may be associated with increased plasma domperidone concentrations. The combined use of domperidone with potent inhibitors of the CYP3A4 isoenzyme, which, according to the data obtained, cause a prolongation of the QT interval is contraindicated { cm.chapter"Contraindications").

Caution should be exercised when co-administering domperidone with potent CYP3A4 inhibitors that do not prolong the QT interval, such as indinavir, and patients should be closely monitored for signs or symptoms of adverse reactions. (cm.chapter"InteractionWithothers medicines").

Caution should be exercised when co-administering domperidone with medicinal products known to prolong the QT interval, and patients should be closely monitored for signs or symptoms of cardiovascular adverse reactions. Examples of such medicines:

• class IA antiarrhythmics (eg, disopyramide, quinidine);
• class III antiarrhythmics (eg amiodarone, dofetilide, dronedarone, ibutilide, sotalol);
• certain antipsychotics (eg, haloperidol, pimozide, sertindole);
• certain antidepressants (eg citalopram, escitalopram);
• certain antibiotics (eg, levofloxacin, moxifloxacin);
• certain antifungals (eg, pentamidine);
• certain antimalarials (eg, halofantrine);
• certain gastrointestinal drugs (eg, dolasetron);
• certain anticancer drugs (eg, toremifene, vandetanib);
• certain other medicines (eg bepridil, methadone).

If the medicinal product has become unusable or the expiration date has expired, do not throw it into wastewater and into the street! Place the medicine in a bag and put it in a trash can. These measures will help protect the environment!

Influence on the ability to drive vehicles and mechanisms

Care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions due to the risk of adverse reactions that may affect these abilities.

Release form

Primary packaging: 10 lozenges in a PVC-PE-PVDC/aluminum blister pack.
Secondary packaging: 1 or 3 blisters along with instructions for medical use in a cardboard box.

Storage conditions

Store in a dry place at a temperature not exceeding 25 °C.
Keep out of the reach of children.
Store in original packaging.

Best before date

2 years. Do not use after the expiration date.

Holiday conditions

On prescription

Manufacturer

Finished manufacturer dosage form and packer(primary packaging):

Catalent UK Swindon Zydis Limited, United Kingdom

Actualaddress productionsites:

Frankland Road, Blagrove, Swindon, SN5 8RU, United Kingdom

Packer (secondary packaging) and releasing quality control:

Janssen Cilag S.p.A., Italy / Janssen Cilag S.p.A., Italy; Janssen-Cilag, France/Janssen-Cilag, France

Actualaddress production site:

Via C. Janssen (loc. Borgo S. Michele) -04100 Latina, Italy;

Domaine de Maigremont, Val-de-Reuil, 27100, France

host organization claims:

LLC "Johnson & Johnson", Russia 121614, Moscow, st. Krylatskaya, 17, bldg. 2

Motilium- This is a drug that affects the stomach and intestinal system, helping to cope with many ailments. It allows you to improve intestinal motility, eliminate vomiting, nausea and other problems caused by a malfunction of the stomach.

Indications for the use of various forms of Motilium

The drug is produced in the form of tablets, both simple and lingual, and in the form of a suspension. Adults are advised to drink tablets, other forms are used to treat children.

The presence of many useful substances allows you to take medicine for the treatment of various pathologies caused by disruption of the gastrointestinal tract. The medication is prescribed in such cases:

1. As a symptomatic composition for diseases of the upper stomach, accompanied by vomiting and nausea, including radiation therapy, infections and.
2. With dyspeptic disorders, the cause of which is complicated gastric emptying, esophagitis, and reflux.
3. A medicine is prescribed for nausea caused by the use of dopamine agonists in Parkinson's disease, with vomiting provoked by the action of radiotherapy, the use of drugs, and non-compliance with the diet.

The drug Motilium has also found its use in:

• prolonged hiccups;
• flatulence;
• soreness in the upper parts of the peritoneum;
• atony of the stomach as a result of surgical interventions;
• frequent and profuse regurgitation.

Indications for the use of Motilium tablets

The drug activates the motility of the gastrointestinal tract, accelerates emptying and is recommended for various nutritional problems.

In case of failure of the digestive process, Motilium is used one tablet half an hour before a meal (three times a day). If vomiting is observed, then the dose is doubled.

How to take Motilium?

In different cases, the use of Motilium, the methods of its application and the dose will be different. In the form of a suspension, a medicine is prescribed for children, 2.5 ml for every ten kilograms of the patient's weight. The total number of doses per day should be no more than three. If necessary, the doctor increases the dose, but the total volume of the drug per day should not be more than 80 ml.

If the digestive disorder is accompanied by vomiting, then Motilium suspension is prescribed, the method of application of which for adults involves taking twenty milliliters of medication four times a day. The duration of treatment is determined by the doctor depending on the patient's condition.

Side effect of the drug

As for the side effects, the most pronounced are:

• upset stomach and intestinal system;
• spasms of the intestines;
• rash:
• gynecomastia;
• karpivnitsa;

Spasms of the muscles of the face, muscle hypertonicity, protrusion of the tongue are much less common, which after discontinuation of the drug.

Uncontrolled use of Motilium in excessive amounts causes overdose symptoms. These include drowsiness and disorientation, which are most common in the treatment of children. Noticing such signs, it is important to immediately stop treatment with this remedy.

Contraindications to the use of Motilium

For certain groups of people, the use of the tool may be prohibited. Contraindications to taking Motilium are: