Cardiac adverse effects of domperidone in adult patients: a systematic review

• Published in: Revista medíca de Chile Vol. 143; no. 1; pp. 14 - 21
• Main Authors: Marzi, Marta, Weitz, Darío, Avila, Aylén, Molina, Gabriel, Caraballo, Lucía, Piskulic, Laura
• Format: Journal Article
• Language: Spanish
• Published: Chile 01-01-2015
• Subjects: Adult; Antiemetics - adverse effects; Arrhythmias, Cardiac - chemically induced; Death, Sudden, Cardiac - etiology; Domperidone - adverse effects; Female; Gastroesophageal Reflux - drug therapy; Humans; Male; Middle Aged; Nausea - drug therapy; Odds Ratio; Risk Factors; Vomiting - drug therapy
• ISSN: 0717-6163
• DOI: 10.4067/S0034-98872015000100002

Domperidone is widely prescribed in patients with gastrointestinal disorders but some cardiac adverse effects have been recently reported.
To evaluate the risk of QT prolongation, ventricular arrhythmias and sudden cardiac death associated with the use of oral domperidone in adults without cancer.
Systematic searches in MEDLINE, LILACS, SciELO, the Cochrane Library and regulatory agencies websites were performed, followed by a manual search of cited references. The search strategy consisted of combining free and indexed text words without any date or language restriction.
Three case-control studies met the inclusion criteria; none of them evaluated QT interval prolongation. With low risk of bias, each study quantified the risk of ventricular arrhythmia or sudden cardiac death (VA/SCD). The odds ratios for these events in these studies were 4.7 (95% confidence interval (CI): 1.4-16), 1.59 (95% CI: 1.28-1.98) and 11.02 (95% CI: 2.02-62.3) respectively. A significantly increased risk was observed in patients older than 60 years of age or receiving doses > 30 mg/day.
Heterogeneity between selected studies did not allow the computation of a summary measure. However, evidence was found that an increased risk of VA/SCD is associated with the use of oral domperidone in adults.