Domperidone and ketoconazole interaction warning in SA
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Domperidone and ketoconazole interaction warning in SA The Medicines Control Council (MCC) of South Africa (SA) has warned healthcare professionals about a potential risk of interactions when ketoconazole, or possibly other drugs, are administered concomitantly with domperidone. According to the council, IV domperidone use in patients with cancer has been reported to be associated with sudden deaths, QT interval prolongation and ventricular tachyarrhythmias. Domperidone is primarily metabolised via cytochrome P450 3A4 (CYP3A4) isoenzyme, and concomitant use of CYP3A4 inhibiting drugs, like macrolides, azole antifungals and HIV protease inhibitors, may result in increased plasma domperidone concentrations, says the council, and coadministration of domperidone and ketoconazole is contraindicated. According to the MCC, studies in volunteers have shown a 3- to 10-fold increase in domperidone AUC and Cmax due to an interaction with ketoconazole. A QT interval prolongation of about 10–20ms was observed when domperidone 10mg four times daily and ketoconazole 200mg twice daily were administered concomitantly, but not when domperidone was administered alone, adds the council. The MCC says that this safety information is being updated in the package inserts of domperidone products. Medicines Control Council of South Africa. Interaction between ketoconazole and domperidone and the risk of QT prolongation - important safety information. 801047294 SAMJ South African Medical Journal 96: 596, No. 7, Jul 2006
0114-9954/10/1121-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 30 Sep 2006 No. 1121
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