Gastro esophageal reflux disease (GERD) is a common disorder in over 60% of infants occurring in their first four months of live and presenting as recurrent vomiting and regurgitation, feeding refusal, abdominal pain, sleep disturbance and frequent or persistent cough. Reamotil suspension is our brand of domperidone suspension, pleasantly flavoured to reduce nausea and vomiting, hiccup, dyspepsia caused by slow stomach movement, gas, gastro esophageal reflux disease and heart burn in children. Reamotil is a dependable ally for children’s comfort.


Clinical Pharmacology

Domperidone is a dopamine-receptor blocking agent. Its action on the dopamine –receptors in the chemo-emetic trigger zone produces an anti-emetic effect. Domperidone does not cross the blood brain barrier to any appreciable degree and so exerts relatively little effect on cerebral dopaminergic receptors. Domperidone has been shown to increase the duration of antral and duodenal contractions, to increase the gastric emptying.
Domperidone does not alter gastric secretions and has no effect on intracranial pressure or on the cardiovascular system. Domperidone is rapidly absorbed, with peak plasma concentrations approximately 1 hour after oral administration. The absolute bioavailability of oral Domperidone is low (approximately 15%) due to first-pass hepatic and intestinal metabolism. Domperidone is 91-93% bound to plasma proteins. The plasma half-life after the single oral dose is 7-9 hours in healthy subjects but is prolonged in patients with severe renal insufficiency. Domperidone undergoes rapid and extensive hepatic metabolism by hydroxylation and N-dealkylation. In vitro metabolism experiments with diagnostic inhibitors revealed that CYP3A4, CYP1A2, and CYP2E1 are involved in Domperidone aromatic hydroxylation. Urinary and faecal excretion amount to 31% and 66% of the oral dose, respectively. The proportion of drug, excreted unchanged is small (approximately 1% of urinary and 100% of faecal excretion).

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Domperidone is rapidly absorbed after oral administration, with peak plasma concentrations at 30 to 60 minutes. The low absolute bioavailability of oral Domperidone (approximately 15%) is due to an extensive first-pass metabolism in the gut wall and liver. Although Domperidone’s bioavailability is enhanced in normal subjects when taken after a meal. Reduced gastric acidity impairs the absorption of Domperidone. The time of peak absorption is slightly delayed and the AUC somewhat increased when the oral drugs is taken after a meal