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Re: Domperidone Dosages

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Hi here in the UK the NHS UKMI guidance on The Drug Treatment of Inadequate

Lactation revised earlier this year advises a maximum dose of 30mgs a day of

domperidone. There doesn't appear to be any information about duration of

treatment, I have asked the UKMI and am awaiting a reply. The concern is about

cardiac arrythmias and long QT syndrome. HTH katherine fisher IBCLC

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Just for your information the Toronto Hosp I work in policy is; if there is an

indication Prolatin level taken first which has to be below 100 for Domperidone

which is then prescribed at 10mgs TDS.

I know despite the Health Canada protocol there are quite a few local Family Drs

and Paeds that will prescribe larger doses but offer no follow up to the women.

Vikki Kidd

>

> Hey all -- PTP again...

>

> I have a mom taken domperidone. When asked about max dosing guidelines, I gave

her Hale's info that says maximum dose is 20mg every 8 hours for a maximum dose

in 24 hours of 60mg. To make sure this was the most current information, I

contacted Dr. Hale's Infant Risk Hotline (). I was told that Dr.

Hale states that there is zero research that demonstrates any gain in milk

production over 60mg in 24 hours and that the potential for harm to the mother

goes up over that dose.

>

> Mom then contacted Dr. Newman. Mom says Dr. Newman said to to do 120mg, and if

that isn't working to do 160mg after a couple of weeks.

>

> The difference between Hale's recommendation and Newman's recommendation is

substantial! I am interested to hear if any of you have patients who have used

high dosages and what you observed clinically, including prevalence of side

effects. Also, if you have had a mom on a high dose, how long did she stay on

it?

>

> Thanks! -- Carroll

>

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for those of us non nurses.. please translate TDS. Beebe, M.Ed., RLC, IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months--- Subject: Re: Domperidone

dosagesTo: Date: Thursday, June 21, 2012, 7:28 PM

Just for your information the Toronto Hosp I work in policy is; if there is an indication Prolatin level taken first which has to be below 100 for Domperidone which is then prescribed at 10mgs TDS.

I know despite the Health Canada protocol there are quite a few local Family Drs and Paeds that will prescribe larger doses but offer no follow up to the women.

Vikki Kidd

>

> Hey all -- PTP again...

>

> I have a mom taken domperidone. When asked about max dosing guidelines, I gave her Hale's info that says maximum dose is 20mg every 8 hours for a maximum dose in 24 hours of 60mg. To make sure this was the most current information, I contacted Dr. Hale's Infant Risk Hotline (). I was told that Dr. Hale states that there is zero research that demonstrates any gain in milk production over 60mg in 24 hours and that the potential for harm to the mother goes up over that dose.

>

> Mom then contacted Dr. Newman. Mom says Dr. Newman said to to do 120mg, and if that isn't working to do 160mg after a couple of weeks.

>

> The difference between Hale's recommendation and Newman's recommendation is substantial! I am interested to hear if any of you have patients who have used high dosages and what you observed clinically, including prevalence of side effects. Also, if you have had a mom on a high dose, how long did she stay on it?

>

> Thanks! -- Carroll

>

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Sorry and others.

TDS = three times a day it's a latin abreviation 'tie die sumendum' there is

also TDI 'tie in die' which means the same.

Vikki Kidd

>

> >

>

> > Hey all -- PTP again...

>

> >

>

> > I have a mom taken domperidone. When asked about max dosing guidelines, I

gave her Hale's info that says maximum dose is 20mg every 8 hours for a maximum

dose in 24 hours of 60mg. To make sure this was the most current information, I

contacted Dr. Hale's Infant Risk Hotline (). I was told that Dr.

Hale states that there is zero research that demonstrates any gain in milk

production over 60mg in 24 hours and that the potential for harm to the mother

goes up over that dose.

>

> >

>

> > Mom then contacted Dr. Newman. Mom says Dr. Newman said to to do 120mg, and

if that isn't working to do 160mg after a couple of weeks.

>

> >

>

> > The difference between Hale's recommendation and Newman's recommendation is

substantial! I am interested to hear if any of you have patients who have used

high dosages and what you observed clinically, including prevalence of side

effects. Also, if you have had a mom on a high dose, how long did she stay on

it?

>

> >

>

> > Thanks! -- Carroll

>

> >

>

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Must be Canadian. In the US it is TID -- which is Latin for three times a day (t.i.d. Seen on a prescription, t.i.d. means three times a day. It is an abbreviation for "ter in die" which in Latin means three times a day) -- from Google....

BID -- twice a day; QID -- four times a day. However, it isn't being used any more as too many mistakes were made, evidently, so docs now have to write it out -- three times/day.

Interesting that in Canada they use TDI instead of TID.

Jan

Sorry and others. TDS = three times a day it's a latin abreviation 'tie die sumendum' there is also TDI 'tie in die' which means the same.Vikki Kidd> > >> > > Hey all -- PTP again...> > > > > > I have a mom taken domperidone. When asked about max dosing guidelines, I gave her Hale's info that says maximum dose is 20mg every 8 hours for a maximum dose in 24 hours of 60mg. To make sure this was the most current information, I contacted Dr. Hale's Infant Risk Hotline (). I was told that Dr. Hale states that there is zero research that demonstrates any gain in milk production over 60mg in 24 hours and that the potential for harm to the mother goes up over that dose.> > > > > > Mom then contacted Dr. Newman. Mom says Dr. Newman said to to do 120mg, and if that isn't working to do 160mg after a couple of weeks. > > > > > > The difference between Hale's recommendation and Newman's recommendation is substantial! I am interested to hear if any of you have patients who have used high dosages and what you observed clinically, including prevalence of side effects. Also, if you have had a mom on a high dose, how long did she stay on it?> > > > > > Thanks! -- Carroll> > >>

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In a message dated 6/22/2012 2:29:37 A.M. Pacific Daylight Time, writes:

for those of us non nurses.. please translate TDS.

Three times per day (ter die sudendum)

Ann , non-RN

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Hi Jan

I would not take it as Canadian. Being a Brit TDI is what I am uised to in the

UK. To be honest I dont know what the usual abreviation would be for Canada I

would imagine it could well be TID as much of what is said here is from the US.

Interestingly the longer I am here (2+yrs) the more I realise although we are

thought to speak the same language we don't. It can be very interesting at

times and quite hard for my 12yr old son who comes across words that aren't

acceptable this side of the Atlantic and visa versa.

I rejoice in our differences ...... Vikki Kidd

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