Domperidone
| Evidence Level: L5 | Predicted Indications: 1 |
Table of Contents
- Domperidone
- Pharmacist Assessment Report
- Domperidone: peripheral dopamine D2/D3 receptor antagonist → nephrogenic syndrome of inappropriate antidiuresis
- One-Sentence Summary
- Quick Overview
- Why is This Prediction Reasonable?
- Clinical Trial Evidence
- Literature Evidence
- Australia Market Information
- Safety Considerations
- Conclusion and Next Steps
- Disclaimer
Domperidone: peripheral dopamine D2/D3 receptor antagonist → nephrogenic syndrome of inappropriate antidiuresis
One-Sentence Summary
Domperidone is a peripheral dopamine D2/D3 receptor antagonist used to manage nausea, vomiting and upper gastrointestinal symptoms. The TxGNN model predicts it may be relevant to nephrogenic syndrome of inappropriate antidiuresis, but no clinical trials and no publications currently support this direction, so the prediction rests on the model alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | nephrogenic syndrome of inappropriate antidiuresis |
| TxGNN Prediction Score | 0.9908 |
| Evidence Level | L5 |
| Australia Market Status | Listed on the PBS Schedule (1 of 1 items) – TGA (ARTG) registration status is not included in this data |
| Number of PBS Items | 1 (valid: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Pharmacology records show that domperidone binds the dopamine D2 and D3 receptors (DRD2 and DRD3), acting as a peripheral antagonist.
Nephrogenic syndrome of inappropriate antidiuresis is caused by gain-of-function variants in the vasopressin V2 receptor (AVPR2), which lead to excess water retention. No mechanistic link between dopamine D2/D3 blockade and the V2 receptor pathway has been identified. The high TxGNN score of 0.9908 is a model-based output only, with no supporting trial or literature data, so the prediction should be treated as a hypothesis rather than a established opportunity.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Australia Market Information
| ARTG Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| ARTG 1347X | APO-DOMPERIDONE | Tablet 10 mg | Not recorded in the local data |
Safety Considerations
- Conditions flagged as contraindication-related in the model’s reference data (not label text): long QT syndrome, familial long QT syndrome, torsades de pointes, liver disease, gallbladder disease. These should be verified against the TGA-approved Product Information.
- Pharmacological targets: dopamine D2 receptor (DRD2) and D3 receptor (DRD3).
Please refer to the TGA-approved Product Information (PI) for full warnings, contraindications and interaction information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction has no supporting clinical trials or publications (evidence level L5), and no plausible mechanistic link exists between dopamine D2/D3 antagonism and the V2 receptor-driven pathology of this condition. Domperidone’s QT-prolongation-related safety concerns add further caution.
To proceed, the following is needed:
- A plausible mechanistic rationale connecting domperidone to AVPR2-mediated antidiuresis, supported by preclinical data
- Any published case reports or studies in this condition
- Mechanism of action data and TGA Product Information warnings and contraindications
- A cardiac safety assessment (QT risk) for the target population
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.