Positives

• In long-term follow-up, 36% of gastroparesis patients continued domperidone for an average of 7.6 years and reported being moderately better, per a Neurogastroenterology & Motility long-term cohort study.
  
  
• Patients refractory to other prokinetics describe meaningful symptom improvement on high-dose 40-120 mg/day regimens, per a Journal of Investigative Medicine cohort report.
  
  

Negatives

• Patients commonly describe headache, palpitations or tachycardia, and diarrhea, with about 5% experiencing clinically important QTc prolongation, per a PubMed single-center cohort study.
  
  
• A meta-analysis found a meaningful rate of cardiac and neurologic adverse events leading some patients to discontinue, per a PMC systematic review.
  
  

Hurdles & Side Effects

• In the US, domperidone is not FDA-approved and patients must enroll in an expanded-access IND with informed consent and pay roughly $70/month out of pocket, per FDA's information page.
  
  
• Patients describe long delays sourcing domperidone since the FDA tightened restrictions on compounding pharmacies and importation, per FDA's expanded access guidance.