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A Systematic Review of the Efficacy of Domperidone for the Treatment of Diabetic Gastroparesis
Open accessAbstract
Background & aims Despite being widely used in more than 20 countries for the treatment of diabetic gastroparesis for several decades, domperidone is approved only on an investigational basis in the United States. However, because its use is increasing, it is important for gastroenterologists in this country to understand its effectiveness in this condition. The literature on this subject varies considerably with respect to the methods and outcome measures, making a meta-analysis unfeasible.Methods Our objective was to systematically analyze studies of the efficacy of domperidone in diabetic gastroparesis, with a focus on their methodologic and scientific merit. Information from 28 trials (11 full articles and 17 abstracts) from 1981 to 2007 was analyzed.Results The average study quality score was 8.3 out of a possible 15 and the total sample size equaled 1016. Overall, 64% of the studies showed significant efficacy of domperidone on the improvement of symptoms. Sixty percent of the studies showed an efficacy in gastric emptying and 67% of the studies proved the drug effective in reducing hospital admissions.Conclusions Overall, our assessment is that there is level 3 evidence for the efficacy of domperidone in diabetic gastroparesis, leading to a grade C recommendation for its use in this condition. These results need to be interpreted very cautiously because of significant methodologic limitations of these studies, including the fact that most positive studies lacked a control arm. It is clear that larger and better-designed studies are needed to further validate the use of this drug in diabetic gastroparesis.
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“Domperidone, another D2-antagonist, has much less penetration through the blood-brain barrier when compared to metoclopramide. In use throughout the world, it has not been approved by the FDA, because of unconvincing efficacy data, although it possesses a good safety profile [61].”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [61]
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Varvoglis, D. N., & Farrell, T. M. (2022) · Journal of Laparoendoscopic & Advanced Surgical Techniques · doi:10.1089/lap.2022.0342 · Cited by 2
Mosli, M. H., Al-Judaibi, B., & Almadi, M. A. (2014) · Saudi Journal of Gastroenterology · doi:10.4103/1319-3767.141683 · Cited by 1
Arya, D. K., Pèrié, L., Mohanta, G. C., Mishra, R., Kumar, Y., Picot, C. R., & Verma, N. (2026) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2026.119218 · Cited by 2
Diabetic Gastroparesis in Evolution
Eubanks, A., Jehu, D. A., Obineme, C. G., & Sharma, A. (2026) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000002381 · Cited by 1
Drugs Acting on the Gut: Prokinetics, Antispasmodics, Laxatives
Har, A. F., & Croffie, J. M. B. (2012) · Humana Press eBooks · doi:10.1007/978-1-60761-709-9_41 · Cited by 2
Alteraciones motoras gástricas
Luè, A., & Biarge, F. S. (2012) · Medicine - Programa de Formación Médica Continuada Acreditado · doi:10.1016/s0304-5412(12)70267-6 · Cited by 1
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Kuzemko-Baranowska, D., Rymarz, E., Prystupa, A., Dzida, G. J., & Mosiewicz, J. (2017) · Journal of Pre-Clinical and Clinical Research · doi:10.26444/jpccr/75140 · Cited by 1
“Its oral dose is 10 mg 3x/day and max 20 mg 3x/day in resistant cases [36].”
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Gastrointestinal Manifestations of Diabetes
Bharucha, A. E., & Camilleri, M. (2010) · Wiley eBooks · doi:10.1002/9781444324808.ch46 · Cited by 1
Upper Gastrointestinal Manifestations of Diabetes
Camilleri, M. (2021) · Wiley eBooks · doi:10.1002/9781119603207.ch22 · Cited by 1
Sanger, G. J., & Andrews, P. L. R. (2023) · Gastroenterology · doi:10.1053/j.gastro.2023.01.043 · Cited by 1
Gastrointestinal Manifestations of Diabetes
Camilleri, M., & Bharucha, A. E. (2024) · Wiley eBooks · doi:10.1002/9781119697473.ch55 · Cited by 1
Clinical studies of glucose variability and hypoglycemia in adult patients with type 1 diabetes
Bragd, J. (2011) · Figshare
Diagnosis & dietary intervention in patients with diabetic gastroparesis
Olausson, E. A. (2013)
Russian Federation (2014) · CyberLeninK (CyberLeninka)
Small Bowel Obstruction, Cyclic Vomiting, and Gastroparesis
Nagarwala, J., Dev, S., & Markin, A. (2016)
Ghorpade, V. S., Mali, K. K., Dias, R. J., & Havaldar, V. D. (2017) · Indian Journal of Pharmaceutical Education and Research · doi:10.5530/ijper.51.4s.87
“In order to propose a possible release mechanism, release data was fitted to the following equations: Korsmeyer-Peppas equation:33 Mt/M∞ = kKPt n (2) Where, Mt/M∞ = fraction of drug released at time‘t’, kKP = release rate constant, and n = the release exponent.”
MethodCorrales, P. J. P., & Meneses, A. L. (2012) · Medicine - Programa de Formación Médica Continuada Acreditado · doi:10.1016/s0304-5412(12)70421-3
Parkman, H. P., & Talley, N. J. (2016) · doi:10.1002/9781119127437.ch21
Zheng, T., & Camilleri, M. (2023) · Elsevier eBooks · doi:10.1016/b978-0-443-13911-6.00033-5
Management of failed pyloric drainage procedures in patients with gastroparesis
Awad, M. M. (2025) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2025.102231
Metadata
- Authors
- Sugumar, A., Singh, A., & Pasricha, P. J.
- Affiliations
- Mayo Clinic (US)
- The University of Texas Medical Branch at Galveston (US)
- Stanford Medicine (US)
- Corresponding author
- Pasricha, Pankaj Jay
- ORCID
- Pasricha, Pankaj Jay
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2008-07
- Volume
- 6
- Issue
- 7
- Pages
- 726-733
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2069589846
- Cited by
- 102
- References
- 28
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 1 · 2023: 8 · 2022: 6 · 2021: 5 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 8 · 2013: 7 · 2012: 13
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- domperidone, diabetic gastroparesis, drug efficacy, gastric emptying, symptom improvement, hospitalization, study quality, level of evidence
- MeSH terms
- Clinical Trials as Topic, Domperidone, Humans, United States, Treatment Outcome, Gastroparesis, Diabetes Complications
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