Any gastroenterologists or paediatricians about?

[inthethickofit19]

I'm confused by the following advice regarding domperidone dosage from the BNF

For Child (body-weight up to 35 kg)
250 micrograms/kg up to 3 times a day; maximum 750 micrograms/kg per day.

My 24 week old is prescribed 2.5ml 3 times a day. His suspension is 1ml/1mg. His weight is 6.85kilos so this means he is prescribed it on the 750micrograms per kilo THREE times a day dosage.

The above suggests it's only 250micrograms 3 times a day OR 750micrograms once a day (dp basically the same dosage can be split or kept as one dose). Am I right?

He's prescribed it for severe silent reflux / delayed gastric emptying.

I would go back to your pharmacist and get them to check it

I will tomorrow but I have ants in my pants now

Call 111 and ask

Who prescribed it? And how much has he had today?

I'd call 111, they have doctors to speak to who can help work it out.

He's been on this dose for a while (maybe nearly two month?) but someone claimed it was too high so thought I would check. It's been prescribed by a paediatrician and he's checked the dose at least twice on separate occasions. The wording is confusing though.

A quick bit of maths here makes me think his dose should be 1.7ml rather than 2.5ml

250mcg x 6.85 = 1712.5mcg (1.7mg)
Concentration is 1mg / ml = 1.7ml / dose

Maybe wrong - get it double checked by someone independent of the prescriber eg pharmacist

According to the BNFC for reflux it can be given up to 400mcg/kg 3 times a day. So that would be 2740mcg or 2.74mg (2.74ml if 1mg in a ml) three times a day.

Dose can be increased to 400mcg/kg 3 times a day if lower dose is ineffective. Which would be 2.74mg or 2.7ml x3 in your sons case. I've added a screen shot of the children's BNF for you as well.

Hope that gives you a bit of reassurance.

Yes recommended doses are often a starting dose and what can actually be prescribed is often quite a lot higher. I have found that to be the case with quite a few of my children's meds ( 2x complex needs ) including domperidone.

Ah thank you so much! I had phoned the pharmacy and pharmacist checked the BNF also (the same one i was referring to) and agreed with me. But looks like there is a BNFC with different guidelines. Thanks you

I was going to ask if it was the BNFC you'd looked at rather than the adult BNF.