The Surrey & North West Sussex Area Prescribing Committee recommends the off label use of domperidone for the treatment of nausea & vomiting  when used in conjunction with apomorphine in Parkinson's Disease patients, only when prescribed within a secondary care setting. Treatment duration is restricted to a maximum of one week in all patients*.

Prescribers should ensure that the patient understands the risks and consents to using domperidone off-label, noting the updated MHRA alert (December 2019) and the MHRA drug safety update (April 2016) in relation to this treatment combination.

Primary care prescribers should ensure that patient medication records include any medicine for which prescribing remains the responsibility of secondary or tertiary care. This will ensure that GP records, which are accessed by other healthcare providers, are a true and accurate reflection of the patient's medication

Domperidone will be considered RED on the traffic light system for this indication.

*MHRA drug safety update (December 2019) https://www.gov.uk/drug-safety-update/domperidone-for-nausea-and-vomiting-lack-of-efficacy-in-children-reminder-of-contraindications-in-adults-and-adolescents

MHRA drug safety update (April 2016) : Apomorphine with domperidone: minimising risk of cardiac side effects https://www.gov.uk/drug-safety-update/apomorphine-with-domperidone-minimising-risk-of-cardiac-side-effects