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Domperidone cardiac risk — GPhC CRA MCQ

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ModerateGastro-intestinal TherapeuticsDomperidone cardiac riskGPhC CRA

A 76-year-old woman asks to restart domperidone for chronic nausea. She takes clarithromycin and amiodarone and has a history of QT prolongation. What is the most appropriate action?

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Correct answer: C — Avoid supply and refer because cardiac arrhythmia risk is high

Domperidone is associated with QT prolongation and serious ventricular arrhythmias, especially in older patients and with interacting QT-prolonging or CYP3A4-inhibiting medicines. Clarithromycin and amiodarone make this scenario high risk. Referral for alternative management is appropriate.

Reference: BNF; MHRA Drug Safety Update