Use in infants: Given that the metabolic and blood-brain barrier functions are not fully developed during the first months of life, any medication should be administered to infants with great caution and under close medical supervision. Although the typical absence of neurological side effects with domperidone is primarily due to its limited penetration through the blood-brain barrier, the potential occurrence of such effects cannot be entirely ruled out in infants under 1 year of age.
Use in liver disorders: Because domperidone undergoes extensive metabolism in the liver, it should be employed cautiously in patients with hepatic impairment.
Use in kidney disorders: In individuals with severe renal insufficiency (serum creatinine andgt;6 mg/100ml, i.e., andgt;0.6 mmol/l), the elimination half-life of domperidone increases from 7.4 to 20.8 hours, although plasma drug levels remain lower than in healthy volunteers. Since very little unchanged drug is excreted through the kidneys, it is unlikely that the dose of a single acute administration needs to be adjusted in patients with renal insufficiency. However, for repeated administration, the dosing frequency should be reduced to once or twice daily, depending on the severity of the impairment, and the dose may need to be lowered. In general, patients on prolonged therapy should undergo regular reviews.