Prescribing trends of fixed-dose combination of domperidone and proton-pump inhibitor across tertiary care centers in India, is the combination rational?

Abstract

Background: There have been concerns over the rationality of prescribing practices of fixed-dose combinations (FDCs) available in India. The FDC of domperidone and pantoprazole recently emerged as a top-selling product at Janaushadhi Kendras in India.

Methods: This cross-sectional study is a part of the prescription research which was conducted under the Indian Council of Medical Research (ICMR) Task Force Project on Rational Use of Drugs at 13 tertiary healthcare centers across the countries that were part of the ICMR-Rational Use of Medicine Centres Network. An assessment of rationality for prescribing practices of FDC of domperidone and proton-pump inhibitors (PPIs) was done based on the available guidelines and evidence from the literature.

Results: In this study, 8839 outpatient prescriptions were analyzed in which FDCs with domperidone and PPI were prescribed in 481 (5.44%) cases. The FDC containing domperidone + PPI was prescribed for nausea and vomiting in 10.81% of cases. The dose was not mentioned in 55% of prescriptions; the dose of domperidone up to 30 mg/day was mentioned in 42.41% of prescriptions and more than 30 mg/day in 2.28% of prescriptions. In 89.18% of cases, it was prescribed to patients under 60 years of age.

Conclusions: This study has shown a lack of rationality in the prescribing practices in FDC containing domperidone and PPI in terms of indications, dose, frequency, duration, and administration instructions.