Since domperidone is highly metabolised in the liver, domperidone should be used with caution in patients with hepatic impairment (and in the elderly).
Domperidone should be used with caution in patients with renal impairment or in those at risk of fluid retention. In patients with severe renal insufficiency (serum creatinine more than 6mg/100ml, i.e. more than 0,6mmol/L) the elimination half-life of domperidone was increased from 7,4 to 20,8 hours. The dosing frequency should be reduced to once or twice daily, depending on the severity of impairment, and the dose may need to be reduced. Patients on prolonged therapy should be reviewed regularly.