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Effect of Parity on Pituitary Prolactin Response to Metoclopramide and Domperidone: Implications for the Enhancement of Lactation

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Abstract

Objective

The gastrointestinal motility agents metoclopramide and domperidone are known to increase pituitary prolactin (PRL) secretion and breast milk production. This study compared the effect of single doses of two strengths of metoclopramide and a single dose of domperiodone on PRL secretion.

Methods

Ten nonpregnant women had baseline evaluation of serum PRL concentrations. The PRL concentrations were then determined after random oral administration of metoclopramide 10 mg, metoclopramide 5 mg, and domperiodone 10 mg. Blood samples were drawn in the first 7 days of the menstrual cycle, at 13 time points over a 6-hour period (0, 15, 30, 45, 60, 75, 90, 120, 150, 180, 240, 300, and 360 minutes), with the zero time point beginning at 0800 hours. Variables such as weight, height, age, gravidity, parity, and oral contraceptive use were recorded.

Results

Baseline PRL concentrations showed the natural circadian rhythm. Metoclopramide and domperidone both caused a significant increase in PRL. However, PRL secretion was most influenced by parity. Nulliparous women had the quickest and highest PRL secretion with metoclopramide 10 mg, compared with the PRL response with metoclopramide 5 mg and domperidone 10 mg. Conversely, multiparous women had PRL secretion patterns that were equivalent between the medications.

Conclusions

The PRL response to the medications was most influenced by parity. Therefore, we suggest that the medication therapy of choice for enhancing lactation many not be the same in all women, but may instead be determined by parity.

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Authors and Affiliations

  1. Department of Pharmaceutical Services, Health Sciences Centre, and the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

    Thomas E. R. Brown PharmD, P. Audrey Fernandes PhD, Lorna J. Grant MD, Jo-Anne Hutsul PhD & John A. McCoshen PhD

Authors
  1. Thomas E. R. Brown PharmD
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  2. P. Audrey Fernandes PhD
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  3. Lorna J. Grant MD
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  4. Jo-Anne Hutsul PhD
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  5. John A. McCoshen PhD
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Corresponding author

Correspondence to Thomas E. R. Brown PharmD.

Additional information

Supported by Manitoba Medical Services Foundation grant no. 385-3123-03.

The authors are grateful to Karen Downing, RN, Agnes Wodzicki, ART, and Tamara Mose for their expertise, dedication, and assistance in this project.

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Brown, T.E.R., Fernandes, P.A., Grant, L.J. et al. Effect of Parity on Pituitary Prolactin Response to Metoclopramide and Domperidone: Implications for the Enhancement of Lactation. Reprod. Sci. 7, 65–69 (2000). https://doi.org/10.1177/107155760000700110

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  • DOI: https://doi.org/10.1177/107155760000700110

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