Development of a sensitive UPLC-MS/MS assay for domperidone and pharmacokinetics of domperidone tablet formulations in fasting and fed Chinese healthy subjects

OBJECTIVE: The objective of this study was to evaluate and compare the pharmacokinetics of domperidone tablets in Chinese healthy subjects both under fasting and fed conditions. MATERIALS AND METHODS: A total of 36 subjects were recruited to the monocentric pharmacokinetic study. All subjects were randomly divided into two groups. One group was given a single 10-mg oral dose of domperidone tablet after ~ 10 hours of fasting, and the other group was given the same oral dose of domperidone tablet 30 minutes after a high-fat meal. 18 blood samples were collected over 24 hours for every subject. Plasma concentrations of domperidone were analyzed by a rapid and sensitive UPLC-MS/MS assay, and the pharmacokinetic parameters were determined by the standard non-compartmental method. RESULTS: A significant difference was observed in the pharmacokinetics of domperidone between fasting and fed subjects. The AUC0-24h (area under curve of plasma concentration until the last concentration observed) was 75.71 hxmicrog/L in the fed subjects, which was much higher than AUC0-24h (56.76 hxmicrog/L) in the fasting subjects. For the fasting test, the T1/2 (elimination half-life) was 7.15 hours, Cmax (the maximum plasma concentration) was 16.97 microg/L, and tmax; was 0.79 hours. For the fed test, the T1/2 was 8.72 hours, Cmax was 15.11 microg/L, and tmax was 1.66 hours. T1/2 and tmax were both prolonged under fed condition when comparing fed condition to fasting condition. CONCLUSION: In this study, the absorption and elimination of domperidone was slowed down by a high-fat meal, with the mean tmax being 52% longer and T1/2 18% longer in fed subjects than in fasting subjects. In addition, a high-fat meal increased the exposure of domperidone, with the mean AUC being 25% more in fed subjects than in fasting subjects, which provided an important reference for the clinical application of domperidone in the Chinese population.