2025 Alternatives to Motilium (Domperidone): Practical Choices

If Motilium (domperidone) isn’t an option for you—because of availability, safety concerns, or side effects—there are other things to try in 2025. Below I cover the main drug alternatives, plus non-drug steps people use to manage nausea, bloating, and slow stomach emptying. Read this before you switch anything and bring it to your prescriber.

Safer drug options to discuss with your doctor

Metoclopramide (brand names like Reglan) is the most common alternative. It helps move food through the stomach and eases nausea. It works fast but long-term use can risk movement side effects (like tremors or rarely tardive dyskinesia). Doctors often recommend short courses or the lowest effective dose.

Erythromycin is an older antibiotic that, at low doses, acts like a prokinetic. It can help gastroparesis or immediate post-op gastric emptying. Expect diminishing benefit over weeks (tachyphylaxis) and watch for gut upset and possible heart rhythm issues, especially with other medicines that affect QT intervals.

Prucalopride (a selective 5‑HT4 agonist) is approved mainly for chronic constipation but has growing evidence for helping delayed gastric emptying in some patients. It’s generally seen as having fewer cardiac risks than older drugs like cisapride (which was pulled from many markets). Ask your doctor if prucalopride could suit your symptoms.

Tegaserod is another 5‑HT4 agent used for IBS with constipation; it can help motility for some people but availability and eligibility rules vary by country. Because of mixed safety histories, it’s prescribed selectively.

Non-drug strategies and procedures that help

Diet changes often make a big difference. Small, frequent meals, lower-fat choices, and fewer high-fiber foods can ease symptoms. For diabetic gastroparesis, tighter blood sugar control helps gastric function.

If medicines don’t work, there are procedures: endoscopic pyloric therapies (to ease a tight pylorus), gastric electrical stimulation (for severe nausea/vomiting), or temporary use of feeding tubes in extreme cases. These are specialist options—ask a gastroenterologist.

Also consider short-term antiemetics like ondansetron for nausea while you sort out a motility plan; they don’t speed emptying but do help symptoms. Natural options such as ginger can reduce mild nausea for some people, but don’t rely on them alone for severe motility problems.

Finally, every medicine has trade-offs. Domperidone was restricted in some places because of heart risks; metoclopramide has movement risks with long use; erythromycin loses effect over time. Talk specifics with your clinician, tell them every drug and supplement you take, and ask about ECG checks if you have heart concerns.

On InternationalDrugMart.com we have deeper guides about domperidone, metoclopramide, erythromycin, and non-drug approaches—use those articles to prepare for your next doctor visit and to compare options safely.