Domperidone induced galactorrhea: An unusual presentation of a common drug
A 19 year old married housewife with no premorbidities came with chief complaints of bilateral mastalgia and galactorrhea since the past one week. Patient had been suffering from irregular menstruation since, the past six months for which no treatment was taken. Her last menstrual period was 43 days prior to the episode. She was suffering from fever, dysuria, vomiting in the week prior, for which she had taken ciprofloxacin at the dose of 500 mg twice a day for 5 days. She took oral domperidone 10 mg thrice a day for 5 days for her vomiting and galactorrhea developed on the sixth day. There was no history of increase in breast size. She also gave history of intermittent headache since 3 months. On examination, other than breast tenderness and galactorrhea there were no other findings. Field of vision was normal. Prolactin level was done using enzyme immune assay which was elevated (100.5 ng/ml). Routine investigations including liver, renal, and thyroid function tests (other causes of hyperprolactinemia) were within normal limits. In view of headache, formal perimetry and MRI brain including pituitary was done which was normal. Urine pregnancy tests were repeatedly negative. A repeat prolactin done after 5 days was 9.7 ng/ml which was within normal limits. As other causes of hyperprolactinemia were ruled out, it was ascertained that the oral domperidone could be the culprit in this situation. Causality assessment was carried out using the Naranjo's causality assessment scale which showed highly probable causal association.