Introduction
nausea and vomiting, cardiac disease
HYPERPROLACTINEMIA, SECONDARY, CARDIAC DISEASE
Domperidone is a dopaminergic antagonist with antiemetic properties, marketed with indication for the relief of symptoms of nausea and vomiting. It is well tolerated and safe but can produce increasement in the QT interval, the time from the start of the Q wave to the end of the T wave ortime taken for ventricular depolarisation and repolarisation. Thus, it has warnings when used for patients with cardiac disease or with concomitant use of other drugs affecting the QT interval. This drug stimulates the secretion of prolactin in the pituitary gland as a secondary effect.The clinical trial here reported explored the antiviral activity in clinic of domperidone, as a drug repositioning strategy. Although the cellular mechanism of action of domperidone as an antiviral is unknown, there are some published data on the potential role of domperidone for the management of COVID-19. Moreover, our research group found Prolactin is involved in many other pathways that protect the immune system. It stimulates B and T cells, with a direct correlation between prolactin levels and the number of B and T lymphocytes [In addition to prolactin’s role in enhancing adaptive immunity, it has a key role in innate immunity, which is the first line of defense against pathogens, which stimulates NK cells, macrophages, neutrophils and dendritic cells [From this rationale it follows that the controlled increase in blood prolactin levels at physiological levels or inducing mild hyperprolactinemia, using dopamine antagonists, could stimulate innate and adaptive immunity and increase the survival of patients in certain critical situations, among which can be found patients infected with SARS-CoV-2.The present randomized double-blind clinical trial was conducted to assess the efficacy of domperidone to reduce the viral load in patients with mild-to-moderate COVID-19 in the primary healthcare setting.