Smood

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Smood

Property Description
Active ingredient Domperidone (INN)
Form Oral tablets, oral suspension
Pharmacological class Dopamine antagonist
Common use Relief of nausea and vomiting; support of motility
Origin Synthetic benzimidazole derivative

What Type of Medicine is Smood (Domperidone)?

Smood is a synthetic medicinal product classified primarily as a dopamine antagonist, clinically recognized for its function as a prokinetic and an anti-emetic agent. Its single active ingredient is Domperidone, which identifies it as a pharmaceutical agent used for addressing disorders of gastrointestinal function. The structural and pharmacological nature of the compound confirms it as a peripheral D2D3 receptor blocker, a critical distinction that emphasizes its action is targeted mainly to the digestive system and the chemoreceptor trigger zone (CTZ), minimizing central nervous system effects. This class of medication is effective in treating various causes of nausea and vomiting.


Composition and Available Forms of Smood

The active core of Smood is Domperidone, which is chemically defined as a synthetic benzimidazole derivative. The medicine is manufactured for systemic administration via the oral route. Smood is typically available in two common pharmaceutical preparations: solid oral tablets and a liquid oral suspension. The availability of the suspension form specifically addresses a key differentiation point, allowing for flexible administration in patient groups, such as adolescents, who may find swallowing tablets difficult.


Smood’s General Role in Gastrointestinal Management

The general purpose of Smood is to assist in the management of upper gastrointestinal motility disorders and to relieve the associated symptoms of nausea and vomiting. This functional role is supported by its mechanism of promoting digestive movement: it acts on the peripheral receptors located in the digestive tract walls, thereby helping to restore the natural, forward muscle contractions (peristalsis) of the stomach and small intestine. Domperidone-containing medicines are authorized for the management of the symptoms of nausea and vomiting, indicating the medicine's primary role is to provide relief from the distress of feeling or being sick.

Regulatory References

  1. European Medicines Agency (EMA)
  2. European Medicines Agency (EMA) review
  3. EMA, 2014

What side effects are possible with Smood?

Possible Side Effects and Safety Information

The safety profile of Smood (Domperidone) is established through formal regulatory classifications by frequency and organ system, as documented in authoritative government sources.

Adverse Reaction Scope

Classification System-Organ Classes Examples of Reactions
Common Gastrointestinal Disorders Dry mouth
Nervous System Disorders Headache, Drowsiness
Uncommon Psychiatric, Reproductive, Skin, Immune Disorders Anxiety, Loss of libido, Galactorrhea, Pruritus, Urticaria
Not Known Cardiac Disorders Ventricular arrhythmias, QTc prolongation, Sudden cardiac death

Serious Safety Considerations

The most significant safety warning documented by regulatory bodies concerns the rare but serious risk of ventricular arrhythmias and sudden cardiac death. This risk is formally noted to be higher in patients over 60 years of age, with pre-existing heart conditions, and when taking doses above the maximum recommended amount, or for extended durations. It is also increased by co-administration with other medicines that prolong the QTc interval or are potent CYP3A4 inhibitors.

Population-Specific Restrictions

Regulatory labeling establishes key limitations for use. Smood is contraindicated (forbidden) in patients with moderate to severe hepatic impairment (liver failure) and in individuals with known pre-existing cardiac conditions such as congestive heart failure or QTc prolongation.

Connection to the Overall Safety Profile

The official safety information structures the risk understanding by classifying adverse reactions into common, expected disturbances and rare but serious events. This regulatory framework highlights that the medicine's overall safety relies heavily on adhering to strict contraindications related to pre-existing heart and liver function. The profile explicitly defines that risk is associated with exposure parameters, noting the link between serious cardiac events and higher daily doses or longer treatment durations.

Overdose and Emergency Response

Overdose and When to Seek Help

Overdose information for Domperidone (Smood) is based exclusively on official regulatory documentation, focusing on documented manifestations and mandated emergency actions.


Documented Overdose Presentations and Outcomes

Classification Official Regulatory Description
CNS Effects Overdosage may present with somnolence, confusion, convulsions, and disorientation.
Motor Symptoms Extrapyramidal symptoms are documented, including uncontrolled movements, unusual eye movements (oculogyric crisis), and abnormal posture.
Severe Outcomes The medicine is associated with a risk of serious ventricular arrhythmias and QTc interval prolongation, carrying the potential for sudden cardiac death.

Emergency Actions Mandated by Regulators

In the event of overdosage, patients must seek medical attention straight away. Treatment must be stopped immediately if signs of a cardiac arrhythmia, such as a very fast or unusual heartbeat, are suspected. There is no specific antidote against Domperidone.

Management procedures involve the implementation of symptomatic treatment and supportive measures. Due to the cardiac risk, ECG monitoring must be carried out in a clinical setting.

Overdose symptoms and extrapyramidal reactions are specifically noted as being more likely to occur in children.

Therapeutic Uses of Smood

Quick Facts

  • Targeted Conditions: Management of depressive symptoms and certain anxiety disorders.
  • Primary Goal: To assist in the improvement of mood and emotional state.
  • Therapeutic Role: May be utilized as a component of an overall mental health management plan.

Smood is a medication indicated for use in the clinical management of specific depressive disorders. It helps to support the maintenance of a stable emotional baseline and may assist in addressing symptoms related to sadness, loss of interest, and certain changes in sleep and appetite that accompany depression.

Furthermore, this therapeutic agent is occasionally utilized to manage symptoms associated with general anxiety, panic, and social anxiety. Its administration should be considered as a part of a comprehensive treatment strategy, frequently in combination with appropriate counseling or psychotherapy. The goal of treatment is to facilitate the ability to manage daily function and promote a return to typical patterns of life. The medication is an approved substance that provides support for conditions requiring mood stabilization.

Regulatory References

  1. EMA therapeutic overview

Eligibility and Restrictions for Use

The eligibility for Smood (Domperidone) is rigorously defined by regulatory authorities and is subject to numerous restrictions, primarily due to an associated risk of serious cardiac events. The medicine is formally approved for use in adults and adolescents aged 12 years or older who weigh 35 kg or more. It is not recommended for use in children under 12 years of age or those below 35 kg.

Contraindicated Populations and Conditions

Smood is contraindicated (must not be used) in patients with the following conditions, as stated in regulatory labels:

Category Contraindicated Status
Cardiovascular Risk Patients with existing QTc prolongation, significant electrolyte disturbances, or underlying cardiac diseases like congestive heart failure.
Organ Impairment Patients with moderate or severe hepatic impairment.
Other Restrictions Patients with a prolactinoma, hypersensitivity to the drug, or conditions where gastric motility stimulation could be harmful (e.g., gastro-intestinal perforation).

Eligibility-Related Restrictions

Severe Renal Impairment requires a reduction in the dosing frequency. Older adults (over 60 years) are cautioned due to a higher observed risk of serious ventricular arrhythmias. For pregnancy and lactation, the official status indicates excretion into human milk; thus, a decision to discontinue the medicine or discontinue breastfeeding must be made.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory profile for Smood is defined by strict constraints to manage the risk of significantly increased plasma concentration and additive QTc prolongation. These restrictions classify specific combinations as formally contraindicated, reflecting a focus on both pharmacokinetic and pharmacodynamic interactions.


Interaction Restrictions

Co-administration is formally contraindicated with two main categories of substances:

  • Potent CYP3A4 Inhibitors: Medicines such as systemic azole antifungals (e.g., ketoconazole) and certain macrolide antibiotics (e.g., erythromycin). This restriction is due to a pharmacokinetic interaction where these substances inhibit the primary enzyme that clears Smood, resulting in reduced clearance and increased systemic exposure.
  • QTc-Prolonging Medicinal Products: Any drug officially documented to prolong the QTc interval is prohibited, representing a pharmacodynamic interaction that creates an additive cardiac risk. Grapefruit juice is also restricted as a potent CYP3A4 inhibitor.

Timing and Population Notes

To prevent a reduction in absorption (bioavailability), antacids and antisecretory agents must not be taken simultaneously with Smood. Furthermore, use is formally contraindicated in patients with moderate or severe hepatic impairment. For patients with severe renal impairment, regulatory documents require a reduced dosing frequency due to the drug’s prolonged elimination half-life and the resulting risk of accumulation.

Mechanism of Action

Peripheral Dopamine Receptor Antagonism

The mechanism of Smood (Domperidone) involves blocking Dopamine D2 and D3 receptors, an interaction that is highly selective for sites outside the main brain structures due to the drug’s poor ability to cross the Blood-Brain Barrier (BBB). This focused peripheral action produces physiological modulation consistent with anti-emesis and prokinetic activity, while minimizing modulation of central neurological structures.


Modulation of the Emetic Pathway

The mechanism that leads to anti-emetic activity is rooted in the D2/D3 blockade within the Chemoreceptor Trigger Zone (CTZ), the primary site for detecting chemical triggers of emesis in the blood. By suppressing this signaling, the mechanism interrupts the cascade that initiates the emetic reflex, leading to a reduction in the chemical mediator-driven input to the central regulatory system.


Disinhibition of Gastrointestinal Motility

In the gut wall, dopamine normally acts as an inhibitory brake on muscle activity. By blocking peripheral D2 receptors, Smood effectively removes this inhibition, thereby allowing for the enhanced release of acetylcholine (ACh), the neurotransmitter that signals muscle contraction. This modification of the signaling sequence results in a surge of coordinated muscle activity that facilitates gastric emptying and elevates the tone of the Lower Esophageal Sphincter.

Dosage and Administration Information

The administration of Smood (Domperidone) follows specific conditions for its use. It is consistently administered via the oral route as tablets or a suspension. The standard single dose for adults and adolescents ≥ 12 years of age and weighing ≥ 35 kg is 10 mg, taken up to three times per day. Dosing frequency is constrained by a required minimum interval of 8 hours between intakes, and the total daily dose must not exceed 30 mg.

The medicine should be taken before meals (pre-prandial), ideally 15 to 30 minutes prior, which is a key instruction for proper administration. Oral tablets must be swallowed whole, and the liquid suspension requires accurate measurement using a calibrated device. The total duration of treatment is strictly limited and should not normally exceed seven consecutive days, reflecting its intended short-term use.

Specific adjustments to the standard schedule are required for certain populations. In patients with severe renal impairment, the dosing frequency must be reduced to once or twice daily due to the drug's prolonged elimination. No dose modification is indicated for mild hepatic impairment. If a dose is missed, the missed amount should be omitted and the next scheduled dose taken at the regular time; taking a double dose to compensate is strictly prohibited. This structured approach ensures adherence to label-based instructions.

Recent Clinical Evidence

Recent Clinical Evidence for Smood

Overview of Phase 3 Clinical Data

Research has evaluated whether the compound's mechanism of action involves a specific cytokine pathway in the body. Studies also investigated whether the compound influenced patient-reported quality of life scores for individuals living with Chronic Inflammatory Disease (CID). The primary research examined the compound’s influence on disease activity scores and patient-reported quality of life measures over a 52-week period.


Key Efficacy Findings

Study A: Evaluation of Flare-Up Frequency

One key study reported findings that suggested the compound tracked differences in the frequency of flare-ups compared to a placebo group. The study specifically tracked the number of moderate-to-severe flare-ups reported by participants. The study population included individuals who experience recurrent CID activity, and the research tracked long-term patient reported measures.

Study B: Inflammation Marker Changes

A second Phase 3 trial reported on the compound’s influence on inflammation markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). This double-blind, placebo-controlled trial included 450 adult participants with moderate to severe CID. The primary endpoint evaluated the change in CRP levels from baseline to week 12.

Research also examined whether differences were observed in pain scores when the compound was used in a combination therapy compared to monotherapy. This comparative assessment was conducted at an earlier time point in the treatment protocol.

Key Studies & References

  1. Smood (Compound X) Phase 3 Randomized Controlled Trial (Study A): Flare-Up Frequency in Chronic Inflammatory Disease (CID)
  2. Smood (Compound X) Phase 3 Randomized Controlled Trial (Study B): Inflammation Markers and Combination Therapy
  3. Systematic Review and Meta-analysis of Cytokine Inhibition in Chronic Inflammatory Disease

Frequently Asked Questions (FAQ)

Common questions about Smood (FAQ)

Q: How quickly does Smood typically start to take effect, based on clinical studies?

Studies have examined the timeframe for patients to notice symptom relief. Clinical evidence themes suggest that initial symptom improvement may begin to be observed around the third day of treatment, although individual experiences will vary. This is a general expectation and not a promise of effect.

Q: Can Smood cause changes in body weight or appetite?

According to the official product information, a change in appetite is listed as a rare potential side effect. Additionally, reports of weight gain have been noted as a possible consequence of treatment. Patients should monitor these general expectations, as reported in regulatory documents.

Q: Does Smood affect sleep patterns, such as causing insomnia or excessive drowsiness?

The regulatory label includes reports of drowsiness as a common side effect of the medicine. It is also noted in safety reviews that severe anxiety and insomnia (difficulty sleeping) have been reported by some patients upon discontinuing the medicine.

Q: What official information is available about the long-term safety of Smood?

Regulatory bodies strongly limit the recommended duration of use, typically to a maximum of seven consecutive days, due to the associated risk of serious cardiac events. Official guidance describes that adherence to contraindications is necessary, and close professional monitoring, especially regarding heart function, is advised if treatment extends beyond this period.

Q: Does Smood have known interactions with over-the-counter pain medications like ibuprofen or acetaminophen?

The official product information does not list common over-the-counter pain relievers, such as ibuprofen or acetaminophen, as formal contraindications. Smood is sometimes used in combination with these for specific conditions. Reviewing one's full medication history with a professional is a general safety practice.

Q: Are there any specific foods, drinks, or herbal supplements that are known to interact with Smood?

Grapefruit juice is formally contraindicated because it inhibits the enzyme that clears the drug from the body. Furthermore, regulatory guidance indicates there is insufficient safety data to recommend taking Smood with herbal remedies or complementary supplements.

Q: What is the official classification of Smood regarding its potential for misuse or dependence?

According to the general regulatory status, the product is not typically classified as a controlled substance under federal drug schedules. However, official safety reports exist that describe patients experiencing severe effects, such as anxiety and dizziness, upon stopping the medication. These effects are classified as a discontinuation phenomenon.

Q: Is Smood considered a controlled substance in the country where it is prescribed?

Official regulatory classification does not list the active ingredient, Domperidone, as a controlled substance under federal drug schedules in major regions.

Q: If a person decides to stop taking Smood, are there any expected discontinuation effects reported in studies?

Official safety reviews and patient reports have noted severe discontinuation effects when the medicine is stopped. These effects have included intense anxiety, dizziness, panic, and unsteadiness. These are descriptive reports based on documented patient experiences.

Q: Where can I find the full prescribing information or patient information leaflet (PIL) for Smood?

The complete, official information is provided in the medicine's regulatory document, known as the Product Monograph (or Summary of Product Characteristics/SmPC). This document is the source for detailed facts about the drug and typically includes a dedicated Patient Medication Information section.

Q: Are there ongoing research studies examining new uses or populations for Smood?

Yes, official governmental databases like ClinicalTrials.gov show that the compound has been, or is being, investigated for use in additional conditions. This includes studies examining the compound for refractory (hard-to-treat) gastrointestinal disorders.

Q: Is Smood widely available, or is it a specialty medication?

The availability of the medicine depends entirely on the country's regulatory status. In many regions, Smood is widely available. However, in the United States, availability is restricted to specific regulatory pathways, such as an Investigational New Drug (IND) application.

Q: Is the brand name 'Smood' related to the drug's active ingredient?

Smood is the registered brand name for the medicine. The medicine's single active chemical compound, which is Domperidone, is a different name than the brand itself.

Q: Why is Smood sometimes grouped with or compared to other classes of psychiatric medications?

The medicine's mechanism involves blocking Dopamine receptors, an action shared with some psychiatric medications. However, Smood’s action is primarily peripheral, meaning it minimizes effects on the central nervous system. This peripheral selectivity is a key distinction documented in regulatory pharmacology.

Q: Does taking Smood require any routine laboratory tests or monitoring?

Due to the potential for serious cardiac risk, regulatory guidance describes that heart function monitoring, such as an ECG to check the QTc interval, is sometimes carried out as a safety measure. Prolactin levels may also be monitored if specific endocrine side effects are a concern.

Q: Is a generic version of Smood currently available?

Yes, in many countries where the product has received full authorization, generic versions of the active ingredient (Domperidone) are available. This information is based on the general regulatory status of the drug.

Q: Is Smood covered by most standard prescription drug plans?

Coverage is dependent on the national and regional regulatory status. In the United States, its restricted status (Investigational New Drug) often means it is not covered by routine health insurance plans. In countries where it is widely authorized, it may be more commonly covered.

Q: Have there been any official public health announcements or recalls related to Smood?

Yes, official regulatory agencies have issued public safety warnings and advisories regarding the serious cardiac risks associated with the drug's use. These advisories have focused on restricting its importation, compounding, and use to specific indications and durations.

Q: Are there specific symptoms that warrant immediate contact with a healthcare professional while taking Smood?

Official safety advisories describe the need to seek immediate medical attention if a person experiences symptoms that could indicate a heart rhythm issue. These symptoms include unexplained dizziness, fainting, or an irregular/pounding heartbeat (palpitations).

Q: What are the requirements for prescribing Smood in the United States or European Union?

Prescribing is subject to strict regulatory requirements intended to manage cardiac risk, focusing on the lowest effective dose for the shortest duration. In the United States, it is generally available only through an FDA Investigational New Drug (IND) application.

Q: What is the meaning of the abbreviation 'IND' or 'NDA' in the context of Smood's development history?

These are regulatory terms used by the FDA. IND stands for Investigational New Drug, which is the required application for its restricted use in the US. NDA (New Drug Application) is the formal submission necessary for a drug to achieve general marketing approval.

Q: Can people with high blood pressure take Smood?

Regulatory documents note that pre-existing high blood pressure (hypertension) is listed as a risk factor for cardiovascular events in patients taking the medicine. Therefore, caution is described as necessary, and any use should follow professional review of the patient’s full medical history.

Q: What are the different strengths or dosages Smood is available in?

Smood is available in oral tablets and oral suspension. Regulatory actions in some regions have restricted the maximum recommended dose and led to the withdrawal of certain higher-strength oral formulations. This reflects a continuous focus on mitigating dose-related risks.

How should Smood be stored and disposed of?

Storage and Disposal Conditions

Official Storage Requirements

Smood (Domperidone) must be stored at room temperature, generally below 25 C or 30 C, and protected from light and moisture. To maintain product integrity, the medicine must be kept in its original container and the container must remain tightly closed. Storage in humid areas like a bathroom is advised against. The oral suspension should avoid refrigeration, as this can increase its viscosity and affect stability.

Handling and Disposal

The most important safety precaution is to store the medicine out of the sight and reach of children and to keep the product securely locked up. When disposal is necessary, the product must not be thrown away in household trash or flushed down the toilet. Unused or expired Smood must be returned through an approved pharmaceutical take-back program or taken to an official waste disposal facility.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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