International Board of Certified Lactation Consultant (IBCLC) Practice Exam

What are two of the most common drugs used as galactagogues?

1. Metoclopramide and cimetidine

2. Metoclopramide and domperidone

3. Domperidone and ranitidine

4. Metoclopramide and pseudoephedrine

The correct answer is: Metoclopramide and domperidone

The use of galactagogues, which are substances that promote lactation, is an important topic in lactation consultancy. Metoclopramide and domperidone are both commonly recognized for their ability to enhance milk production. Metoclopramide, a medication primarily used to treat nausea and gastroparesis, works by increasing the levels of prolactin, a hormone crucial for milk production. This occurs through its action as a dopamine antagonist, which can stimulate the pituitary gland to secrete more prolactin. Domperidone is another dopamine antagonist that also increases prolactin levels, but it is preferred by some healthcare providers because it has fewer central nervous system side effects compared to metoclopramide. Domperidone does not readily cross the blood-brain barrier, which tends to reduce the risk of causing sedation or other neurological effects. Both of these medications are evidence-based options for addressing low milk supply due to their impacts on hormone levels related to lactation. Consequently, they are included among the most common drugs used to promote lactation and are often recommended in clinical practice for this purpose.