The antiemetic domperidone’s reclassification shows the importance of pharmacovigilance, but the loss of such a useful over-the-counter medicine ought to have been better communicated to community pharmacies. On 3 September 2014, community pharmacists were given 48 hours to remove over-the-counter (OTC) domperidone products from their shelves over concerns about cardiac safety. The UK’s Medicines and Healthcare products Regulatory Agency had stripped the product of its status as a pharmacy medicine and the drug is now only available with a prescription. The injectable form of domperidone was withdrawn in 1985 because of cardiac side effects. But the oral form had long been considered to be well tolerated with minimal toxicity — which is why it was switched from prescription to pharmacy medicine in 1998 for the relief of post-prandial symptoms of fullness, nausea, bloating and belching, occasionally accompanied by epigastric discomfort and heartburn. The 10mg oral domperidone product had its OTC licence extended in 2010 to include the relief of nausea and vomiting lasting less than 48 hours. In consulting on the licence extension, the MHRA acknowledged that there are few treatments available for purchase in pharmacies to manage nausea and vomiting, leaving pharmacists frequently having to refer patients to their doctor. They work by easing the passing of food through the digestive system. This helps to treat both short term feelings of sickness, and other cases lasting for up to two weeks. In addition to this, it can help to reduce heartburn and trapped wind. Nausea is a condition where the body’s vomiting reflex is heightened by internal or external stimulus, resulting in the need to be sick. This stimulus sends messages to the vomiting centre in the brain, via the CTZ, or chemoreceptor trigger zone, telling the body that it needs to expel vomit. This then causes the spasms in the stomach which cause sickness. 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