Metoclopramide – what it is, what it is for and side effects!

Metoclopramide increases muscle contractions in the upper digestive tract, this speeds up the rate at which the stomach empties into the intestines. Oral (taken by mouth) is used for 4 to 12 weeks to treat heartburn caused by gastroesophageal reflux in people who have used other medications without relief.

Oral metoclopramide is also used to treat gastroparesis (slow emptying of the stomach) in people with diabetes, which can cause heartburn and stomach discomfort after meals.

Metoclopramide injection is used to treat severe diabetic gastroparesis . The injection is also used to prevent nausea and vomiting caused by chemotherapy or surgery, or to help with certain medical procedures involving the stomach or intestines.

Important Information About Metoclopramide:

Do not use this medication if you have had muscle movement problems after using metoclopramide or similar medications, or if you have had a movement disorder called tardive dyskinesia.

You also should not use this medication if you have stomach or bowel problems (a blockage, bleeding, or a hole or tear), epilepsy or another seizure disorder, or a tumor of the adrenal gland (pheochromocytoma).

NEVER USE METOCLOPRAMIDE IN MORE THAN RECOMMENDED AMOUNTS OR FOR MORE THAN 12 WEEKS. High doses or long-term use can cause a serious movement disorder that may not be reversible.

Precautions Before Taking This Medicine:

You should not use metoclopramide if you are allergic to it, or if you have:

• Tardive dyskinesia (a disorder of involuntary movements);
• Stomach or intestinal problems, such as obstruction, bleeding, or perforation (a hole or tear in the stomach or intestines)
• Epilepsy or other seizure disorder;
• A tumor of the adrenal gland (pheochromocytoma);
• If you have ever had muscle movement problems after using metoclopramide or similar medications.

Tell your doctor if you’ve ever had:

• Liver or kidney disease;
• Problems with muscle movements;
• Congestive heart failure or heart rhythm disorder;
• Arterial hypertension;
• Seizures;
• Breast cancer;
• Parkinson’s Disease ;
• Diabetes;
• Depression or mental illness.

How Should I Use Metoclopramide?

Take metoclopramide exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Use the medicine exactly as directed.

An injection of metoclopramide is given into a muscle or as an infusion into a vein. In addition, a healthcare professional will do the injection, usually during surgery, chemotherapy, or medical procedure. Oral metoclopramide is taken for only 4 to 12 weeks.

Metoclopramide is usually taken 30 minutes before meals and at bedtime, or just with meals that usually cause heartburn. Follow your doctor’s dosage instructions very carefully.

Do not use two different forms of metoclopramide (such as tablets and oral syrup) at the same time. Also, measure the liquid medicine carefully. Use the dosing syringe provided or use a medication dose measuring device (not a kitchen spoon).

To Take the Oral Disintegrating Pill (ODT):

Remove a tablet from the blister only when you are ready to take the tablet. Also, use dry hands and be careful not to damage a tablet while pushing it out of the blister. Place the tablet in your mouth and allow it to dissolve, without chewing or swallowing. You can drink liquid if needed to help swallow the dissolved tablet.

Store at room temperature in a tightly closed container, away from moisture and heat. Keep the bottle tightly closed. After you stop taking metoclopramide , you may experience unpleasant withdrawal symptoms, such as a headache, dizziness, or nervousness.

Metoclopramide Dosage:

Metoclopramide Dosage Information .

Usual Adult Dose for Nausea/Vomiting:

• Postoperative nausea and vomiting :
• Parenteral: 10 to 20 mg IM at or near the end of surgery.

Usual Adult Dose for Gastroesophageal Reflux Disease:

• Oral: 10 to 15 mg up to 4 times daily, 30 minutes before meals and at bedtime, depending on symptoms treated and clinical response. Therapy should not exceed 12 weeks.

Usual Adult Dose for Small Intestine Intubation:

If the tube has not passed the pylorus with conventional methods within 10 minutes, a single (undiluted) dose can be administered IV slowly over 1 to 2 minutes:
Adults and pediatric patients 14 years of age and older: 10 mg IV as a single dose administered for 1 to 2 minutes.

Usual Adult Dose for Radiographic Examination:

Adults and pediatric patients 14 years of age and older: 10 mg IV given in single doses over 1 to 2 minutes to facilitate gastric emptying when delayed gastric emptying interferes with radiological examination of the stomach and/or small intestine.

Usual Adult Dose for Gastroparesis:

During the first manifestations of diabetic gastric stasis, oral administration can be initiated. If severe symptoms are present, therapy should begin with IM or IV administration for up to 10 days until symptoms resolve, at which point the patient can be switched to oral therapy. As diabetic gastric stasis is frequently recurrent, therapy should be reinstituted at the earliest manifestation.

• Parenteral: 10 mg 4 times daily, IV (slowly over a period of 1 to 2 minutes) or IM for up to 10 days.
• Oral: 10 mg 4 times daily, 30 minutes before meals and at bedtime, for 2 to 8 weeks, depending on clinical response.

Usual Adult Dose for Nausea/Vomiting – Induced Chemotherapy:

IV infusion: 1 to 2 mg/kg/dose (depending on the emetogenic potential of the agent) IV (infused over a period of not less than 15 minutes) 30 minutes prior to chemotherapy administration. The dose may be repeated twice at 2 hour intervals after the initial dose. If vomiting is still not suppressed, the same dose can be repeated 3 more times at 3-hour intervals.

• For doses greater than 10 mg, the injection should be diluted in 50 mL of parenteral solution. Normal saline is the preferred diluent.
• If acute dystonic reactions occur, 50 mg of diphenhydramine hydrochloride can be injected IM.

Usual Adult Dose for Migraine:

Use to treat migraines is not an FDA-approved indication; however, metoclopramide has shown efficacy in studies with a dose of 10 to 20 mg IV once (used in combination with analgesics or ergot derivatives).

Usual pediatric dose for gastroesophageal reflux disease:

Metoclopramide is not FDA – approved for gastroesophageal reflux disease in pediatric patients; however, the following doses have been studied:

• Oral, IM, IV:
• Infants and children: 0.4 to 0.8 mg/kg/day in 4 divided doses

Usual Pediatric Dose for Small Intestinal Intubation:

IV Metoclopramide is FDA approved for pediatric use to facilitate intubation of the small intestine, causing gastric emptying when delayed gastric emptying interferes with radiological examination of the stomach and/or small intestine.

If the tube has not passed through the pylorus with conventional methods in 10 minutes, a single dose (undiluted) can be given slowly IV over 1 to 2 minutes:

• Less than 6 years: 0.1 mg/kg IV as a single dose
• 6 to 14 years: 2.5 to 5 mg intravenously as a single dose
• Children over 14 years: 10 mg as a single dose

Usual Pediatric Dose for Nausea/Vomiting – Induced Chemotherapy:

Metoclopramide is not FDA approved for chemotherapy- induced nausea and vomiting in pediatric patients; however, the following doses have been studied:

• IV:
• 1 to 2 mg/kg/dose IV every 30 minutes before chemotherapy and every 2 to 4 hours

Usual Pediatric Dose for Nausea / Vomiting – Postoperative:

Metoclopramide is not FDA approved for postoperative nausea and vomiting in pediatric patients; however, the following doses have been studied:

• IV:
• Children under 14 years of age: 0.1 to 0.2 mg / kg / dose (maximum dose: 10 mg / dose); repeat every 6 to 8 hours as needed.
• Children over 14 years and adults: 10 mg; repeat every 6 to 8 hours as needed

What Happens if I Miss a Metoclopramide Dose?

Take the medicine as soon as possible, but skip the missed dose if it is almost time for your next dose. Do not take two doses at the same time.

What Happens If I Overdose Metoclopramide?

Seek emergency medical attention. Symptoms of overdose may include drowsiness, confusion or uncontrolled muscle movements.

What Should I Avoid While Taking Metoclopramide?

Drinking alcohol with this medication can cause side effects. Avoid driving or dangerous activities until you know how this drug will affect you. Your reactions can be impaired.

Metoclopramide side effects:

Get emergency medical help if you have signs of an allergic reaction to metoclopramide : hives; breathing difficulty; swelling of the face, lips, tongue or throat.

Stop taking metoclopramide and call your doctor right away if you have any of these SIGNS OF SERIOUS MOVEMENT DISORDER, which can occur within the first 2 days of treatment:

• Tremors or tremors in the arms or legs;
• Uncontrolled muscle movements in your face (chewing, smacking your lips, frowning, flicking your tongue, blinking or eye movements)
• Any new or unusual muscle movement that you cannot control.

Call your doctor right away if you have:

• Confusion, Depression , thoughts of suicide or harming yourself;
• Also, slow or jerky muscle movements, problems with balance or walking;
• Mask appearance on your face;
• In addition, a seizure;
• Anxiety , restlessness, feeling nervous, trouble staying still, trouble sleeping
• Bloating, feeling short of breath, rapid weight gain;
• Also, severe nervous system reaction: very stiff (stiff) muscles, high fever, sweating, confusion, fast or irregular heartbeat, tremors, feeling faint.

Common metoclopramide side effects can include:

• Also, feeling restless;
• Feeling sleepy or tired;
• Also, lack of energy;
• Nausea , vomiting ;
• Headache , confusion;
• Also, sleep problems (insomnia).

What Other Drugs Will Affect Metoclopramide?

Using metoclopramide with other drugs that make you drowsy can exacerbate this effect. Ask your doctor before taking pain medication with opiates, a sleeping pill, a muscle relaxant, or medication for Anxiety , Depression , or seizures.

Tell your doctor about all your current medications. Many drugs can affect metoclopramide , especially:

• Acetaminofeno (Tylenol);
• Also, cyclosporine (Gengraf, Neoral, Sandimmune);
• Digoxina (digitalis, Lanoxin);
• Glycopyrrolate (Robinul);
• In addition, insulin;
• Levodopa (Larodopa, Atamet, Parcopa, Sinemet);
• Also, mepenzolate (Cantil);
• Tetraciclina (Ala-Tet, Brodspec, Panmicina, Sumicina, Tetracap);
• Also, atropine (Donnatal and others), benzotropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
• Bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas);
• Also, medications to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa, Symbyax), prochlorperazine (Compazine), risperidone (Risperdal), thiothixene (Navane), and others .

Other information:

Remember, keep this and all other medications out of the reach of children, never share your medications with others, and use metoclopramide only for the indication prescribed.

Always consult your physician to ensure that the information displayed on this page applies to your personal circumstances.