Metoclopramide
Description
Metoclopramide is one of the effective anti-sickness medicine used to treat and prevent nausea and vomiting caused by cancer medicines (chemotherapy), surgery, and aid in some medical examinations involving the stomach or intestines. It is also used to treat heartburn caused by acid reflux disease when other medicines do not work well enough. In diabetic patients who have gastroparesis (poor emptying of the stomach), Metoclopramide is used to relieve symptoms of nausea, vomiting, and stomach discomfort/fullness by making a fast stomach emptying.
Common side effects of Metoclopramide are diarrhoea, sleepiness, and dizziness. Do not use this medicine in people with muscle movement problems/disorders and who are previously allergic to it. Avoid use in patients with stomach or intestinal problems such as blockage, bleeding, or perforation.
Metoclopramide is available in many different forms like tablet, capsule, syrup, mouth dissolving tablet, oral drops and injection. Your doctor will decide an appropriate dosage form and dose based on your condition. You may have to oral forms of this medicine 30 minutes before the food on an empty stomach. The oral forms are usually taken for 4 to 12 weeks. The injection is given into a muscle or a vein.
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Side effects
Major & minor side effects for Metoclopramide
- Dizziness
- Stomach pain
- Fits
- Headache
- Skin rash
- Irregular heartbeat
- Diarrhoea
- Restlessness
- Breast pain and tenderness
- Drowsiness
- Blurred vision
Uses of Metoclopramide
What is it prescribed for?
- Chemotherapy induced nausea and vomiting
- Gastroparesis
- Gastroesophageal Reflux Disease
- Small Intestine Intubation
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Concerns
Commonly asked questions
- Onset of actionThe onset of action for metoclopramide can be observed within 1 to 3 minutes for injection into a vein, 10 to 15 minutes for injection into a muscle, and 30 to 60 minutes for the oral forms.
- Duration of effectThe effect of metoclopramide lasts for a duration of 1 to 2 hours.
- Safe with alcohol?Consumption of alcohol with Metoclopramide is not recommended due to the risk of central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills. Do not drive a vehicle or operate heavy machinery if alcohol and Metoclopramide are used together.
- Is it habit forming?No habit-forming tendency has been reported for Metoclopramide.
- Usage in pregnancy?Metoclopramide is not recommended for use in the first and third trimesters of pregnancy unless directed by the doctor. After delivery, mothers are at moderately high risk for depression. Treatment should be avoided in women with a history of depression. If you are using Metoclopramide any changes in your mood or any movement disorders should be reported to the doctor immediately.
- Usage while breast-feeding?Metoclopramide can pass into breast milk. Hence use is generally not recommended in breastfeeding women. If used, the baby should be observed for symptoms such as stomach discomfort and gas.
Allergy
Avoid taking Metoclopramide if you are previously allergic to it. Allergic reactions to this medicine are rare. Seek immediate medical attention if you notice any symptoms of allergic reactions such as skin rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, breathing difficulties, etc.
Gastrointestinal disorders
Metoclopramide is a gastrointestinal motility agent that helps in improving the motility of the oesophagus (food pipe) and stomach. Therefore it is not recommended for use in patients with stomach or intestinal problems such as blockage, bleeding, or perforation where stimulation of gastrointestinal motility might be harmful.
Seizure disorder
A seizure is a sudden abnormal electrical disturbance in the brain. Metoclopramide is not recommended for use in patients with seizures due to the risk of worsening the condition.
Pheochromocytoma
Pheochromocytoma is a tumour that grows in an adrenal gland located on top of the kidneys. This tumour produces hormones like norepinephrine (noradrenaline) and epinephrine (adrenaline) which may cause high blood pressure, headache, sweating and symptoms of a panic attack. Metoclopramide is not recommended for use in patients with pheochromocytoma due to an increase in the risk of hypertensive crisis (very severe increase in the blood pressure).
Warnings for special population
Pregnancy
Metoclopramide is not recommended for use in the first and third trimesters of pregnancy unless directed by the doctor. After delivery, mothers are at moderately high risk for depression. Treatment should be avoided in women with a history of depression. If you are using Metoclopramide any changes in your mood or any movement disorders should be reported to the doctor immediately.
Breast-feeding
Metoclopramide can pass into breast milk. Hence use is generally not recommended in breastfeeding women. If used, the baby should be observed for symptoms such as stomach discomfort and gas.
General warnings
Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a condition characterized by fever, muscle rigidity, involuntary movements and altered mental status. Use Metoclopramide cautiously in patients with a history of NMS, since NMS may recur. Do not use this medicine in patients with active NMS and should be immediately stopped if currently being used in such patients.
Depression
Depression is a common condition nowadays which can occur due to various reasons. Use Metoclopramide cautiously in patients with or without a prior history of depression since it may worsen the condition. If the patient has negative thoughts such as suicidal attempts, sad mood, or less social interaction, discontinue the medicine and seek medical treatment.
Hypertension
Metoclopramide can increase blood pressure and hence use it cautiously in patients with high blood pressure. Monitor blood pressure levels at regular intervals while on treatment with this medicine.
Kidney impairment
Kidney helps in the clearance of Metoclopramide from the body. Therefore, patients with impaired kidney function may require a dosage adjustment to prevent medicine accumulation in the body.
Driving or operating machinery
In some patients Metoclopramide may cause blurred vision, dizziness, or drowsiness and hence do not perform any activities such as driving a vehicle or operating machinery if you experience any of these symptoms.
Muscle spasms
Metoclopramide may cause muscle spasms in the face, neck, body, arms, and legs during the first two days of use. These effects are more likely to occur in children and adults below 30 years of age.
Missed Dose
Oral forms: Try not to skip a dose of metoclopramide. And if a dose is skipped, do not add it up to the next dose.
Injection: Metoclopramide is administered in the hospital or clinical setting by a qualified healthcare professional, the likelihood of a missed dose is very low.
Overdose
Oral forms: Seek emergency medical attention or contact the doctor in case of overdose with metoclopramide.
Injection: Since metoclopramide is administered in the hospital or clinical setting by a qualified healthcare professional, the chances of an overdose are very low. However, emergency medical treatment will be initiated by the doctor if an overdose is suspected.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol
Description
N/A
Instructions
Consumption of alcohol with Metoclopramide is not recommended due to the risk of central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills. Do not drive a vehicle or operate heavy machinery if alcohol and Metoclopramide are used together.
Interaction with Medicine
Phenytoin
Olanzapine
Chlorpromazine
Promethazine
Disease interactions
Tardive Dyskinesia
Tardive dyskinesia (TD) is a condition of involuntary and abnormal movements of your face and body. You might blink your eyes, repetitively chew, stick out your tongue, or move arms, legs or trunk without your control. Long term treatment with Metoclopramide should be avoided in patients with TD unless if the benefit is thought to outweigh the risk of developing TD.
Parkinsonism
Parkinsonism is a progressive condition with gradual brain tissue damage that results in the weakening of the muscle tissues, difficulty in walking and coordination. Metoclopramide should be used with caution in patients with parkinsonism due to the risk of worsening of parkinsonian-like symptoms such as tremors, pill-rolling motion, and postural abnormalities.
Food interactions
Information not available.
Lab interactions
Information not available.
Metoclopramide uses are widely accepted. Metoclopramide is available as oral and injectable forms.
Oral forms: Take metoclopramide 30 minutes before your food. Never take more than the prescribed dose. Monitoring of blood pressure and symptoms like involuntary movements of the tongue, lips, face, and trunk is necessary while consuming this medicine.
Injection: Metoclopramide should be administered by a qualified healthcare professional in the clinical or hospital setting.
Miscelleneous
How it works
Metoclopramide mechanism of action is in two ways:
1. It works by increasing the movement of food in the stomach and the intestine.
2. It blocks a natural substance in the brain that causes nausea and vomiting.
Legal Status
Classification
Category
Gastrointestinal Stimulants, Antiemetics
Schedule
Schedule H
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Medicines.org.uk. 2021. Metoclopramide Hydrochloride 10-Mg Tablets - Summary Of Product Characteristics (Smpc) - (Emc). [online] Available at: < [Accessed 20 January 2021].
Drugs, H., 2021. Metoclopramide: Medlineplus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 20 January 2021].
Pubchem.ncbi.nlm.nih.gov. 2021. Metoclopramide. [online] Available at: < [Accessed 16 March 2021].
Accessdata.fda.gov. 2021. [online] Available at: < [Accessed 20 January 2021].
Lupin.com. 2021. [online] Available at: < [Accessed 20 January 2021].
Information on this page was last updated on 17 Mar 2021
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