Metoclopramide

What is Metoclopramide?

Metoclopramide causes muscle contractions to increase in the upper digestive system. It speeds up how quickly the stomach emptys into the intestines.The oral form of metoclopramide (taken orally) can be used to treat acid reflux, which is caused by the gastroesophagealThe oral form of metoclopramide is used for the treatment of gastroparesis, which causes heartburn or stomach discomfort following meals.The injection of metoclopramide is given to patients with severe gastroparesis caused by diabetes. It is used for nausea or vomiting that may be caused by chemotherapy, surgery, or certain procedures.

Warnings

This medicine should not be used if your muscle movements have been affected by metoclopramide, similar medications, or a condition called tardive dyskinesia. This medicine should also not be used if you have had any stomach or intestinal issues (a blockage or bleeding or a tear or hole), epilepsy, other seizure disorders, or an adrenal tumor (pheochromocytoma).Never use metoclopramide in higher doses than recommended or for longer than 12 weeks. A serious movement disorder may result from long-term usage. This movement disorder is more common the longer you take metoclopramide. This side effect occurs more frequently in older women and diabetics.Tell your doctor before taking metoclopramide if you suffer from kidney, liver, heart, or diabetes disease.Avoid alcohol. Alcohol can cause some side effects to be worsened by metoclopramide. Call your doctor immediately if you experience tremors, uncontrolled movements of the muscles, fever, rigid muscles, confusion, or sweating. You may also have thoughts of self-harm or suicide, a depressed state of mind, hallucinations, or anxiety.

Similar/related drugs

Botox, omeprazole, famotidine, pantoprazole, ondansetron, hydroxyzine, and diclofenac

Before you take this drug

If you're allergic to metoclopramide or have any of the following:

• The disorder is called tardive dyskinesia.
• Stomach or intestinal issues such as bleeding or a perforation in the stomach or intestines;
• Epilepsy and other seizure disorders
• An adrenal gland tumor (pheochromocytoma);
• If you have ever experienced muscle problems following the use of metoclopramide or other similar medications,

If you've ever:

• Liver or kidney disease
• Problems with muscular movements
• Congestive heart failure, or an abnormal heart rhythm;
• High blood pressure
• Seizures;
• Breast Cancer
• Parkinson's disease;
• Diabetes;
• Mental disorder

The medicine you are taking may contain phenylalanine. If you have phenylketonuria, check the label of your medication. Inform your doctor that you're pregnant. Metoclopramide can harm an unborn child if used during late pregnancy. You may be unable to breastfeed your baby when you use this medication. You should ask your doctor if there are any possible risks. Metoclopramide should not be used by those under the age of 18.

How to take Metoclopramide?

Follow all instructions listed on your prescription label and carefully read all medication guides. Carefully read through and follow all the instructions found on your label. The injection of metoclopramide is administered into the muscle or in a vein. The injection is usually given by a healthcare professional during a surgical procedure, chemotherapy, or medical procedure. Oral metoclopramide is only taken between 4 and 12 weeks. Never use metoclopramide in higher doses than recommended or for longer than 12 weeks. Metoclopramide overdoses and long-term usage can lead to a severe movement disorder, which may be irreversible. This movement disorder is more common the longer you take metoclopramide. This side effect occurs more frequently in older women and diabetics. Take metoclopramide 30 minutes prior to eating, before bedtime, or with only meals that cause you heartburn. Do not forget to follow your doctor's instructions.

Use only one form of metoclopramide at a time (e.g., tablets or oral syrup). Measuring liquid medication is important. Dosing devices are available, but not spoons.

Take the Orally Disintegrating Tablet (ODT).

• Only remove a tablet's blister when you want to use it. When removing a tablet from the blister, use dry hands to avoid damaging it.
• You can dissolve the tablet by placing it in your mouth without having to chew or swallow it. If you need to, sip some liquid in order to swallow the tablet.

Keep the container tightly closed and at room temperature, far from heat or moisture. Close the bottle tightly.You may experience unpleasant withdrawal symptoms after stopping metoclopramide. These include headaches or dizziness.

Details on dosage

Adult dose for nausea or vomiting:
Postoperative nausea, vomiting, and postoperative pain
Parents: 10–20 mg IM near or at the end of surgery
Adult dose for gastroesophageal reflux:
Oral: Up to 10–15 mg, up to four times per day. This depends on the symptoms treated and their clinical response. The treatment should not last more than 12 weeks.
Adult dose for small intestinal intubation:
A single dose (undiluted) given slowly IV over 1 or 2 minutes is an option if the tube does not pass the pylorus using conventional methods within 10 minutes.
Adults and pediatric patients older than 14 years old: 10 mg intravenously as an effervescent dose over a period of 1 to 2 minutes.
Adult dose for radiographic examination:
For adults and children older than 14 years, 10 mg intravenously in a single dosage administered for 1 to 2 minutes will aid gastric emptying when delayed gastric emptying is interfering with the radiological examinations of the stomach or small intestine.
Adult dose for gastroparesis:
Oral administration can be started during the first signs of diabetes gastric stasis. If there are severe symptoms, therapy can begin by administering IM or intravenous (IV) for 10 days. Once symptoms have subsided, oral administration may be initiated. As diabetic stasis can be recurrent in nature, the therapy should begin at its earliest manifestation.
Parenteral: Up to 10 days, 10 mg IV or IM 4 times per day.
Oral: Take 10 mg four times daily, 30 minutes prior to meals and before bedtime, for up to eight weeks, depending on the clinical response.
Adult dose for nausea or vomiting from chemotherapy:
Infusion IV: 1 to 2 mg/kg/dose, depending on the emetogenic potency of the drug. IV (infused for a minimum of 15 minutes), 30 minutes prior to chemotherapy. After the first dose, it is possible to repeat this dose twice every 2 hours. The same dose can be repeated three more times, at 3-hour intervals, if vomiting still does not subside.
Dilute injections above 10 mg in 50 mL parenteral solutions. The preferred diluent is normal saline.
In the case of an acute dystonic reaction, diphenhydramine chloride 50 mg may be injected IM.
Adult dose for migraine:
The FDA has not approved metoclopramide for the treatment of migraine headaches. However, studies have shown that it is effective at doses of up to 20mg IV given once in conjunction with analgesics and ergot derivatives.
The usual pediatric dose for gastroesophageal reflux disease is:
The FDA has not approved the use of metoclopramide in children with gastroesophageal reflux disease. However, certain doses were studied.
Oral, IM, IV:
Infants and children: 4 divided doses of 0.4–0.8 mg/kg/day
The usual pediatric dose for small intestinal intubation ()
Metoclopramide IV has been approved for use in pediatrics to allow small-bowel intubation. This is done by gastric emptying, which can interfere with radiological evaluation of the stomach or small intestine.
A single dose (non-diluted) can be given IV over a period of 1 or 2 minutes if the tube does not pass the pylorus using conventional methods within 10 minutes.
Less than six years: 0.1 mg/kg IV in a single dosage
From 6 to 14 years old: 2.5 to 5 mg intravenous as one dose
Children older than 14: Take 10 mg in a single dose.
Common Pediatric Dose of Nausea/Vomiting: Chemotherapy Induced:
The FDA has not approved the use of metoclopramide for the treatment of chemotherapy-induced nausea and vomiting among pediatric patients. However, it is worth noting that the FDA has studied the doses below:
IV:
Every 2 to 4 hours, or 30 minutes prior to chemotherapy, give 1 to 2 mg/kg/dose intravenously.
The usual pediatric dose for nausea and vomiting postoperatively is:
The FDA has not approved the use of metoclopramide for pediatric postoperative nausea or vomiting; however, it is worth knowing that the FDA has studied the doses below:
IV:
Children younger than 14 years old: 0.1–0.2 mg/kg/dose; maximum dose: 10 mg/dose. Repeat every 6–8 hours as necessary.
Repeat every 6–8 hours for children and adults older than 14 years.

What happens if I miss the dose?

If you are almost due for the next dose, skip the missed one. Never take more than one dose at the same time.

What happens if I overdose?

Call the Poison Help Line at 1-800-222-1222 or seek emergency medical care. Drowsiness or confusion may be symptoms of an overdose.

What should be avoided?

Alcohol consumption can have side effects when taken with this medication. Do not drive or engage in hazardous activities until you have determined how the medicine affects you. You may be unable to react properly.

Side effects of Metoclopramide

If you experience any of the following symptoms of an allergy to metoclopramide, seek immediate medical attention: itching, difficulty breathing, swelling in your lips, face, throat, or tongue. If you experience any of the following signs of a severe movement disease, it is important to call your doctor immediately. This may happen within 2 days after starting treatment.

• You may experience tremors in your legs or arms.
• Uncontrolled facial movements (such as lip-smacking, frowning, and tongue movement)
• Any new or abnormal muscle movements that you can't control

If you experience:

• Confuse, depression or thoughts of self-harming or harming oneself;, depression, or thoughts of harming yourself, suicide, or self-harming;
• Slow or jerky movements of the muscles; difficulties with walking or balance;
• Mask-like appearance on your face
• A seizure;
• Anxiety, aggression, jittery feelings, difficulty sleeping, and the inability to stay still
• Rapid weight gain, swelling, and a feeling of shortness of breath
• Severe reaction of the nervous system: very stiff muscles (rigid), high temperature sweating, confusion, and fast heartbeats.

Metoclopramide can cause a variety of side effects.

• Feeling restless
• Feeling tired or drowsy
• Lack of energy
• Nausea, vomiting;
• Headache, confusion;
• Sleep problems (insomnia).

There may be other side effects. For medical advice on side effects, call your doctor. Report side effects by calling the FDA at 1-800-FDA-1088.

Interaction with other drug

Metoclopramide can make this worse if taken with drugs that cause drowsiness. Before taking opioid pain medications, sleeping pills, muscle relaxers, anxiety or depression medicines, or medication for seizures, ask your doctor.

Inform your doctor of all the medications you are taking. Metoclopramide can be affected by many drugs, including:

• Acetaminophen, also known as Tylenol (Tylenol),
• Cyclosporine is available as Gengraf (neoral), Sandimmune, and Neoral.
• Digoxin (digitalis, lanoxin);
• Glypyrrolate
• Insulin;
• Levodopa (Larodopa, Atamet, Parcopa, Sinemet);
• Mepenzolate (Cantil);
• Tetracycline
• Atropine, benztropine, dimenhydrinate, and scopolamine are all examples of scopolamine.
• Medications for the bladder or urine, such as darifenacin, flavoxate, oxybutynin, and tolterodine.
• Blood pressure medication
• Bronchodilators like ipratropium or tiotropium
• Irritable bowel medication such as Dicyclomine, Cystospaz, or Levsin (Hyoscyamine), propantheline, Anaspaz (Pro-Banthine), and Cystospaz (Anaspaz)
• An MAO-inhibitor such as Furazolidone (Furoxone), Isocarboxazid, Rasgiline, Emsam (Zelapar), Selegiline, Eldepryl (Emsam), Tranylcypromine, etc.
• There are many medicines that treat psychiatric conditions, including chlorpromazine, clozapine, haloperidol, olanzapine, compazine, risperidone, thiothixene, and more.

Metoclopramide can be affected by many drugs. This isn't a complete list. These include prescription, over-the-counter, and herbal medicines. This list does not include all drug interactions.