What is metoclopramide?

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Generic Name: Metoclopramide Brand Name(s): Generics only. No brands available.

Know the basics

What is metoclopramide used for?

Metoclopramide is used to treat certain conditions of the stomach and intestines. Metoclopramide is used as a short-term treatment (4 to 12 weeks) for persistent heartburn when the usual medicines do not work well enough. It is used mostly for heartburn that occurs after a meal or during the daytime. Treating persistent heartburn can decrease the damage done by stomach acid to the swallowing tube (esophagus) and help healing.

Metoclopramide is also used in diabetic patients who have poor emptying of their stomachs (gastroparesis). Treating gastroparesis can decrease symptoms of nausea, vomiting, and stomach/abdominal fullness. Metoclopramide works by blocking a natural substance (dopamine). It speeds up stomach emptying and movement of the upper intestines.

OTHER USES: This section contains uses of metoclopramide that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use metoclopramide for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Metoclopramide may also be used to prevent nausea/vomiting from chemotherapy orradiation treatments for cancer.

How should I take metoclopramide?

Take metoclopramide by mouth 30 minutes before meals and at bedtime, usually 4 times daily or exactly as directed by your doctor. If you are using the liquid form of metoclopramide, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

If you are using the disintegrating tablet, do not remove the tablet from the blister pack until right before your dose. Dry your hands before using metoclopramide. Do not use the tablet if it is broken or crumbled. Immediately after removing the tablet, place it on the tongue. Allow it to dissolve completely, then swallow it with saliva. You do not need to take this product with water.

Dosage is based on your weight, medical condition, and response to treatment. If heartburn only occurs at certain times (such as after the evening meal), your doctor may direct you to take a single dose before those times instead of taking it throughout the day. This will reduce your risk of side effects.

Because of the risk of tardive dyskinesia, do not take this more often, in larger doses, or for longer than directed by your doctor. According to the manufacturer, treatment should not exceed 12 weeks.

To treat diabetic gastroparesis, metoclopramide is usually taken for 2 to 8 weeks until your gut is working well. This condition may recur from time to time. Your doctor may direct you to start taking metoclopramide as soon as your symptoms reappear and stop when you feel better. Ask your doctor for directions for starting and stopping metoclopramide.

Take metoclopramide regularly as directed to get the most benefit from it. To help you remember, take it at the same times before a meal each day.

If metoclopramide has been used regularly for a long time or in high doses, withdrawal symptoms (such as dizziness, nervousness, headaches) may occur if you suddenly stop using metoclopramide. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.

Tell your doctor if your condition persists or worsens.

How do I store metoclopramide?

Metoclopramide is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store metoclopramide in the bathroom or the freezer. There may be different brands of metoclopramide that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush metoclopramide down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using metoclopramide?

Before taking metoclopramide,

  • Tell your doctor and pharmacist if you are allergic to metoclopramide, any other medications, or any of the ingredients in metoclopramide tablets or solution. Ask your doctor or pharmacist or check the metoclopramide guide for a list of the ingredients.
  • Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: acetaminophen (tylenol, others); antihistamines; aspirin; atropine (in lonox, in lomotil); cyclosporine (gengraf, neoral, sandimmune); barbiturates such as pentobarbital (nembutal), phenobarbital (luminal), and secobarbital (seconal); digoxin (lanoxicaps, lanoxin); haloperidol (haldol);insulin; ipratropium (atrovent); lithium (eskalith, lithobid); levodopa (in sinemet, in stalevo); medications for anxiety, blood pressure, irritable bowel disease, motion sickness, nausea, parkinson’s disease, ulcers, or urinary problems; monoamine oxidase (mao) inhibitors, including isocarboxazid (marplan), phenelzine (nardil), selegiline (eldepryl, emsam, zelapar), and tranylcypromine (parnate); narcotic medications for pain; sedatives; sleeping pills; tetracycline (bristacycline, sumycin); or tranquilizers. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
  • Tell your doctor if you have or have ever had blockage, bleeding, or a tear in your stomach or intestines; pheochromocytoma (tumor on a small gland near the kidneys); or seizures. Your doctor will probably tell you not to take metoclopramide.
  • Tell your doctor if you have or have ever had parkinson’s disease (pd; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance); high blood pressure; depression; breast cancer; asthma;glucose-6-phosphate dehydrogenase (g-6pd) deficiency (an inherited blood disorder); nadh cytochrome b5 reductase deficiency (an inherited blood disorder); or heart, liver, or kidney disease.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking metoclopramide, call your doctor.
  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking metoclopramide.
  • You should know that metoclopramide may make you drowsy. Do not drive a car or operate machinery until you know how metoclopramide affects you.
  • Ask your doctor about the safe use of alcohol while you are taking metoclopramide. Alcohol can make the side effects of metoclopramide worse.

Is it safe to take metoclopramide during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using metoclopramide during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking metoclopramide. Metoclopramide is pregnancy risk category  B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Know the side effects

What are the side effects of metoclopramide?

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

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

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

Stop taking metoclopramide and call your doctor at once if you have any of these other serious side effects:

  • Slow or jerky muscle movements, problems with balance or walking;
  • Mask-like appearance in your face;
  • Very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;
  • Depressed mood, thoughts of suicide or hurting yourself;
  • Hallucinations, anxiety, agitation, jittery feeling, trouble staying still;
  • Swelling, feeling short of breath, rapid weight gain;
  • Jaundice (yellowing of your skin or eyes); or
  • Seizure (convulsions).

Less serious side effects may include:

  • Feeling restless, drowsy, tired, or dizzy;
  • Headache, sleep problems (insomnia);
  • Nausea, vomiting, diarrhea;
  • Breast tenderness or swelling;
  • Changes in your menstrual periods; or
  • Urinating more than usual.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with metoclopramide?

Metoclopramide may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Before using metoclopramide, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by metoclopramide.

Tell your doctor about all other medications you use, especially:

  • Acetaminophen (Tylenol);
  • Cyclosporine (Gengraf, Neoral, Sandimmune);
  • Digoxin (digitalis, Lanoxin);
  • Glycopyrrolate (Robinul);
  • Insulin;
  • Levodopa (Larodopa, Atamet, Parcopa, Sinemet);
  • Mepenzolate (Cantil);
  • Tetracycline (Ala-Tet, Brodspec, Panmycin, Sumycin, Tetracap);
  • Atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
  • Bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
  • Blood pressure medications;
  • Bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);
  • Irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), or propantheline (Pro-Banthine);
  • An MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate); or
  • Medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (Clozaril, fazaclo), haloperidol (Haldol), olanzapine (Zyprexa, Symbyax), prochlorperazine (Compazine), risperidone (Risperdal), thiothixene (Navane), and others.

Does food or alcohol interact with metoclopramide?

Metoclopramide may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using metoclopramide.

What health conditions may interact with metoclopramide?

Metoclopramide may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Abdominal or stomach bleeding;
  • Intestinal blockage or perforation (hole in the intestine);
  • Pheochromocytoma (adrenal gland tumor);
  • Seizures or epilepsy—Should not be used in patients with these conditions.
  • Asthma;
  • Cirrhosis (liver disease);
  • Congestive heart failure;
  • Diabetes;
  • Heart rhythm problems (e.g., ventricular arrhythmia);
  • Hypertension (high blood pressure);
  • Mental depression, or history of ;
  • Neuroleptic malignant syndrome, history of;
  • Parkinson’s disease, history of—Use with caution. May make these conditions worse.
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency (an enzyme problem) ;
  • Nicotinamide adenine dinucleotide (NADH) cytochrome reductase deficiency (an enzyme problem)—May increase the risk for side effects affecting the blood.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using metoclopramide.

What is the dose of metoclopramide for an adult?

Usual Adult Dose for Postoperative Nausea/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 a day 30 minutes before meals and at bedtime, depending upon symptoms being 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 in 10 minutes, a single (undiluted) dose may be administered intravenous slowly over 1 to 2 minutes:
    Adults and pediatric patients greater than or equal to 14 years: 10 mg IV as a single dose administered over 1 to 2 minutes.

Usual Adult Dose for Radiographic Exam

  • Adults and pediatric patients greater than or equal to 14 years: 10 mg intravenous as a single dose administered over 1 to 2 minutes to facilitate gastric emptying where delayed gastric emptying interferes with radiological examination of the stomach and/or small intestine.

Usual Adult Dose for Gastroparesis

  • Parenteral: 10 mg 4 times daily, intravenous (slowly over a 1 to 2 minute period) 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 – Chemotherapy Induced

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

Usual Adult Dose for Migraine

  • Use for treatment of migraine headaches is not an FDA approved indication; however, metoclopramide has shown efficacy in studies at a dose of 10 to 20 mg intravenous once (used in combination with analgesics or ergot derivatives).

What is the dose of metoclopramide for a child?

Usual Pediatric Dose for Gastroesophageal Reflux Disease

  • Oral, intramuscular, intravenous: Infants and Children: 0.4 to 0.8 mg/kg/day in 4 divided doses.

Usual Pediatric Dose for Small Intestine Intubation

  • If the tube has not passed the pylorus with conventional methods in 10 minutes, a single (undiluted) dose may be administered intravenous slowly over 1 to 2 minutes:
  • Less than 6 years: 0.1 mg/kg intravenous as a single dose;
  • 6 to 14 years: 2.5 to 5 mg intravenous as a single dose;
  • Children greater than 14 years: 10 mg as a single dose;

Usual Pediatric Dose for Nausea/Vomiting – Chemotherapy Induced

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

Usual Pediatric Dose for Nausea/Vomiting – Postoperative

  • The following intravenous doses have been studied:
  • children less than or equal to 14 years: 0.1 to 0.2 mg/kg/dose (maximum dose: 10 mg/dose); repeat every 6 to 8 hours as needed.
  • children greater than 14 years and adults: 10 mg; repeat every 6 to 8 hours as needed.

How is metoclopramide available?

Metoclopramide is available in the following dosage forms and strengths:

  • Solution, Injection: 5 mg/mL.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of metoclopramide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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