Generic
Metoclopramide Hydrochloride
17 brands available in the market
At a glance
Metoclopramide Hydrochloride is a prokinetic drug used to treat nausea, vomiting, indigestion, and stomach discomfort.
Description
Metoclopramide Hydrochloride is a prokinetic drug that works on the region in the brain that controls vomiting. It also acts on the upper digestive tract to increase the movement of the stomach and intestines, allowing food to move more easily through the stomach. It blocks dopamine receptors and at higher doses also blocks serotonin receptors.
Indications
- Nausea and vomiting
- Indigestion and heartburn
- Diabetic gastroparesis
- Gastroesophageal reflux disease (GERD)
- Chemotherapy-induced nausea and vomiting
- Postoperative nausea and vomiting
Therapeutic class
Anti-emetic & Prokinetic Drugs
Pharmacological class
Dopamine Receptor Antagonist
Pharmacology
Metoclopramide blocks dopamine receptors and at higher doses also blocks serotonin receptors. It enhances the response to acetylcholine of tissue in the upper GI tract causing enhanced motility and accelerated gastric emptying. It also increases lower esophageal sphincter tone.
Mechanism of action
Controls vomiting and increases gastrointestinal motility to facilitate food movement.
Dosage
Adult Dose (Oral):
- Diabetic Gastric Stasis: 10 mg 4 times daily (2-8 weeks)
- Chemotherapy-induced Nausea: 10 mg (up to 3 times daily, max 5 days)
- GERD: 10-15 mg 4 times daily (max 12 weeks)
- Elderly: 5 mg/dose
Parenteral Dose: 10 mg IM or slow IV (1-2 minutes)
Child Dose: 0.1-0.2 mg/kg IV/IM/PO (6-8 hourly)
Renal Dose: CrCl <40 mL/min: reduce dose by 50%; CrCl <10 mL/min: reduce dose by 75%
Administration
- Take 30 minutes before meals on an empty stomach
- Swallow tablet whole; do not chew, crush or break
- Take at the same time each day
- Take last dose at bedtime
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Restlessness
- Drowsiness and fatigue
- Headache
- Dysgeusia (taste changes)
Serious Side Effects:
- Tardive Dyskinesia (uncontrolled movements)
- Extrapyramidal Symptoms (EPS)
- Neuroleptic Malignant Syndrome (NMS)
- Depression and suicidal ideation
Precautions & warnings
- Caution while driving (may cause drowsiness and dizziness)
- Avoid alcohol (may cause excessive drowsiness)
- Avoid in patients with Parkinson's Disease
- Caution in epilepsy (may increase seizure frequency)
- Do not use if history of tardive dyskinesia
Contraindications
- GI hemorrhage, mechanical obstruction or GI perforation
- Confirmed or suspected pheochromocytoma
- History of tardive dyskinesia
- Epilepsy (seizure disorder)
- Parkinson's Disease
- History of methemoglobinemia with metoclopramide
- Concomitant use with levodopa or dopaminergic agonists
Drug interactions
- CNS Depressants: Increased sedative effects
- Antimuscarinics and Opioids: GI effects antagonized
- Digoxin: Reduced absorption
- Cyclosporine, Levodopa, Aspirin, Paracetamol: Increased absorption
- Bromocriptine: Interferes with hypoprolactinaemic effect
- Sertraline (SSRI): Serotonin syndrome (potentially fatal)
- Suxamethonium and Mivacurium: Prolongs neuromuscular blockade
Food interactions
Alcohol with Metoclopramide Hydrochloride may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy (Category B): Generally considered safe. Animal studies show low or no adverse effects on developing baby; limited human studies.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe. Limited human data suggests the drug may pass into breastmilk and harm the baby.
Pediatric use
Pediatric dose: 0.1-0.2 mg/kg IV/IM/PO (6-8 hourly). Age 14 years: 10 mg IV (1-2 minutes).
Geriatric use
Elderly dose: 5 mg/dose (half of adult dose).
Renal / hepatic impairment
Renal Impairment: CrCl <40 mL/min: reduce dose by 50%; CrCl <10 mL/min: reduce dose by 75%.
Hepatic Impairment: Safe - dose adjustment may not be needed.
Overdose effects
Acute overdose may cause drowsiness, confusion, extrapyramidal symptoms, seizures. Symptomatic treatment.
Storage conditions
Store at 20-25°C. Protect from light. Keep out of reach of children.
Chemical structure
Metoclopramide Hydrochloride