Metoclopramide: functions, dosage, side effects, how to use

What drug metoclopramide?

What is Metoclopramide for?

Metoclopramide is a medicine to treat several problems in the stomach and intestines, such as a burning sensation in the stomach (heartburn), stomach acid, and ulcers that don't heal. Metoclopramide is usually used for ulcers that appear after meals or during the day.

Metoclopramide is also used in diabetic patients who have difficulty emptying the stomach (gastroparesis). Metoclopramide works by inhibiting a natural substance (dopamine). It speeds up stomach emptying and upper bowel movements.

Metoclopramide may also be used to prevent nausea / vomiting due to chemotherapy or radiation for cancer treatment.

Metoclopramide dosage and side effects of metoclopramide are described further below.

How should I take Metoclopramide?

Take metoclopramide by mouth 30 minutes before meals and before bed, usually 4 times a day or as directed by your doctor. To make sure you are measuring the right dose if you are going to consume liquid medicine, use a special spoon or glass of medicine provided. It is not recommended to measure the dose using a tablespoon. If you do not have a medicated spoon, ask your pharmacist.

If you are using the dissolved tablet version, do not take the tablet from the package until just before taking it. Dry your hands before handling this medication. Do not take it if the tablet is broken or crushed. After removing the tablet from the package, put it directly in your mouth and let it dissolve completely, then swallow it up saliva. There is no need to use water to swallow this form of medicine.

The dosage is always given based on your weight, health condition, and how you respond to therapy. If your heartburn only appears at certain times (such as after dinner), your doctor may ask you to take one dose before that time instead of taking it throughout the day. This will reduce the risk of side effects.

Because there is a risk of tardive dyskinesia, do not take this medicine more often or in doses more than what your doctor prescribes. According to the manufacturer of this drug, treatment should not exceed 12 weeks.

To treat diabetic gastroparesis, this drug is usually taken for 2-8 weeks until the stomach returns to normal function. This condition can reappear from time to time. Your doctor may ask you to take this drug again when symptoms return, and stop when you feel better. Ask your doctor about when you should start and stop using this drug.

Use this medication regularly according to the instructions for optimal benefits. To help you remember, drink it at the same time each day before meals.

If this medicine has been used routinely for a long time or at high doses, addiction symptoms (such as dizziness, nervousness, headache) may appear if you suddenly stop using this drug. To prevent this, the doctor may reduce the dose slowly. Consult your doctor or pharmacist for further details, and report any symptoms of addiction as soon as possible.

Tell your doctor if your condition does not improve or if it gets worse.

How is Metoclopramide stored?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Metoclopramide dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the Metoclopramide dosage for adults?

Metoclopramide dose to treat nausea / vomiting after surgery

10 mg as a single dose by intramuscular injection or slow intravenous injection over 3 minutes.

Metoclopramide dosage for treating stomach acid reflux

Oral: 10-15 mg up to 4 times daily, depending on symptoms treated and clinical response. If the symptoms are severe, 20 mg may be given before the trigger. Treatment should not exceed 12 weeks.

Metoclopramide dosage for treating gastroparesis

Parenteral: 10 mg 4 times a day, IV (slowly over a period of 1-2 minutes) or IM up to a maximum of 10 days.

Oral: 10 mg 4 times daily, for 2-8 weeks depending on clinical response.

Metoclopramide dose for small bowel intubation

10 mg IV as a single dose, given over 1-2 minutes.

Metoclopramide dose to treat nausea / vomiting due to chemotherapy

Oral: 10 mg three times a day. Maximum duration is 5 days.

What is the dosage of Metoclopramide for children?

Metoclopramide dose for small bowel intubation in children

• Age under 6 years: 0.1 mg / kg IV as a single dose
• 6 to 14 years: 2.5 to 5 mg IV as a single dose

Metoclopramide dose for prophylaxis of nausea / vomiting after surgery in children (parenteral)

• 1-3 years, 10-14 kg: 1 mg, 3 times daily
• > 3 - 5 years, 15-19 kg: 2 mg, 3 times daily
• > 5 - 9 years, 20-29 kg: 2.5 mg, 3 times daily
• > 9 - 18 years, 30-60 kg: 5 mg, 3 times daily
• Maximum duration: 48 days.

In what dosage is Metoclopramide available?

Solution, Injection: 5 mg / mL.

Metoclopramide side effects

What side effects can be experienced due to Metoclopramide?

Common side effects of metoclopramide are:

• Feelings of tiredness, drowsiness, weakness, or dizziness
• Headache, difficulty sleeping (insomnia)
• Nausea, vomiting, diarrhea
• Sore or swollen breasts
• Changes to the menstrual cycle
• Urinating more often than usual

Stop treatment with metoclopramide and contact your doctor immediately if you experience serious side effects from metoclopramide, which may appear within the first 2 days of starting treatment, such as:

• Shaking hands or feet or tremors
• Uncontrolled facial muscle movements (chewing, tasting, frowning, tongue twitching, blinking, and eye movement)
• New and unusual muscle movements that you cannot control

Stop using metoclopramide and call your doctor right away if you experience any of the following serious side effects:

• Slow or sudden muscle movements, problems with balance or when walking
• The face looks like it is wearing a mask
• Very stiff muscles, high fever, sweating, confusion, fast and irregular heartbeat, tremors, feeling like being faint
• Depression, thoughts of suicidal thoughts or hurting yourself
• Hallucinations, nervousness, restlessness, feeling groggy, unable to sit still
• Swelling, shortness of breath, rapid weight gain
• Jaundice (yellowing of the skin or eyes)
• Seizures

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Metoclopramide Drug Warnings and Cautions

What should be known before using Metoclopramide?

Before using metoclopramide:

• Tell your doctor and pharmacist if you are allergic to metoclopramide, other drugs, or any of the ingredients in metoclopramide, either in tablet or liquid form. Ask your doctor or pharmacist, or check the drug guide label for a list of ingredients
• Tell your doctor and pharmacist what medicines you are taking, or will take, with or without a prescription, including vitamins, nutritional supplements, and herbal products. Make sure you don't miss any of the following drugs: acetaminophen (Tylenol, etc.); 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); medicines for nervousness, blood pressure, bowel disease, motion sickness, nausea, Parkinson's disease, stomach ulcers, or urinary problems; monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); narcotic drugs for pain; sedative; sleeping pills; tetracycline (Bristacycline, Sumycin); or tranquilizers. Your doctor may have to change the dose of your medication or monitor you more closely for signs of side effects
• Tell your doctor if you have or have had a blocked, bleeding, or torn stomach or intestine, pheochromocytoma (a tumor in a small gland near the kidney); or convulsions. Your doctor may ask you not to take metoclopramide
• Tell your doctor if you have or have ever had Parkinson's disease (PD; a nervous system disorder that causes difficulty moving, controlling muscles, and maintaining balance); high blood pressure, depression, breast cancer; asthma; glucose-6-phosphate dehydrogenase (G-6PD) deficiency (an inherited blood disorder); deficiency of NADH cytochrome B5 reductase (hereditary blood disorder); or heart, liver, or kidney disease
• Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you are on metoclopramide treatment and become pregnant, call your doctor
• If you are going to have surgery, including dental surgery, tell your doctor and dentist that you are on metoclopramide medication
• Be aware that this drug may make you drowsy. Do not drive a car or run machinery until you know how this medication affects your body
• Consult your doctor about safe alcohol consumption while you are on this medication. Alcohol can make the side effects of metoclopramide worse

Is Metoclopramide safe for pregnant and lactating women?

There is no adequate research on the risks of using metoclopramide in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category B (according to some studies without risk) according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

Metoclopramide Drug Interactions

What medicines may interact with Metoclopramide?

Interactions with other drugs can affect how the drug works and increase the risk of dangerous side effects. This article does not list all possible drug interactions. Record all medicinal products you use (including prescription, non-prescription and herbal medicines) and show them to your doctor and pharmacist. Do not start, stop, or change the dose of any medicine without your doctor's permission.

Before using metoclopramide, tell your doctor if you routinely use other drugs that make you sleepy (such as cold or allergy medicine, sedatives, narcotic painkillers, sleeping pills, muscle relaxants, and medications for seizures, depression , or anxiety). These drugs add to the drowsiness of metoclopramide.

Tell your doctor about other medicines 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)
• Medicines related to bladder or urinary system disorders, 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)
• Digestive disease drugs such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), or propantheline (Pro-Banthine)
• MAO inhibitors such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate)
• Medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa, Symbyax), prochlorperazine (Compazine), risperidone (Risperdal), thiothixene (Navane), etc.

Can food or alcohol interact with Metoclopramide?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions may interact with Metoclopramide?

Any other health conditions you have can affect the use of this drug. Always tell your doctor if you have other health problems, especially:

• Abdominal or abdominal bleeding
• Blocked or perforated intestine
• Pheochromocytoma (tumor of the adrenal glands)
• Seizures or epilepsy - This medicine should not be used by patients with these conditions
• Asthma
• Cirrhosis (liver disease)
• Congestive heart failure
• Diabetes
• Heart rhythm problems (for example, ventricular arrhythmia)
• Hypertension (high blood pressure)
• Mental depression or have a history
• Neuroleptic malignant syndrome or have a history
• Parkinson's disease or have a history - Use with caution. This medicine can make the condition worse
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency (enzyme problem)
• Nicotinamide adenine dinucleotide (NADH) cytochrome reductase (enzyme problem) deficiency - May increase the risk of side effects that affect the blood
• Kidney disease — Use with caution. Side effects can increase as the drug takes longer to leave the body

Metoclopramide overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (118/119) or immediately to the nearest hospital emergency department.

Overdose symptoms include:

• Sleepy
• Confusion
• Convulsions
• Uncontrolled and unusual movements
• Lack of energy
• Bluish skin
• Headache
• Shortness of breath

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.