What it's for (Indications)
- To treat dyspepsia (indigestion), flatulence, heartburn, peptic ulcer gastritis (inflammation of the stomach and intestine), duodenitis (inflammation of the small intestine), nausea, vomiting, gastroesophageal reflux (GERD), and acute and recurrent diabetic gastroparesis.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Treatment duration should generally be avoided for longer than 12 weeks due to the increased risk of tardive dyskinesia. For Gastroesophageal Reflux: - Continuous: Administer 10 to 15 mg, 30 minutes before each meal and at bedtime (maximum of 60 mg per day) for 4 to 12 weeks. - Intermittent: Single doses up to 20 mg prior to a provoking situation. For Acute and Recurrent Diabetic Gastroparesis: - Administer 10 mg, 30 minutes before each meal and at bedtime (maximum of 40 mg per day) for 2 to 8 weeks. Dosage Adjustments: Dosage reductions are recommended for elderly patients, in patients with moderate or severe hepatic or renal impairment, and for cytochrome P450 2D6 (CYP2D6) poor metabolizers. |
Safety & Warnings
Common Side Effects
- Tardive dyskinesia (often irreversible serious movement disorder), other extrapyramidal effects, neuroleptic malignant syndrome, raised prolactin levels (hyperprolactinemia) leading to galactorrhea (abnormal nipple discharge), irregular periods, and gynecomastia (breast enlargement in men); depression, hypertension, fluid retention, drowsiness, tremors, and effects on the ability to drive and operate machinery.
Serious Warnings
- Black Box Warning: WARNING: TARDIVE DYSKINESIA. Metoclopramide can cause tardive dyskinesia (TD), a serious movement disorder that is often irreversible. There is no known treatment for TD. The risk of developing TD increases with duration of treatment and total cumulative dosage. Discontinue metoclopramide in patients who develop signs or symptoms of TD. In some patients, symptoms may lessen or resolve after metoclopramide is stopped.
- Risk of Tardive Dyskinesia (TD), a serious and often irreversible movement disorder; the risk increases with duration of treatment and total cumulative dosage.
- Discontinue immediately if signs or symptoms of TD develop.
- Risk of Neuroleptic Malignant Syndrome (NMS).
- Other extrapyramidal effects may occur.
- Can cause depression, hypertension, fluid retention, and hyperprolactinemia.
- May affect the ability to drive or operate machinery.
- Use cautiously in patients with renal (kidney) or hepatic (liver) impairment, porphyria (liver disorder), Parkinson’s disease (neurological disorder), atopy (genetic tendency to develop allergies), and heart abnormalities.
- Dosage adjustments are required for elderly patients, those with moderate or severe hepatic or renal impairment, and cytochrome P450 2D6 (CYP2D6) poor metabolizers.
- The effects of this medicine are undetermined in pregnant and lactating females; consult a doctor before use.
- Avoid treatment with metoclopramide for longer than 12 weeks due to the increased risk of developing TD with longer-term use.
How it Works (Mechanism of Action)
Metoclopramide stimulates motility of the upper gastrointestinal tract without stimulating gastric, biliary, or pancreatic secretions. It appears to sensitize tissues to the action of acetylcholine. Its effect on motility is not dependent on intact vagal innervation but can be abolished by anticholinergic drugs. Metoclopramide increases the tone and amplitude of gastric (especially antral) contractions, relaxes the pyloric sphincter and the duodenal bulb, and increases peristalsis of the duodenum and jejunum, leading to accelerated gastric emptying and intestinal transit. It increases the resting tone of the lower esophageal sphincter, with little to no effect on the motility of the colon or gallbladder. The exact mechanism in treating gastroesophageal reflux and acute/recurrent diabetic gastroparesis is not fully established.
Commercial Brands (Alternatives)
No other brands found for this formula.