Metoclopramide(met oh kloe pra’ mide)
Apo-Metoclop (CAN), Metoclopramide Omeza (CAN), Metozolv ODT, Nu-Metoclopramide (CAN), PMS-Metoclopramide (CAN), Reglan
PREGNANCY CATEGORY B
Drug Classes
Antiemetic
Dopaminergic blocker
GI stimulant
Therapeutic Actions
Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions; appears to sensitize tissues to action of acetylcholine; relaxes pyloric sphincter, which, when combined with effects on motility, accelerates gastric emptying and intestinal transit; little effect on gallbladder or colon motility; increases lower esophageal sphincter pressure; has sedative properties; induces release of prolactin.
Indications
Relief of symptoms of acute and recurrent diabetic gastroparesis
Short-term therapy (4–12 wk) for adults with symptomatic gastroesophageal reflux who fail to respond to conventional therapy
Parenteral: Prevention of nausea and vomiting associated with emetogenic cancer chemotherapy
Prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable
Single-dose parenteral use: Facilitation of small-bowel intubation when tube does not pass the pylorus with conventional maneuvers
Single-dose parenteral use: Stimulation of gastric emptying and intestinal transit of barium when delayed emptying interferes with radiologic examination of the stomach or small intestine
Unlabeled uses: Improvement of lactation (doses of 30–45 mg/day); treatment of nausea and vomiting of a variety of etiologies; adjunctive therapy for migraines, vascular headaches; tardive dyskinesia, gastric bezoars, gastroparesis, hiccups, Tourette syndrome
Contraindications and Cautions
Contraindicated with allergy to metoclopramide; GI hemorrhage, mechanical obstruction or perforation; pheochromocytoma (may cause hypertensive crisis); epilepsy.
Use cautiously with previously detected breast cancer (one-third of such tumors are prolactin dependent); lactation, pregnancy; fluid overload; renal impairment.
Available Forms
Tablets—5, 10 mg; oral solution (syrup)—1 mg/mL; injection—5 mg/mL; orally disintegrating tablets—5, 10 mg
Dosages
Adults
Relief of symptoms of gastroparesis: 10 mg PO 30 min before each meal and at bedtime for 2–8 wk. If symptoms are severe, initiate therapy with 10 mg IM or IV administration for up to 10 days until symptoms subside.
Symptomatic gastroesophageal reflux: 10–15 mg PO up to four times/day 30 min before meals and at bedtime. If symptoms occur only at certain times or in relation to specific stimuli, single doses of 20 mg may be preferable; guide therapy by endoscopic results. Do not use longer than 12 wk.
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