metoclopramide (Injection route, Intravenous route)

Pronunciation

met-oh-KLOE-pra-mide

Injection route(Solution)

Metoclopramide treatment can cause tardive dyskinesia, a serious movement disorder that is often irreversible. Risk is increased with duration of treatment and total cumulative dose. Discontinue metoclopramide therapy in patients who develop signs or symptoms of tardive dyskinesia. There is no known treatment for tardive dyskinesia, although symptoms may lessen or resolve after metoclopramide discontinuation. Prolonged treatment with metoclopramide (greater than 12 weeks) should be avoided in all but rare cases where therapeutic benefit outweighs the risks .

Commonly used brand name(s)

In the U.S.

  • Reglan

Available Dosage Forms:

  • Solution

Therapeutic Class: Antiemetic

Pharmacologic Class: Dopamine Antagonist

Uses For metoclopramide

Metoclopramide injection is a medicine that increases the movements or contractions of the stomach and intestines. It is used to help diagnose certain problems in the stomach or intestines. metoclopramide is also used to prevent the nausea and vomiting that may occur after surgery or after treatment with cancer medicines. Another medicine may be used with metoclopramide injection to prevent side effects that may occur when it is used with cancer medicines.

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Metoclopramide injection is also used to relieve symptoms (such as nausea, vomiting, heartburn, a feeling of fullness after meals, and loss of appetite) that are caused by a stomach problem called gastroparesis in patients with diabetes.

metoclopramide is available only with your doctor's prescription.

Before Using metoclopramide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For metoclopramide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to metoclopramide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of metoclopramide injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of metoclopramide injection in the elderly. However, elderly patients are more likely to have side effects such as tardive dyskinesia, confusion, or drowsiness, and age-related kidney problems, which may require an adjustment in the dose for patients receiving metoclopramide injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving metoclopramide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using metoclopramide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amitriptyline
  • Amoxapine
  • Aripiprazole
  • Asenapine
  • Bupropion
  • Chlorpromazine
  • Citalopram
  • Clomipramine
  • Clozapine
  • Desipramine
  • Desvenlafaxine
  • Doxepin
  • Duloxetine
  • Escitalopram
  • Fluoxetine
  • Fluphenazine
  • Fluvoxamine
  • Haloperidol
  • Iloperidone
  • Imipramine
  • Loxapine
  • Lurasidone
  • Maprotiline
  • Mesoridazine
  • Mirtazapine
  • Molindone
  • Nefazodone
  • Nortriptyline
  • Olanzapine
  • Paliperidone
  • Paroxetine
  • Perphenazine
  • Pimozide
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Protriptyline
  • Quetiapine
  • Risperidone
  • Rivastigmine
  • Thioridazine
  • Thiothixene
  • Trazodone
  • Trifluoperazine
  • Trimethobenzamide
  • Venlafaxine
  • Ziprasidone

Using metoclopramide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Bromocriptine
  • Isocarboxazid
  • Linezolid
  • Milnacipran
  • Phenelzine
  • Rasagiline
  • Selegiline
  • Tramadol
  • Tranylcypromine

Using metoclopramide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cyclosporine
  • Didanosine
  • Digoxin
  • Levodopa
  • Mivacurium
  • Posaconazole
  • Sertraline
  • Succinylcholine
  • Tacrolimus
  • Thiopental

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of metoclopramide. Make sure you tell your doctor if you have any other medical problems, especially:

  • Abdominal or stomach bleeding or
  • Intestinal blockage or
  • Pheochromocytoma (adrenal gland tumor) or
  • Seizures or epilepsy—Should not be used in patients with these conditions.
  • Asthma or
  • Cirrhosis (liver disease) or
  • Congestive heart failure or
  • Diabetes or
  • Hypertension (high blood pressure) or
  • Mental depression, history of or
  • Neuroleptic malignant syndrome, history of or
  • Parkinson's disease—Use with caution. May make these conditions worse.
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency (an enzyme problem) or
  • 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. Effects may be increased because of slower removal of the medicine from the body.

Proper Use of metoclopramide

A nurse or other trained health professional will give you metoclopramide in a hospital. metoclopramide is given through a needle placed in one of your veins or as a shot into one of your muscles.

Your doctor will give you a few doses of metoclopramide until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using metoclopramide

It is very important that your doctor check your progress while you receive metoclopramide to make sure that it is working properly.

Tell your doctor or nurse right away if you have any of the following symptoms after receiving metoclopramide: convulsions (seizures); difficulty with breathing; a fast heartbeat; a high fever; high or low blood pressure; increased sweating; loss of bladder control; severe muscle stiffness; unusually pale skin; or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

Check with your doctor right away if you have any of the following symptoms: difficulty with speaking; drooling; loss of balance control; muscle trembling, jerking, or stiffness; restlessness; shuffling walk; stiffness of the limbs; twisting movements of the body; or uncontrolled movements of the face, neck, and back.

metoclopramide may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while using metoclopramide: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

metoclopramide may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to metoclopramide before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

metoclopramide will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using metoclopramide.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

metoclopramide Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare
  • Convulsions
  • difficulty in breathing
  • fast heartbeat
  • high fever
  • high or low blood pressure
  • inability to move the eyes
  • increased blinking or spasms of the eyelid
  • increased sweating
  • loss of bladder control
  • seeing, hearing, or feeling things that are not there
  • severe muscle stiffness
  • sticking out of the tongue
  • tiredness
  • trouble in breathing, speaking, or swallowing
  • uncontrolled twisting movements of the neck, trunk, arms, or legs
  • unusual facial expressions
  • unusually pale skin
Incidence not known
  • Abdominal or stomach pain or tenderness
  • black, tarry stools
  • bluish-colored lips, fingernails, or palms
  • blurred vision
  • chest pain or discomfort
  • chills
  • clay colored stools
  • confusion
  • cough or hoarseness
  • dark urine
  • decrease in the amount of urine
  • decreased appetite
  • decreased urine output
  • difficulty in swallowing
  • dilated neck veins
  • dizziness or lightheadedness
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • extreme fatigue
  • fainting
  • fast, slow, pounding, or irregular heartbeat or pulse
  • fatigue
  • feeling of warmth
  • fever with or without chills
  • fluid-filled skin blisters
  • general feeling of tiredness or weakness
  • headache
  • inability to sit still
  • increased need to urinate
  • incremental or ratchet-like movement of the muscle
  • itching of the skin
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • loss of appetite
  • loss of balance control
  • lower back or side pain
  • mask-like face
  • mental depression
  • mood or mental changes
  • muscle discomfort
  • nausea and vomiting
  • need to keep moving
  • nervousness
  • noisy, rattling breathing
  • painful or difficult urination
  • pale skin
  • palpitations
  • passing urine more often
  • pounding in the ears
  • pounding, slow heartbeat
  • rapid heart rate
  • redness of the face, neck, arms and occasionally, upper chest
  • restlessness of the arms legs, hands, or feet
  • rigid or stiff muscles
  • sensitivity to the sun
  • shakiness in the legs, arms, hands, or feet
  • shortness of breath
  • shuffling walk
  • skin rash
  • skin thinness
  • slow movement
  • slow or irregular breathing
  • slow reflexes
  • slowed movements
  • slurred speech
  • sore throat and fever
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiffness of the arms and legs
  • sweating
  • swelling of the face, fingers, feet, or lower legs
  • thoughts of killing oneself changes in behavior
  • tic-like (jerky) movements of the head, face, mouth, and neck
  • tightness in the chest
  • trembling and shaking of the fingers and hands
  • troubled breathing at rest
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weight gain
  • wheezing
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Confusion about identity, place, and time
  • drowsiness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Absent, missed, or irregular menstrual periods
  • blurred or loss of vision
  • cough
  • decreased interest in sexual intercourse
  • diarrhea
  • disturbed color perception
  • double vision
  • halos around lights
  • hives or welts
  • inability to have or keep an erection
  • itching
  • loss in sexual ability, desire, drive, or performance
  • loss of strength or energy
  • muscle pain or weakness
  • night blindness
  • noisy breathing
  • overbright appearance of lights
  • redness of the skin
  • sleeplessness
  • stopping of menstrual bleeding
  • swelling of the breasts or unusual milk production
  • swelling of the breasts or breast soreness in both females and males
  • trouble sleeping
  • tunnel vision
  • unable to sleep
  • unexpected or excess milk flow from the breasts
  • unusual weak feeling

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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