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metoclopramide

Generic Name: metoclopramide (meh toe KLOE pra mide)
Brand names: Reglan

What is metoclopramide?

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Metoclopramide increases muscle contractions in upper digestive tract. This speeds up the rate at which the stomach empties into the intestines.

Metoclopramide is used short-term to treat heartburn caused by gastroesophageal reflux in people who have used other medications without relief of symptoms.

Metoclopramide is also used to treat slow gastric emptying in people with diabetes (also called diabetic gastroparesis), which can cause nausea, vomiting, heartburn, loss of appetite, and a feeling of fullness after meals.

Metoclopramide may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about metoclopramide?

You should not take this medication if you are allergic to metoclopramide, or if you have bleeding or blockage in your stomach or intestines, epilepsy or other seizure disorder, or an adrenal gland tumor (pheochromocytoma).

Before taking metoclopramide, tell your doctor if you have kidney or liver disease, congestive heart failure, diabetes, or a history of depression.

Avoid drinking alcohol. It can increase some of the side effects of metoclopramide. There are many other medicines that can interact with metoclopramide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you. Stop using metoclopramide and call your doctor at once if you have tremors or uncontrolled muscle movements, fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing, depressed mood, thoughts of suicide or hurting yourself, hallucinations, anxiety, agitation, seizure, or jaundice (yellowing of your skin or eyes). After you stop taking metoclopramide, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

What should I discuss with my healthcare provider before taking metoclopramide?

You should not take this medication if you are allergic to metoclopramide, or if you have:

• bleeding or blockage in your stomach or intestines;

• a perforation (hole) in your stomach or intestines;

• epilepsy or other seizure disorder; or

• an adrenal gland tumor (pheochromocytoma).

Before taking this medication, tell your doctor if you have

• kidney disease;
• liver disease (especially cirrhosis);

• congestive heart failure;

• diabetes (your insulin dose may need adjusting); or

• a history of depression.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take metoclopramide.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Metoclopramide can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take metoclopramide?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The oral concentrate form of metoclopramide must be mixed with another liquid, such as water, fruit juice, soda, or a soft food like applesauce or pudding. Carefully follow mixing directions to make sure you get the correct dose.

Metoclopramide is usually taken before meals and at bedtime. Your doctor may want you to take the medication as needed only with meals that usually cause heartburn. Follow your doctor's instructions.

Store metoclopramide at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include drowsiness, confusion, tremors or uncontrolled muscle movements in face or neck, or seizure (convulsions).

What should I avoid while taking metoclopramide?

Narcotic pain medicine, sleeping pills, and medicine for anxiety can add to sleepiness caused by metoclopramide. Tell your doctor if you regularly use any of these other medicines. Avoid drinking alcohol. It can increase some of the side effects of metoclopramide. Metoclopramide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Metoclopramide side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using metoclopramide and call your doctor at once if you have any of these serious side effects:

• tremors, or restless muscle movements in your eyes, tongue, jaw, or neck;

• mask-like appearance of the face;

• fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing;

• depressed mood, thoughts of suicide or hurting yourself;

• hallucinations, anxiety, agitation, jittery feeling, trouble staying still;

• swelling, fluid retention;

• jaundice (yellowing of your skin or eyes); or

• seizure (convulsions).

Less serious side effects may include:

• feeling restless, drowsy, tired, or dizzy;

• headache, sleep problems (insomnia);

• nausea, diarrhea;

• breast tenderness or swelling;

• changes in your menstrual periods; or

• urinating more than usual.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

After you stop taking metoclopramide, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

What other drugs will affect metoclopramide?

Before taking metoclopramide, tell your doctor if you are taking any of the following medicines:

• acetaminophen (Tylenol);

• cyclosporine (Gengraf, Neoral, Sandimmune);

• digoxin (digitalis, Lanoxin);

• glycopyrrolate (Robinul);

• levodopa (Larodopa, Atamet, Parcopa, Sinemet);

• mepenzolate (Cantil);

• tetracycline (Brodspec, Panmycin, Robitet, Sumycin, Tetracap, and others);

• atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

• bladder or urinary medications such as darifenacin (Enablex), tolterodine (Detrol), or solifenacin (Vesicare);

• bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);

• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), or propantheline (Pro-Banthine); or

• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

This list is not complete and there may be other drugs that can interact with metoclopramide. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about metoclopramide.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 4.07. Revision Date: 10/23/2007 4:40:17 PM.

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