Metoclopramide can cause tardive dyskinesia, a serious movement disorder that is often irreversible. The risk of developing tardive dyskinesia increases with duration of treatment and total cumulative dose. Discontinue metoclopramide in patients who develop signs or symptoms of tardive dyskinesia. There is no known treatment for tardive dyskinesia. In some patients, symptoms may lessen or resolve after metoclopramide is stopped. Avoid treatment with Reglan for longer than 12 weeks because of the increased risk of developing TD with longer-term use .Oral route(Tablet, Disintegrating;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 .
Medically reviewed on Jan 17, 2019
Commonly used brand name(s)
In the U.S.
- Metozolv ODT
Available Dosage Forms:
- Tablet, Disintegrating
Therapeutic Class: Antiemetic
Pharmacologic Class: Dopamine Antagonist
Uses For metoclopramide
Metoclopramide is used to treat the symptoms of slow stomach emptying (gastroparesis) in patients with diabetes. It works by increasing the movements or contractions of the stomach and intestines. It relieves symptoms such as nausea, vomiting, heartburn, a feeling of fullness after meals, and loss of appetite. Metoclopramide is also used to treat heartburn for patients with gastroesophageal reflux disease (GERD). GERD is esophageal irritation from the backward flow of gastric acid into the esophagus.
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:
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.
Appropriate studies have not been performed on the relationship of age to the effects of metoclopramide in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of metoclopramide 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.
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 taking 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.
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.
- Chloral Hydrate
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Lispro, Recombinant
- Methylene Blue
- Morphine Sulfate Liposome
- Nitrous Oxide
- Opium Alkaloids
- Sodium Oxybate
- Tolonium Chloride
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.
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. 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 is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use metoclopramide, or give you special instructions about the use of 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:
- Asthma or
- Cirrhosis (liver disease) or
- Congestive heart failure or
- Depression, or history of or
- Diabetes or
- Heart rhythm problems (eg, ventricular arrhythmia) or
- Hypertension (high blood pressure) 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 blood problems.
- Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
- Pheochromocytoma (adrenal gland tumor) or
- Seizures or epilepsy or
- Stomach or bowel problems (eg, bleeding, blockage, perforation) or
- Tardive dyskinesia, history of—Should not be used in patients with these conditions.
Proper Use of metoclopramide
Take metoclopramide only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.
Metoclopramide should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have questions.
Take metoclopramide on an empty stomach, at least 30 minutes before meals and at bedtime.
If you are using the disintegrating tablet, make sure your hands are dry before you handle it. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet on your tongue. It should melt quickly. If the tablet breaks or crumbles before you take it, throw it away and get a new tablet from the blister pack.
Do not use metoclopramide for longer than 12 weeks.
The dose of metoclopramide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of metoclopramide. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage forms (solution or tablets):
- For diabetic gastroparesis:
- Adults—At first, 10 milligrams (mg) four times a day, taken 30 minutes before each meal and at bedtime for 2 to 8 weeks. Your doctor may adjust your dose as needed. However, the dose is usually not more than 40 mg.
- Children—Use and dose must be determined by your doctor.
- For gastroesophageal reflux disease (GERD):
- Adults—At first, 10 to 15 milligrams (mg) four times a day, taken 30 minutes before symptoms are likely to begin or before each meal and at bedtime, for 4 to 12 weeks. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
- Children—Use and dose must be determined by your doctor.
- For diabetic gastroparesis:
If you miss a dose of metoclopramide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using metoclopramide
It is very important that your doctor check your progress at regular visits to make sure that metoclopramide is working properly. Blood tests may be needed to check for unwanted effects.
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 these medicines while you are using metoclopramide.
Metoclopramide may make you dizzy, drowsy, or have trouble with thinking or controlling body movements. Do not drive or do anything else that could be dangerous until you know how metoclopramide affects you.
Metoclopramide may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while taking 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. The risk of tardive dyskinesia is higher if you take metoclopramide for longer than 12 weeks. Treatment for longer than 12 weeks should be avoided in all but rare cases.
Tell your doctor right away if you have the following symptoms while you are using metoclopramide: inability to move the eyes, increased blinking or spasms of the eyelid, trouble with breathing, speaking, or swallowing, uncontrolled tongue movements, uncontrolled twisting movements of the neck, trunk, arms, or legs, unusual facial expressions, or weakness of the arms and legs.
Check with your doctor right away if you have any of the following symptoms while using metoclopramide: convulsions (seizures), difficulty with breathing, fast heartbeat, 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).
Metoclopramide may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.
Your blood pressure might get too high while you are using metoclopramide. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.
Metoclopramide may increase prolactin blood levels if used for a long time. Check with your doctor if you have breast swelling or soreness, unusual breast milk production, absent, missed, or irregular menstrual periods, stopping of menstrual bleeding, loss in sexual ability, desire, drive, or performance, decreased interest in sexual intercourse, or an inability to have or keep an erection.
You may also have dizziness, headaches, or nervousness when you stop taking metoclopramide. These side effects should go away. Check with your doctor if any of the side effects continue or if you have any questions about them.
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 immediately if any of the following side effects occur:
Incidence not known
- clay colored stools
- dark urine
- difficulty with breathing
- difficulty with speaking or swallowing
- dizziness or fainting
- fast or irregular heartbeat
- general feeling of tiredness or weakness
- headache (severe or continuing)
- inability to move the eyes
- increase in blood pressure
- increased sweating
- itching, skin rash
- lip smacking or puckering
- loss of appetite
- loss of balance control
- loss of bladder control
- mask-like face
- muscle spasms of the face, neck, and back
- puffing of the cheeks
- rapid or worm-like movements of the tongue
- shuffling walk
- sore throat
- stiffness of the arms or legs
- stomach pain or tenderness
- swelling of the feet or lower legs
- tic-like or twitching movements
- trembling and shaking of the hands and fingers
- twisting movements of the body
- uncontrolled chewing movements
- uncontrolled movements of the arms and legs
- unusually pale skin
- weakness of the arms and legs
- yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
- drowsiness (severe)
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:
- loss of strength or energy
- muscle pain or weakness
- unusual weak feeling
Incidence not known
- Breast tenderness and swelling
- changes in menstruation
- decreased interest in sexual intercourse
- inability to have or keep an erection
- increased flow of breast milk
- increased need to urinate
- loss in sexual ability, desire, drive, or performance
- mental depression
- passing urine more often
- skin rash
- trouble sleeping
- unusual dryness of the mouth
- unusual irritability
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.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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