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Metoclopramide Patient Tips

Medically reviewed on Sep 29, 2017 by C. Fookes, BPharm.

How it works

  • Metoclopramide increases the motility of the upper gastrointestinal tract, allowing faster transit of food through the GI tract and reducing symptoms such as nausea.
  • Experts are not sure exactly how metoclopramide exerts this effect but suggest it is due to its effects on dopamine receptors in the brain and gut.
  • Metoclopramide belongs to the class of medicines known as antiemetics. It may also be called a prokinetic.

Upsides

  • Used for the short-term relief (4-12 weeks) of symptomatic gastroesophageal reflux that has not responded to other doctor-prescribed treatment. When used for this purpose metoclopramide is more likely to help daytime symptoms, especially those following a meal; effect on night-time symptoms is less. May be effective when used prophylactically, such as a single dose before a meal.
  • May also be effective for people with diabetes who have problems with gastric emptying (symptoms include nausea, vomiting, heartburn, persistent fullness after meals, and weight loss).
  • Metoclopramide injection may be used to prevent nausea and vomiting associated with cancer chemotherapy, to help facilitate small bowel intubation, and to stimulate emptying of the bowel before radiological examination of the stomach.
  • Metoclopramide tablets may also be used for other indications off-label (this means the use has not been FDA-approved, but it is still a recognized use).
  • Generic metoclopramide is available.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Sedation or mental impairment which may affect a person's ability to drive or operate machinery. Avoid alcohol. Other side effects include restlessness, fatigue, confusion, insomnia, galactorrhea (milky nipple discharge unrelated to lactation), gynecomastia (breast enlargement in males), mental depression (may include thoughts of suicide; should only be given to people with a history of depression if benefits outweigh risks), extrapyramidal symptoms (drug-induced movement disorders; usually seen during the first 24-48 hours of treatment with usual dosages; adults aged less than 30 are more at risk), Parkinsonian-like symptoms (such as tremor and rigidity; more common within the first 6 months of treatment; may take two to three months to subside following discontinuation).
  • Metoclopramide use has been associated with the development of tardive dyskinesia (TD) (a nerve disorder characterized by involuntary movements of the face and jaws). Discontinue metoclopramide if TD develops; symptoms may lessen or resolve in some patients once metoclopramide has been stopped; however, in some patients TD is irreversible and there is no known treatment. Risk increases with duration of treatment and cumulative dose and may be higher in the elderly, in women, and in diabetics. Avoid treatment with metoclopramide for longer than 12 weeks unless benefits outweigh risks.
  • Rarely, may cause Neuroleptic Malignant Syndrome; symptoms include high body temperature, muscle rigidity, and mental disturbances; discontinue immediately and seek urgent medical advice.
  • Some people may experience withdrawal symptoms after stopping metoclopramide, such as dizziness, nervousness, or headaches.
  • May not be suitable for some people including those with Parkinson's disease, epilepsy, high blood pressure, cirrhosis, kidney disease, congestive heart failure, preexisting gastrointestinal problems (such as hemorrhage, obstruction, perforation); pheochromocytoma; previous intolerance to metoclopramide.
  • May interact with a number of other drugs including narcotic analgesics, anticholinergics, digoxin, and monoamine oxidase antidepressants. May affect the absorption of a number of other drugs.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Metoclopramide may be useful for the short-term treatment of gastrointestinal reflux unresponsive to other medications or for diabetic stasis. Side effects may include sedation and extrapyramidal symptoms such as tardive dyskinesia.

Tips

  • May be taken with or without food.
  • Take exactly as idrected by your doctor. Do not increase or decrease the dosage without his or her advice.
  • Metoclopramide should only be taken by adults and preferably for less than 12 weeks duration.
  • Do not drink alcohol while you are taking metoclopramide because it may make some side effects worse.
  • Metoclopramide may make you sleepy and affect your ability to drive or operate machinery. Do not do these tasks if metoclopramide affects you in this way.
  • Contact your doctor urgently if you develop thoughts about self harm; develop a high fever, stiff muscles, problems thinking, rapid or erratic heartbeat, and increased sweating; have uncontrollable muscle movements or muscle movements that are new or unusual; have any other worrying side effects.
  • When used to treat diabetic gastric stasis, adjustment may be needed to the dosage of insulin or the timing of the insulin dosage.
  • Do not take any other medications including those bought over the counter before checking with a doctor or pharmacist that the new medication is compatible with metoclopramide.

Response and Effectiveness

  • Metoclopramide takes about one to three minutes to start working following an intravenous dose; 10-15 minutes following an intramuscular dose; and 30-60 minutes following an oral dose. Effects persist for approximately one to two hours.

References

Metoclopramide [Package insert]. Mylan Institutional Inc. Revised: 04/2017. https://www.drugs.com/pro/metoclopramide-tablets.html

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use metoclopramide only for the indication prescribed.

Copyright 1996-2018 Drugs.com. Revision Date: 2017-09-29 02:37:37

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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