Drug information of Metoclopramide

Metoclopramide

Drug group: Antiemetic

Metoclopramide is a medication used mostly for stomach and esophageal problems. It is commonly used to treat and prevent nausea and vomiting , to help with emptying of the stomach in people with delayed stomach emptying, and to help with gastroesophageal reflux disease.It is also used to treat migraine headaches.

Mechanism of effect

Metoclopramide inhibits gastric smooth muscle relaxation produced by dopamine, therefore increasing cholinergic response of the gastrointestinal smooth muscle. It accelerates intestinal transit and gastric emptying by preventing relaxation of gastric body and increasing the phasic activity of antrum.
Metoclopramide also decreases reflux into the esophagus by increasing the resting pressure of the lower esophageal sphincter and improves acid clearance from the esophagus by increasing amplitude of esophageal peristaltic contractions.

Pharmacodynamic

Metoclopramide, although chemically related to procainamide, does not possess local anesthetic or antiarrhythmic properties. Metoclopramide is used to enhance GI motility, to treat diabetic gastroparesis, as an antinauseant, and to facilitate intubation of the small bowel during radiologic examination. Metoclopramide may be used to treat chemotherapy-induced emesis.

Pharmacokinetics

Metoclopramide is rapidly and well absorbed. The absolute oral bioavailability of metoclopramide is 80% ± 15.5% . Peak plasma concentrations occur at about 1 to 2 hours after a single oral dose. Approximately 85% of the radioactivity of an orally administered dose appears in the urine within 72 hours.
Its half life is 5 to 6 hours. The drug is not extensively bound to plasma proteins (about 30%). The whole body volume of distribution is high (about 3.5 L/kg) which suggests extensive distribution of drug to the tissues.

Dosage

Usual Adult Metoclopramide Dose for Nausea/Vomiting :
Postoperative nausea and vomiting :
- Parenteral: 10 to 20 mg IM at or near the end of surgery
Usual Adult Metoclopramide Dose for Gastroesophageal Reflux Disease :
-Oral : 10 to 15 mg up to 4 times a day 30 minutes before meals and at bedtime
Usual Adult Metoclopramide Dose for Gastroparesis: Parenteral: 10 mg 4 times daily, IV (slowly over a 1 to 2 minute period) or IM for up to 10 days .
-Oral : 10 mg 4 times daily, 30 minutes before meals and at bedtime, for 2 to 8 weeks depending on clinical response.
Usual Adult Metoclopramide Dose for Nausea/Vomiting -- Chemotherapy Induced :
IV infusion: 1 to 2 mg/kg/dose (depending on the emetogenic potential of the agent) IV (infused over a period of not less than 15 minutes) 30 minutes before administration of chemotherapy.
Usual Adult Metoclopramide Dose for Migraine: 10 to 20 mg IV once (used in combination with analgesics or ergot derivatives) .
Pediatrics :
Usual Pediatric Metoclopramide Dose for Gastroesophageal Reflux Disease :
Metoclopramide is not approved by the FDA for gastroesophageal reflux disease in pediatric patients; however, the following doses have been studied :
Oral, IM, IV:
Infants and Children: 0.4 to 0.8 mg/kg/day in 4 divided doses
Usual Pediatric Metoclopramide Dose for Nausea/Vomiting -- Chemotherapy Induced IV:
1 to 2 mg/kg/dose IV every 30 minutes before chemotherapy and every 2 to 4 hours

Alerts

NEVER TAKE METOCLOPRAMIDE IN LARGER AMOUNTS THAN RECOMMENDED, OR FOR LONGER THAN 12 WEEKS. High doses or long-term use of metoclopramide can cause a serious movement disorder that may not be reversible. 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.
tell your doctor if you have kidney or liver disease, congestive heart failure, high blood pressure, diabetes, Parkinson's disease, or a history of depression.Do not drink alcohol.

Points of recommendation

Take metoclopramide 30 minutes before eating. Metoclopramide is usually taken before meals and at bedtime . Do not take two different forms of metoclopramide (such as tablets and oral syrup) at the same time. This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Pregnancy level

B

Related drugs

Cisapride , Domperidone


Ask a Pharmacist


User's questions
    No comments yet.