Metoclopramide (Oral Route, Intravenous Route)

Drug Information provided by: Micromedex

ARTICLE SECTIONS

US Brand Names

Reglan

Description

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

When taken by mouth, metoclopramide is used to treat the symptoms of a certain type of stomach problem called diabetic gastroparesis. It relieves symptoms such as nausea, vomiting, continued feeling of fullness after meals, and loss of appetite. Metoclopramide is also used, for a short time, to treat symptoms such as heartburn in patients who suffer esophageal injury from a backward flow of gastric acid into the esophagus.

Metoclopramide may also be used for other conditions as determined by your doctor.

Metoclopramide is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, metoclopramide is used in certain patients with the following medical conditions:

Failure of the stomach to empty its contents
Nausea and vomiting caused by other medicines
Persistent hiccups
Prevention of aspirating fluid into the lungs during surgery
Vascular headaches

This product is available in the following dosage forms:

Solution
Syrup
Tablet

Before Using

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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

Muscle spasms, especially of jaw, neck, and back, and tic-like (jerky) movements of head and face may be especially likely to occur in children, who are usually more sensitive than adults to the effects of metoclopramide. Premature and full-term infants may develop blood problems if given high doses of metoclopramide.

Geriatric

Shuffling walk and trembling and shaking of hands may be especially likely to occur in elderly patients after they have taken metoclopramide over a long time.

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.

Breastfeeding

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.

Drug Interactions

Using this medicine 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.

Linezolid

Other Interactions

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 this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Abdominal or stomach bleeding or
Asthma or
Cirrhosis (liver disease) or
Congestive heart failure or
High blood pressure or
Intestinal blockage or
Mental depression or
Parkinson's disease or
Pheochromocytoma (catecholamine-producing tumor)—Metoclopramide may make these conditions worse

Epilepsy—Metoclopramide may increase the risk of having a seizure

Kidney disease (severe)—Higher blood levels of metoclopramide may result, possibly increasing the chance of side effects

Nicotinamide adenine dinucleotide (NADH) methemoglobin reductase deficiency—Metoclopramide may increase your chance of side effects affecting the blood.

Proper Use

Take this medicine 30 minutes before meals and at bedtime, unless otherwise directed by your doctor.

Take metoclopramide only as directed. 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.

To take metoclopramide oral concentrate: This medicine should be mixed with another liquid, such as water, juices, soda or soda-like beverages, or with a semi-solid food, such as applesauce or pudding.

Dosing

The dose of this medicine 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 this medicine. 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 (concentrate, solution, or tablets):
- To treat the symptoms of a stomach problem called diabetic gastroparesis:
  - Adults and teenagers—10 milligrams (mg) thirty minutes before symptoms are likely to begin or before each meal and at bedtime. The dose may be taken up to four times a day. However, most people usually will not take more than 500 micrograms (mcg) per kilogram (kg) (227 mcg per pound) of body weight a day.
  - Children—Dose must be determined by your doctor.
- For heartburn:
  - Adults and teenagers—10 to 15 mg thirty minutes before symptoms are likely to begin or before each meal and at bedtime. The dose may be taken up to four times a day. However, most people usually will not take more than 500 mcg per kg (227 mcg per pound) of body weight a day.
  - Children—Dose must be determined by your doctor.
- To increase movements or contractions of the stomach and intestines:
  - Children 5 to 14 years of age—2.5 to 5 mg three times a day, thirty minutes before meals.
For injection dosage form:
- To increase movements or contractions of the stomach and intestine:
  - Adults and teenagers—10 mg injected into a vein.
  - Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 1 mg per kilogram (kg) (0.45 mg per pound) of body weight injected into a vein. Your doctor may repeat this dose after sixty minutes if needed.
- To prevent nausea and vomiting caused by anticancer medicines:
  - Adults and teenagers—Dose is based on body weight and must be determined by your doctor. The usual dose is 1 to 2 mg per kg (0.45 to 0.9 mg per pound) of body weight, injected slowly into a vein, thirty minutes before you take your anticancer medicine. Your doctor may repeat this dose every two or three hours if needed. Some people may need a larger dose to start.
  - Children—1 mg per kg (0.45 mg per pound) of body weight injected into a vein. Your doctor may repeat this dose after sixty minutes if needed.
- To prevent vomiting after surgery:
  - Adults and teenagers—10 to 20 mg injected into a muscle near the end of surgery.
  - Children—Dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, 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.

Storage

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.

Precautions

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

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

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 as soon as possible if any of the following side effects occur:

Rare

Abdominal pain or tenderness
Chills
Clay colored stools
Convulsions
Dark urine
Difficulty in breathing
Difficulty in speaking or swallowing
Dizziness or fainting
Fast or irregular heartbeat
Fever
General feeling of tiredness or weakness
Headache (severe or continuing)
Inability to move eyes
Increase in blood pressure
Increased sweating
Itching
Lip smacking or puckering
Loss of appetite
Loss of balance control
Loss of bladder control
Mask-like face
Muscle spasms of face, neck, and back
Nausea and vomiting
Puffing of cheeks
Rapid or worm-like movements of tongue
Shuffling walk
Skin rash
Sore throat
Stiffness of arms or legs
Swelling of feet or lower legs
Trembling and shaking of hands and fingers
Tic-like or twitching movements
Twisting movements of body
Uncontrolled chewing movements
Uncontrolled movements of arms and legs
Unusually pale skin
Weakness of arms and legs
Yellow eyes or skin

With high doses

Aching or discomfort in lower legs
Panic-like sensation
Sensation of crawling in legs
Unusual nervousness, restlessness, or irritability

Symptoms of overdose

Confusion
Convulsions (seizures)
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:

More common