Metoclopramide; Indications, Uses, Dosage, Side Effects, Interactions ,Pregnancy

Therapeutic Uses of Metoclopramide

• Metoclopramide tablets are indicated as short-term (4 to 12 weeks) therapy for adults with symptomatic, documented gastroesophageal reflux who fail to respond to conventional therapy.
• Metoclopramide tablets, USP is indicated for the relief of symptoms associated with acute? and recurrent diabetic gastric stasis. The usual manifestations of delayed gastric emptying (eg, nausea?, vomiting?, heartburn, persistent fullness after meals, and anorexia) appear to respond to Metoclopramide Tablets within different time intervals. Significant relief of nausea occurs early and continues to improve over a three-week period. Relief of vomiting and anorexia may precede the relief of abdominal fullness by one week or more.
• Metoclopramide injection is indicated for the prophylaxis of vomiting? associated with emetogenic cancer chemotherapy.
• Metoclopramide injection is indicated for the prophylaxis of postoperative nausea? and vomiting? in those circumstances where nasogastric suction is undesirable.
• Metoclopramide injection may be used to facilitate small bowel intubation in adults and pediatric patients in whom the tube does not pass the pylorus with conventional maneuvers.
• Metoclopramide injection may be used to stimulate gastric emptying and intestinal transit of bariumin cases where delayed emptying interferes with radiological examination of the stomach and/or small intestine.
• Diamond-Blackfan anemia? (DBA) is a congenital? anemia characterized by a low reticulocyte count, the absence or severe reduction of hemoglobin?-containing cells in the bone marrow, and normal megakaryocytic and granulocytic differentiation. Although the anemia may initially respond to corticosteroid therapy, many patients require lifelong red blood cell (RBC) transfusion, leading to infectious complications and iron overload.

Nausea?/Vomiting? – Chemotherapy Induced

Parenteral

• Initial dose: 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.
• Subsequent doses: The dose should be repeated every 2 hours for 2 doses following the initial dose, then every 3 hours for 3 additional doses.
• Parenteral: 10 to 20 mg IM at or near the end of surgery

Nausea?/Vomiting? – Postoperative

Parenteral

• Initial dose: 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.
• Subsequent doses: The dose should be repeated every 2 hours for 2 doses following the initial dose, then every 3 hours for 3 additional doses.

Small Intestine Intubation

• If the tube has not passed the pylorus with conventional maneuvers in 10 minutes, a single undiluted dose may be administered via slow IV.
• Parenteral: 10 mg IV metoclopramide base over a 1- to 2-minute period

Gastroparesis

• Parenteral: 10 mg IV (slowly over a 1 to 2-minute period) or IM
• Maximum duration of therapy: Up to 10 days
• Oral: 10 mg orally 30 minutes before each meal and at bedtime for 2 to 8 weeks, depending upon response and the likelihood of continued well-being upon drug discontinuation
• Maximum dose: 40 mg/day
• Maximum duration of therapy: 12 weeks

Side Effects of Metoclopramide

The most common

• Diarrhea
• muscle twitching
• weakness
• Any signs of infection, or a skin rash.
• Stomach pain, especially if it comes along with fever and diarrhea or constipation
• Yellowing of the skin or eyes
• Loss of appetite
• Constipation
• Chest pain or discomfort
• lightheadedness, dizziness, or fainting
• unusual tiredness or weakness
• the decrease in the amount of urine
• fast, pounding, or irregular heartbeat or pulse
• false sense of well-being
• increased watering of mouth
• lightheadedness
• constipation;
• vision changes;
• breast swelling (in men or women); or
• decreased sex drive, impotence, or difficulty having an orgasm.
• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• restless muscle movements in your eyes, tongue, jaw, or neck;

Common

• Drowsiness and lightheadedness the day after taking the medicine.
• Confusion.
• Numbed emotions.
• Visual disturbances such as blurred vision or double vision.
• Shaky movements and unsteady walk (ataxia).
• Muscle weakness.
• Dizziness.
• Headache.
• Skin rashes.
• Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.
• Changes in sex drive.
• Low blood pressure (hypotension).
• Blood disorders.
• Unexpected aggression, restlessness or irritability .
• Nightmares or hallucinations 

Rare

• agitation
• anxiety
• behavioural changes, including aggressiveness, angry outbursts,
• confusion
• increased trouble sleeping
• muscle spasms
• shortness of breath
• difficult or labored breathing
• difficulty with swallowing
• dizziness, faintness, or lightheadedness 
• frequent urination
• hallucinations
• bloating or swelling of the face, arms, hands, lower legs, or feet
• blurred vision
• hives or welts, itching, or skin rash
• an increased volume of pale, dilute urine

Drug Interactions of Metoclopramide

Metoclopramide may interact with the following drugs, supplyments, & may change the efficacy of drugs