Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 5mg/mL
syrup
- 5mg/5mL
- 10mg/10mL
tablet
- 5mg
- 10mg
Dispersible tablets
- 5mg
- 10mg
Chemotherapy-Induced Nausea & Vomiting
2 mg/kg IV (infused over at least 15 minutes) 30 minutes before chemotherapy, then repeated 2 more times q2hr (after initial dose)
Vomiting suppressed: Decrease to 1 mg/kg IV q3hr for 3 doses
Vomiting not suppressed: Continue same dose q3hr for 3 doses
Diabetic Gastroparesis
10 mg IV/IM/PO q6hr 30 minutes before meals and at bedtime; use injectable dosing only if severe symptoms are present
Small Bowel Intubation/Radiologic Examination of Upper GI Tract
10 mg IV over 1-2 minutes
Gastroesophageal Reflux Disease
10-15 mg PO q6hr 30 minutes before meals and at bedtime; not to exceed 80 mg/day
Postoperative Nausea & Vomiting (Off-label)
10-20 mg IM administered near end of procedure; may be repeated postoperatively q4-6hr PRN
Dosing Modifications
Renal impairment: CrCl <40 mL/min, decrease dose by 50%; CrCl <10 mL/min, decrease dose by 75%
Dosage Forms & Strengths
injectable solution
- 5mg/mL
syrup
- 5mg/5mL
- 10mg/10mL
tablets
- 5mg
- 10mg
Dispersible tablets
- 5mg
- 10mg
Small Bowel Intubation/Radiologic Examination of Upper GI Tract
<6 years old: 0.1 mg/kg IV over 1-2 minutes
6-14 years old: 2.5-5 mg IV over 1-2 minutes
≥14 years old: 10 mg IV over 1-2 minutes
Gastroesophageal Reflux Disease (Off-label)
Infant: 0.1 mg/kg IV/IM/PO q6-8hr 30 minutes before meals and at bedtime
Not to exceed 0.3-0.75 mg/kg/day
Diabetic Gastroparesis (Off-label)
<6 years old: 0.1 mg/kg PO q8hr; not to exceed 0.1 mg/kg
≥6 years old: 0.5 mg/kg/day PO divided q8hr
Postoperative Nausea & Vomiting (Off-label)
Chemotherapy-Induced Nausea & Vomiting (Off-label)
1-2 mg/kg IV (infused over at least 15 minutes) 30 minutes before chemotherapy; repeat q2-4hr; pretreatment with diphenhydramine decreases risk of extrapyramidal adverse effects
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- lurasidone
metoclopramide increases toxicity of lurasidone by antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Contraindicated. Concomitant use of metoclopramide and antipsychotics is contraindicated by the manufacturer of metoclopramide; increased risk of extrapyramidal effects. .
Serious - Use Alternative (22)
- cabergoline
metoclopramide decreases levels of cabergoline by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated.
metoclopramide decreases levels of cabergoline by pharmacodynamic antagonism. Contraindicated. - citalopram
metoclopramide and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- desvenlafaxine
metoclopramide and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- dopamine
metoclopramide decreases levels of dopamine by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated.
metoclopramide decreases levels of dopamine by pharmacodynamic antagonism. Contraindicated. - duloxetine
metoclopramide and duloxetine both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- escitalopram
metoclopramide and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- fluoxetine
metoclopramide and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- fluvoxamine
fluvoxamine and metoclopramide both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects: Increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- levodopa inhaled
metoclopramide decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of dopamine D2 receptor antagonists with levodopa inhaled.
- levomilnacipran
metoclopramide and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- lisuride
metoclopramide decreases levels of lisuride by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated.
metoclopramide decreases levels of lisuride by pharmacodynamic antagonism. Contraindicated. - methyldopa
metoclopramide decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated.
metoclopramide decreases levels of methyldopa by pharmacodynamic antagonism. Contraindicated. - milnacipran
metoclopramide and milnacipran both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- paroxetine
metoclopramide and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- pramipexole
metoclopramide decreases levels of pramipexole by pharmacodynamic antagonism. Contraindicated.
- red yeast rice
metoclopramide will increase the level or effect of red yeast rice by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. May increase creatine kinase levels and increase risk of myopathy or rhabdomyolysis; red yeast rice contains monocolin K (reportedly identical to lovastatin)
- rivastigmine
rivastigmine, metoclopramide. Either increases toxicity of the other by antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Avoid or Use Alternate Drug.
metoclopramide, rivastigmine. Either increases toxicity of the other by antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Avoid or Use Alternate Drug. - ropinirole
metoclopramide decreases levels of ropinirole by pharmacodynamic antagonism. Contraindicated.
- safinamide
metoclopramide decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.
- sertraline
metoclopramide and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- venlafaxine
metoclopramide and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions
- vilazodone
metoclopramide increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% - Reduce daily dose to 20 mg.
Monitor Closely (37)
- amoxapine
amoxapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
metoclopramide and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. - apomorphine
metoclopramide decreases levels of apomorphine by pharmacodynamic antagonism. Use Caution/Monitor. Avoid combination if possible.
- aripiprazole
aripiprazole and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- benperidol
benperidol and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- bromocriptine
metoclopramide decreases levels of bromocriptine by pharmacodynamic antagonism. Use Caution/Monitor. Avoid combination if possible.
- bupivacaine implant
metoclopramide, bupivacaine implant. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.
- chlorpromazine
chlorpromazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- clobazam
metoclopramide, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clozapine
clozapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- cyclosporine
metoclopramide increases levels of cyclosporine by enhancing GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- deutetrabenazine
metoclopramide and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.
- digoxin
metoclopramide decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- droperidol
droperidol and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- fluphenazine
fluphenazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- haloperidol
haloperidol and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- iloperidone
iloperidone and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- levodopa
metoclopramide decreases levels of levodopa by pharmacodynamic antagonism. Use Caution/Monitor. Avoid combination if possible.
- loxapine
loxapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, metoclopramide. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- olanzapine
olanzapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- oxybutynin
oxybutynin decreases effects of metoclopramide by pharmacodynamic antagonism. Use Caution/Monitor. May antagonize prokinetic effects.
- oxybutynin topical
oxybutynin topical decreases effects of metoclopramide by pharmacodynamic antagonism. Use Caution/Monitor. May antagonize prokinetic effects.
- oxybutynin transdermal
oxybutynin transdermal decreases effects of metoclopramide by pharmacodynamic antagonism. Use Caution/Monitor. May antagonize prokinetic effects.
- paliperidone
paliperidone and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- perphenazine
perphenazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- pimozide
pimozide and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- posaconazole
metoclopramide decreases levels of posaconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- prochlorperazine
prochlorperazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- promethazine
promethazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- quetiapine
quetiapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- risperidone
risperidone and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- tetrabenazine
metoclopramide and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.
- thioridazine
thioridazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- thiothixene
thiothixene and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- trifluoperazine
trifluoperazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- ziprasidone
ziprasidone and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
Minor (8)
- acetaminophen
metoclopramide increases levels of acetaminophen by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- acetaminophen IV
metoclopramide increases levels of acetaminophen IV by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- acetaminophen rectal
metoclopramide increases levels of acetaminophen rectal by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- atovaquone
metoclopramide decreases levels of atovaquone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- ethanol
metoclopramide increases effects of ethanol by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Increased CNS depression.
metoclopramide increases effects of ethanol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression. - fosfomycin
metoclopramide decreases levels of fosfomycin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- meperidine
metoclopramide increases effects of meperidine by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Increased CNS depression.
metoclopramide increases effects of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression. - nitrofurantoin
metoclopramide decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
Adverse Effects
>10%
Extrapyramidal symptoms (dystonic reactions in 25% of young adults 18-30 years old)
1-10%
Fatigue (2-10%)
Restlessness (10%)
Sedation (10%)
Headache (4-5%)
Dizziness (1-4%)
Somnolence (2-3%)
Frequency Not Defined
Diarrhea
Nausea
Galactorrhea
Gynecomastia
Impotence
Menstrual disorders
Neuroleptic malignant syndrome
Hematologic abnormalities
Warnings
Black Box Warnings
May cause tardive dyskinesia (often irreversible)
Risk of developing tardive dyskinesia increases with treatment duration and total cumulative dose
Discontinue with signs or symptoms of tardive dyskinesia
No known treatment exists for tardive dyskinesia
Symptoms may lessen or resolve after metoclopramide treatment is stopped
Do not administer for longer than 12 weeks, except in rare cases where therapeutic benefit is thought to outweigh risk of tardive dyskinesia
Contraindications
Hypersensitivity to metoclopramide or procainamide
History of tardive dyskinesia (TD) or a dystonic reaction to metoclopramide
When stimulation of gastrointestinal motility might be dangerous (e.g., in the presence of gastrointestinal hemorrhage, mechanical obstruction, or perforation)
Presence of pheochromocytoma or other catecholamine-releasing paragangliomas
Patients with history of epilepsy
Other drugs causing extrapyramidal symptoms (eg, phenothiazines, butyrophenones)
Cautions
Mental depression reported; use with caution in patients with history of mental illness
Use with caution or avoid in Parkinson disease patients; may have increased risk of extrapyramidal symptoms
Use with caution after GI anastomosis or closure; promotility agents reported to increase pressure in suture lines
Use caution in patients with hypertension, CHF, renal impairment, cirrhosis
Use caution in patients who are at risk of fluid overload
Metoclopramide may cause a potentially fatal symptom complex called neuroleptic malignant syndrome (NMS). NMS has been reported in association with metoclopramide over dosage and concomitant treatment with another drug associated with NMS; discontinue therapy immediately if symptoms occur
Can cause tardive dyskinesia (see Black Box Warnings), especially in elderly; discontinue if signs or symptoms of tardive dyskinesia develop (metoclopramide itself may completely or partially suppress these manifestations); tardive dyskinesia may persist even after drug is discontinued
As with other dopamine D2 receptor antagonists, metoclopramide elevates prolactin levels
Galactorrhea, amenorrhea, gynecomastia, and impotence reported with prolactin-elevating drugs, including metoclopramide; hyperprolactinemia may potentially stimulate prolactin-dependent breast cancer; however, some clinical studies and epidemiology studies have not shown an association between administration of dopamine D2 receptor antagonists and tumorigenesis in humans
May impair mental and/or physical abilities required for performance of hazardous tasks such as operating machinery or driving a motor vehicle; concomitant use of central nervous system (CNS) depressants or drugs associated with EPS may increase this effect (e.g., alcohol, sedatives, hypnotics, opiates, and anxiolytics); avoid drug or the interacting drug, depending on importance of drug to the patient
Diphenhydramine 50 mg IM can be given for extrapyramidal symptoms
Pseudoparkisonism (eg, tremor, rigidity) may occur within 6 months of therapy; reversible within 2-3 months of discontinuing therapy
Metoclopramide IV administration associated with catecholamine release; use caution in patients with hypertension
Hypertensive crisis reported in patients with undiagnosed pheochromocytoma; discontinue therapy immediately with any sudden increase in blood pressure during therapy
May cause QT prolongation and torsades de pointes in some patients with heart failure patients that also have renal impairment; data on healthy males have failed to show similar effects; implications unclear; use caution in cardiovascular disease
Pregnancy & Lactation
Pregnancy
Published studies, including retrospective cohort studies, national registry studies, and meta-analyses, do not report an increased risk of adverse pregnancy-related outcomes with use of metoclopramide during pregnancy. There are potential risks to neonate following exposure in utero to metoclopramide during delivery; in animal reproduction studies, no adverse developmental effects were observed with oral administration of metoclopramide to pregnant rats and rabbits at exposures about 6 and 12 times the maximum recommended human dose (MRHD)
Metoclopramide crosses the placental barrier and may cause extrapyramidal signs and methemoglobinemia in neonates with maternal administration during delivery; monitor neonates for extrapyramidal signs
Lactation
Limited published data report the presence of metoclopramide in human milk in variable amounts; breastfed infants exposed to metoclopramide have experienced gastrointestinal adverse reactions, including intestinal discomfort and increased intestinal gas formation; metoclopramide elevates prolactin levels; however, published data are not adequate to support drug effects on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition
Monitor breastfeeding neonates because metoclopramide may cause extrapyramidal signs (dystonias) and methemoglobinemia
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Blocks dopamine receptors (at high dose) and serotonin receptors in chemoreceptor trigger zone of CNS; and sensitizes tissues to acetylcholine; increases upper GI motility but not secretions; increases lower esophageal sphincter tone
Absorption
Bioavailability: IM, 74-96%; PO, 65-95%
Onset: 1-3 min (IV, ); 10-15 min (IM); 30-60 min (PO)
Duration: 1-2 hr regardless of route
Peak serum time: IV, 15 min; PO, 60-120 min
Distribution
Protein bound: 30-40%
Vd: 3.5 L/kg
Metabolism
Metabolized by liver
Metabolites: Metoclopramide glucuronides, metoclopramide sulfates, aminoacetic acid (inactive)
Elimination
Half-life (IV/IM): 5-6hr (adults); 4 hr (children)
Dialyzable: Not significant; dose adjustment after dialysis unnecessary
Total body clearance: 0.53-0.55 L/hr/kg (prolonged in neonates as compared with adults)
Excretion: Primarily urine (85%)
Administration
IV Incompatibilities
Solution: D5W (at high drug concentration)
Additive: Dexamethasone sodium phosphate with lorazepam and diphenhydramine, erythromycin lactobionate, floxacillin, fluorouracil, furosemide
Syringe: Ampicillin, calcium gluconate, chloramphenicol sodium succinate, furosemide, methotrexate, penicillin G potassium, sodium bicarbonate
Y-site: Allopurinol, amphotericin B cholesteryl sulfate, amsacrine, cefepime, doxorubicin liposomal, furosemide, propofol
IV Compatibilities
Additive: Cimetidine, clindamycin, meperidine, meropenem, morphine sulphate, potassium chloride, verapamil
Syringe (partial list): Butorphanol, chlorpromazine, cisplatin, cyclophosphamide, cytarabine, dexamethasone, dimenhydrinate, diphenhydramine, doxorubicin, fentanyl, fentanyl with midazolam, fluorouracil, heparin, hydromorphone, hydroxyzine, insulin, lidocaine, magnesium sulfate, meperidine, midazolam, morphine, ondansetron, pentazocine, prochlorperazine, promethazine, ranitidine, vitamins B and C
Y-site (partial list): Aztreonam, bivalirudin, ciprofloxacin, cisplatin, cytarabine, diltiazem, docetaxel, doxorubicin, famotidine, fentanyl, fluconazole, fluorouracil, heparin, hydromorphone, linezolid, meperidine, morphine sulfate, ondansetron, quinupristin-dalfopristin, zidovudine
IV Administration
NS is preferred diluent because drug is most stable in this solution
Dose ≤10 mg: IV push over 1-2 minutes
Dose >10 mg: Dilute in 50 mL D5W or NS, and infuse over at least 15 minutes
Protect from light
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Reglan oral - | 10 mg tablet |  | |
| Reglan oral - | 5 mg tablet |  | |
| metoclopramide oral - | 10 mg tablet | | |
| metoclopramide oral - | 10 mg tablet |  | |
| metoclopramide oral - | 10 mg tablet |  | |
| metoclopramide oral - | 5 mg tablet |  | |
| metoclopramide oral - | 5 mg tablet |  | |
| metoclopramide oral - | 10 mg tablet |  | |
| metoclopramide oral - | 10 mg tablet |  | |
| metoclopramide oral - | 5 mg tablet |  | |
| metoclopramide oral - | 10 mg tablet |  | |
| metoclopramide oral - | 5 mg tablet |  | |
| metoclopramide oral - | 10 mg tablet |  | |
| metoclopramide oral - | 5 mg tablet |  | |
| metoclopramide oral - | 5 mg tablet | | |
| metoclopramide oral - | 5 mg tablet |  | |
| metoclopramide oral - | 5 mg/5 mL solution |  | |
| metoclopramide oral - | 5 mg/5 mL solution |  | |
| metoclopramide injection - | 5 mg/mL vial |  | |
| metoclopramide injection - | 5 mg/mL solution |  | |
| metoclopramide injection - | 5 mg/mL vial |  | |
| metoclopramide injection - | 5 mg/mL vial |  | |
| metoclopramide injection - | 5 mg/mL vial |  | |
| metoclopramide injection - | 5 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
metoclopramide oral
METOCLOPRAMIDE DISINTEGRATING TABLET - ORAL
(MET-oh-KLOE-pra-mide)
WARNING: This medication may cause a serious movement disorder called tardive dyskinesia. In some cases, this condition may be permanent. The risk of tardive dyskinesia is increased with the longer use of the medication and the more medication that you take. The risk is also increased in older adults (especially women) and in people with diabetes. Metoclopramide comes in different forms (such as solution, injection). Do not use metoclopramide products for longer than 12 weeks. Talk to your doctor about the risks and benefits of this medication.Tell your doctor right away if you develop any unusual uncontrolled movements (especially of the face, mouth, tongue, arms or legs). There is no treatment for tardive dyskinesia, but in some cases the symptoms may lessen or stop once metoclopramide is stopped.
USES: This medication is used to treat certain conditions of the stomach and intestines. Metoclopramide is used as a short-term treatment (4 to 12 weeks) for ongoing heartburn when the usual medicines do not work well enough. It is used mostly for heartburn that occurs after a meal or during the daytime. Treating ongoing heartburn can decrease the damage done by stomach acid to the swallowing tube (esophagus) and help healing.Metoclopramide is also used by diabetic patients who have poor emptying of their stomachs (gastroparesis). Treating gastroparesis can decrease symptoms of nausea, vomiting, and stomach/abdominal fullness. Metoclopramide works by blocking a natural substance (dopamine). It speeds up stomach emptying and movement of the upper intestines.This drug is not recommended for use in children due to an increased risk of serious side effects (such as muscle spasms/uncontrolled muscle movements). Ask the doctor or pharmacist for details.
HOW TO USE: See also Warning section.Read the Medication Guide provided by your pharmacist before you start taking metoclopramide and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually up to 4 times daily (at least 30 minutes before meals and at bedtime).Do not remove the tablet from the blister pack until right before your dose. Dry your hands before using this medication. Do not use the tablet if it is broken or crumbled. After removing the tablet from the blister pack, place it on your tongue right away. Allow it to dissolve completely, then swallow it with saliva. You do not need to take this product with water.The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Because of the risk of tardive dyskinesia, do not take this drug more often, in larger doses, or for longer than directed by your doctor.If heartburn only occurs at certain times (such as after the evening meal), your doctor may direct you to take a single dose before those times instead of taking it throughout the day. This will reduce your risk of side effects.To treat diabetic gastroparesis, this medication is usually taken for 2 to 8 weeks until your gut is working well. This condition may recur from time to time. Your doctor may direct you to start taking this medication as soon as your symptoms reappear and stop when you feel better. Ask your doctor for directions for starting and stopping this medication.If directed, take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.If you suddenly stop using this medication, you may have withdrawal symptoms (such as dizziness, nervousness, headaches). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used metoclopramide for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: See also Warning section.Drowsiness, dizziness, tiredness, trouble sleeping, agitation, headache, and diarrhea may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as anxiety, confusion, depression, thoughts of suicide), inability to keep still/need to pace, muscle spasms/uncontrolled muscle movements (such as twisting neck, arching back), Parkinson-like symptoms (such as shaking, slowed/difficult movement, mask-like facial expression), swelling of the hands/feet, decreased sexual ability, abnormal breast-milk production, enlarged/tender breasts, changes in menstruation in women.This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness, severe confusion, sweating, fast/irregular heartbeat.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking metoclopramide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before taking this medication, tell your doctor or pharmacist your medical history, especially of: history of movement/muscle disorders (such as tardive dyskinesia, dystonia) caused by a medication, bleeding/blockage/hole in the intestines/stomach, breast cancer, high blood pressure, kidney problems, heart failure, mental/mood problems (such as depression, thoughts of suicide), Parkinson's disease, liver problems (such as cirrhosis, porphyria), pheochromocytoma, seizures, a certain blood enzyme problem (NADH-cytochrome b5 reductase deficiency).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may contain aspartame or phenylalanine. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame or phenylalanine in your diet, ask your doctor or pharmacist about using this medication safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you have diabetes, this product may make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be more sensitive to the side effects of this drug, especially muscle spasms/uncontrolled muscle movements. See also Uses section.Older adults may be more sensitive to the effects of this drug, especially drowsiness, tardive dyskinesia, and Parkinson's type muscle problems. Drowsiness can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: antipsychotic drugs (such as aripiprazole, haloperidol), atovaquone, dopamine agonists (such as cabergoline, pergolide, ropinirole), fosfomycin, MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine), pramlintide, phenothiazines (such as promethazine, prochlorperazine), rivastigmine.Metoclopramide causes food and medication to move through your stomach more quickly, which may affect the absorption of some drugs. Talk to your doctor or pharmacist to see if any of the drugs that you are taking may be affected.Tell your doctor or pharmacist if you are using other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as endoscopy for ulcer) may be done while you are taking this medication. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised September 2021. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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