Metoclopramide
Brand names Gastrobid Continus, Gastroflux, Gastromax, Maxolon, Metramid, Parmid, Primperan Used in the following combined preparations Migravess, Paramax
General Information
Metoclopramide has a direct action on the gastrointestinal tract. It is used for conditions in which there is a need to encourage normal propulsion of food through the stomach and intestine.
The drug has powerful anti-emetic properties and its most common use is in the prevention and treatment of nausea and vomiting. It is particularly effective for the relief of the nausea that sometimes accompanies migraine headaches, and the nausea caused by treatment with anticancer drugs. It is also prescribed to alleviate symptoms of hiatus hernia caused by acid reflux into the oesophagus.
One side effect of metoclopramide, muscle spasm of the face and neck, is more likely to occur in children and young adults under 20 years. Other side effects are not usually troublesome.
Information for Users
Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.
How taken
Tablets, SR-tablets/capsules, liquid, injection.
Frequency and timing of doses
Usually 3 x daily; 1-2 x daily (SR-products).
Adult dosage range
Usually 15-30mg daily; may be higher for nausea caused by anticancer drugs.
Onset of effect
Within 1 hour.
Duration of action
6-8 hours.
Diet advice
Fatty and spicy foods and alcohol are best avoided if nausea is a problem.
Storage
Keep in a closed container in a cool, dry place out of the reach of children.
Missed dose
Take as soon as you remember. If your next dose is due within 3 hours, take a single dose now and skip the next.
Stopping the drug
Can be safely stopped as soon as you no longer need it.
Exceeding the dose
An occasional unintentional extra dose is unlikely to be a cause for concern. Large overdoses may cause drowsiness and muscle spasms. Notify your doctor.
Possible Adverse Effects
The main adverse effects of metoclopramide are drowsiness and, even less commonly, uncontrolled muscle spasm. Other symptoms rarely occur.
Interactions
Sedatives
The sedative properties of metoclopramide are increased by all drugs that have a sedative effect on the central nervous system. Such drugs include antianxiety and sleeping drugs, antihistamines, antidepressants, opioid analgesics, and antipsychotics.
Phenothiazine antipsychotics
The likelihood of adverse effects from these drugs is increased by metoclopramide.
Lithium
Metoclopramide increases the risk of central nervous system side effects.
Quick Reference
Drug group Gastrointestinal motility regulator and anti-emetic drug .
Overdose danger rating Medium
Dependence rating Low
Prescription needed Yes
Available as generic Yes
Special Precautions
Be sure to tell your doctor if:
You have long-term liver or kidney problems.
You are taking other medications.
Pregnancy
Safety in pregnancy not established. Discuss with your doctor.
Breast-feeding
The drug passes into the breast milk but at normal doses adverse effects on the baby are unlikely. Discuss with your doctor.
Infants and children
Reduced dose necessary.
Over 60
Reduced dose may be necessary.
Driving and hazardous work
Avoid such activities until you have learned how metoclopramide affects you because the drug may cause drowsiness.
Alcohol
Avoid. Alcohol may oppose the beneficial effects and increase the sedative effects of this drug.
Prolonged use
Not normally used long term, except under specialist supervision for certain gastrointestinal disorders.
