Metoclopramide is commonly used to treat nausea and vomiting associated with conditions such as uremia, radiation sickness, cancer and the effects of chemotherapy, labor, infection, and emetogenic drugs.
Substituted Benzamide; Antiemetic
Metoclopramide blocks dopamine receptors and in higher doses, it also blocks serotonin receptors in chemoreceptor trigger zone of the CNS. It enhances the response to acetylcholine of tissue in upper GI tract causing enhanced motility and accelerated gastric emptying w/o stimulating gastric, biliary, or pancreatic secretions. It also increases lower esophageal sphincter tone.
ORAL Nausea & vomiting associated w/ cancer chemotherapy or radiotherapy: Adult: 2 mg/kg/dose. given 1 hr before start of treatment. Repeat dose 3 times at 2-hrly intervals. May repeat 2 additional doses at 3-hrly intervals if needed. Max: 12 mg/kg/day. Child: Neonate: 100 mcg/kg every 6-8 hr; 1 mth-1 yr (up to 10 kg): 100 mcg/kg (max 1 mg)bid;1-3yr(10-14 kg): 1 mg bid-tid; 3-5 yr (15-19 kg): 2 mg bid-tid; 5-9 yr (20-29 kg): 2.5 mg tid; 9-14 yr (30 kg): 5 mg tid; 15-19 yr (30-59 kg): 5mg tid; 15-19yr(50kg): 10mg tid. Where wt is
Antipsychotics: Potential for additive effects, including TD, EPS, and
NMS; avoid concomitant use.
CNS depressants: Increased risk of CNS depression. Avoid concomitant
use and monitor for adverse reactions.
Strong CYP2D6 inhibitors (e.g., quinidine, bupropion, fluoxetine, and
paroxetine)
MAO inhibitors: Increased risk of hypertension; avoid concomitant use.
GI haemorrhage, mechanical obstruction & perforation; phaeochromocytoma; history of seizures. Children, elderly. Renal or hepatic impairment, porphyria, epilepsy, Parkinson’s disease, history of depression. Ability to drive or operate machineries may be impaired. Pregnancy & lactation. Monitor patients on prolonged therapy. Increased risk of tardive dyskinesia in patients on prolonged or highdose treatment.
Extrapyramidal symptoms, restlessness, drowsiness, anxiety, diarrhoea, hypotension, hypertension, headache, depression, blood disorders (e.g. aganulocytosis, methaemoglobinaemia), hypersensitivity reactions (e.g. bronchospasm. rash), galactorrhoea or related disorders, transient increase in plasma aldosterone levels. Neuroleptic malignant syndrome; cardiac conduction disorders may occur w/ IV dosage form.
This drug should be used during pregnancy only if clearly needed and the benefit outweighs the risk to the fetus. Use is not recommended and a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.
Manifestations of metoclopramide overdosage included drowsiness, disorientation, extrapyramidal reactions, other adverse reactions associated with metoclopramide use (including, e.g., methemoglobinemia), and sometimes death. Neuroleptic malignant syndrome (NMS) has been reported in association with metoclopramide overdose and concomitant treatment with another drug associated with NMS.
Store between 20-25°C. Protect from light.
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