METOCLOPRAMIDE (Systemic)
Some commonly used brand names are:
In the U.S.?
In Canada?
- Apo-Metoclop
- Metoclopramide omega
- Nu-Metoclopramide
- PMS-Metoclopramide
Generic name product may be available in the U.S.
Category
- Dopaminergic blocking agent
- Gastrointestinal emptying (delayed) adjunct
- Peristalticstimulant
- Antiemetic
Description
Metoclopramide (met-oh-kloe-PRA-mide) is a medicinethat increases the movements or contractions of the stomach and intestines.When given by injection, it is used to help diagnose certain problems of thestomach and/or intestines. It is also used by injection to prevent the nauseaand vomiting that may occur after treatment with anticancer medicines. Anothermedicine may be used with metoclopramide to prevent side effects that mayoccur when metoclopramide is used with anticancer medicines.
When taken by mouth, metoclopramide is used to treat the symptoms of acertain type of stomach problem called diabetic gastroparesis. It relievessymptoms such as nausea, vomiting, continued feeling of fullness after meals,and loss of appetite. Metoclopramide is also used, for a short time, to treatsymptoms such as heartburn in patients who suffer esophageal injury from abackward flow of gastric acid into the esophagus.
Metoclopramide may also be used for other conditions as determined by yourdoctor.
Metoclopramide is available only with your doctor's prescription. It isavailable in the following dosage forms:
Oral- Tablets (U.S. and Canada)
- Oral Concentrate (U.S.)
- Oral Solution (U.S. and Canada)
Parenteral- Injection (U.S. and Canada)
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For metoclopramide,the following should be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to metoclopramide, procaine, or procainamide. Also tellyour health care professional if you are allergic to any other substances,such as foods, preservatives, or dyes.
Pregnancy?Not enough studies have been done in humans to determinemetoclopramide's safety during pregnancy. However, metoclopramide has notbeen shown to cause birth defects or other problems in animal studies.
Breast-feeding?Metoclopramide passes into the breast milk andmay cause unwanted effects in nursing babies. Be sure you have discussed therisks and benefits of the medicine with your doctor.
Children?Muscle spasms, especially of jaw, neck, and back,and tic-like (jerky) movements of head and face may be especially likely tooccur in children, who are usually more sensitive than adults to the effectsof metoclopramide. Premature and full-term infants may develop blood problemsif given high doses of metoclopramide.
Older adults?Shuffling walk and trembling and shaking of handsmay be especially likely to occur in elderly patients after they have takenmetoclopramide over a long time.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingmetoclopramide, it is especially important that your health care professionalknow if you are taking the following:
- Central nervous system (CNS) depressants (medicine that causes drowsiness)?Usewith metoclopramide may cause severe drowsiness
Other medical problems?The presence of other medicalproblems may affect the use of metoclopramide. Make sure you tell your doctorif 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)?Metoclopramidemay make these conditions worse
- Epilepsy?Metoclopramide may increase the risk of having a seizure
- Kidney disease (severe)?Higher blood levels of metoclopramidemay result, possibly increasing the chance of side effects
- Nicotinamide adenine dinucleotide (NADH) methemoglobin reductasedeficiency?Metoclopramide may increase your chance of side effects affectingthe blood.
Proper Use of This Medicine
Take this medicine 30 minutes before meals and at bedtime, unless otherwisedirected by your doctor.
Take metoclopramide only as directed. Do nottake more of it, do not take it more often, and do not take it for a longertime than your doctor ordered. To do so may increase the chance of side effects.
To take metoclopramide oral concentrate: Thismedicine should be mixed with another liquid, such as water, juices, sodaor soda-like beverages, or with a semi-solid food, such as applesauce or pudding.
Dosing?The dose of metoclopramide will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of metoclopramide. If your dose isdifferent, do not change it unless your doctor tells you to do so.
The number of tablets or teaspoonfuls of solution that you take dependson the strength of the medicine. Also, the number ofdoses you take each day, the time allowed between doses, and the length oftime you take the medicine depend on the medical problem for which you aretaking metoclopramide.
- 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 beforesymptoms are likely to begin or before each meal and at bedtime. The dosemay be taken up to four times a day. However, most people usually will nottake 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 symptomsare likely to begin or before each meal and at bedtime. The dose may be takenup to four times a day. However, most people usually will not take more than500 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 determinedby 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 aftersixty minutes if needed.
- To prevent nausea and vomiting caused by anticancer medicines:
- Adults and teenagers?Dose is based on body weight and mustbe determined by your doctor. The usual dose is 1 to 2 mg per kg (0.45 to0.9 mg per pound) of body weight, injected slowly into a vein, thirty minutesbefore you take your anticancer medicine. Your doctor may repeat this doseevery two or three hours if needed. Some people may need a larger dose tostart.
- Children?1 mg per kg (0.45 mg per pound) of body weight injectedinto 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 nearthe end of surgery.
- Children?Dose must be determined by your doctor.
Missed dose?If you miss a dose of this medicine, take it assoon as possible. However, if it is almost time for your next dose, skip themissed dose and go back to your regular dosing schedule. Do not double doses.
Storage?To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct light.
- Do not store the tablet form of this medicine in the bathroom, nearthe kitchen sink, or in other damp places. Heat or moisture may cause themedicine to break down.
- Keep the concentrate and solution forms of this medicine from freezing.
- Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
Thismedicine will add to the effects of alcohol and other CNS depressants (medicinesthat cause drowsiness). Some examples of CNS depressants are antihistaminesor 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 dentalanesthetics. Check with your doctor before taking anyof 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 knowhow you react to this medicine before you drive, use machines, or do anythingelse that could be dangerous if you are dizzy or are not alert.
Side Effects of This Medicine
Along with its needed effects,a medicine may cause some unwanted effects. Although not all of these sideeffects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possibleif 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 orswallowing; dizziness or fainting; fast or irregular heartbeat; fever; general feeling of tiredness or weakness; headache (severe or continuing); inability to moveeyes; increase in blood pressure; increased sweating; itching; lip smacking or puckering; loss of appetite; loss of balance control; loss of bladdercontrol; mask-like face; muscle spasms of face, neck, and back; nausea andvomiting; puffing of cheeks; rapid or worm-like movements of tongue; shufflingwalk; skin rash; sore throat; stiffness of arms or legs; swelling of feet or lower legs; trembling and shakingof hands and fingers; tic-like or twitching movements; twisting movements of body; uncontrolled chewing movements; uncontrolled movementsof arms and legs; unusually pale skin; weakness of arms and legs; yellow eyesor skin
With high doses?may occur within minutes of receivinga dose of metoclopramide and last for 2 to 24 hours
Aching or discomfort in lower legs; panic-like sensation; sensation of crawling in legs; unusual nervousness, restlessness, or irritability
Symptoms of overdose?may also occur rarely with usualdoses, especially in children and young adults, and with high doses used totreat the nausea and vomiting caused by anticancer medicines
Other side effects may occur that usually donot need medical attention. These side effects may go away during treatmentas your body adjusts to the medicine. However, check with your doctor if anyof the following side effects continue or are bothersome:
Less common or rare
Breast tenderness and swelling; changesin menstruation; constipation; decreased interest in sexual intercourse; inabilityto have or keep an erection; increased flow of breastmilk; increased need to urinate; loss in sexual ability, desire, drive, or performance; mental depression; nausea; passing urine more often; skin rash; trouble in sleeping; unusual drynessof mouth; unusual irritability
Other side effects not listed above may also occur insome patients. If you notice any other effects, check with your doctor.
Additional Information
Once a medicine has been approvedfor marketing for a certain use, experience may show that it is also usefulfor other medical problems. Although these uses are not included in productlabeling, metoclopramide is used in certain patients with the following medicalconditions:
- 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
Other than the above information, there is no additional information relatingto proper use, precautions, or side effects for these uses.
Revised: 04/02/2004
