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Common uses
Metoclopramide increases muscle contractions in upper digestive tract. This speeds up the rate at which the stomach empties into the intestines.
Metoclopramide is used short-term to treat heartburn caused by gastroesophageal reflux in people who have used other medications without relief of symptoms.
Metoclopramide is also used to treat slow gastric emptying in people with diabetes (also called diabetic gastroparesis), which can cause nausea, vomiting, heartburn, loss of appetite, and a feeling of fullness after meals.
Metoclopramide may also be used for other purposes not listed in this medication guide.
Before using
You should not take Metoclopramide if you are allergic to metoclopramide, or if you have:
• bleeding or blockage in your stomach or intestines;
• a perforation (hole) in your stomach or intestines;
• epilepsy or other seizure disorder; or
• an adrenal gland tumor (pheochromocytoma).
Before taking Metoclopramide, tell your doctor if you have
• kidney disease;
• liver disease (especially cirrhosis);
• congestive heart failure;
• diabetes (your insulin dose may need adjusting); or
• a history of depression.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take Metoclopramide.
FDA pregnancy category B. Metoclopramide is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Metoclopramide can pass into breast milk and may harm a nursing baby. Do not use Metoclopramide without telling your doctor if you are breast-feeding a baby.
Directions
Take Metoclopramide exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.
Take this medicine with a full glass of water.
Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
The oral concentrate form of Metoclopramide must be mixed with another liquid, such as water, fruit juice, soda, or a soft food like applesauce or pudding. Carefully follow mixing directions to make sure you get the correct dose.
Metoclopramide is usually taken before meals and at bedtime. Your doctor may want you to take the medication as needed only with meals that usually cause heartburn. Follow your doctor's instructions.
Store Metoclopramide at room temperature away from moisture and heat.
Cautions
Mental depression has occurred in patients with and without prior history of depression. Symptoms have ranged from mild to severe and have included suicidal ideation and suicide. Metoclopramide should be given to patients with a prior history of depression only if the expected benefits outweigh the potential risks.
Extrapyramidal symptoms, manifested primarily as acute dystonic reactions, occur in approximately 1 in 500 patients treated with the usual adult dosages of 30 to 40 mg/day of metoclopramide. These usually are seen during the first 24 to 48 hours of treatment with metoclopramide, occur more frequently in pediatric patients and adult patients less than 30 years of age and are even more frequent at higher doses. These symptoms may include involuntary movements of limbs and facial grimacing, torticollis, oculogyric crisis, rhythmic protrusion of tongue, bulbar type of speech, trismus, or dystonic reactions resembling tetanus. Rarely, dystonic reactions may present as stridor and dyspnea, possibly due to laryngospasm. If these symptoms should occur, inject 50 mg diphenhydramine hydrochloride intramuscularly, and they usually will subside. Benztropine mesylate, 1 to 2 mg intramuscularly, may also be used to reverse these reactions.
Possible side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Metoclopramide and call your doctor at once if you have any of these serious side effects:
• tremors, or restless muscle movements in your eyes, tongue, jaw, or neck;
• mask-like appearance of the face;
• fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing;
• depressed mood, thoughts of suicide or hurting yourself;
• hallucinations, anxiety, agitation, jittery feeling, trouble staying still;
• swelling, fluid retention;
• jaundice (yellowing of your skin or eyes); or
• seizure (convulsions).
Less serious side effects may include:
• feeling restless, drowsy, tired, or dizzy;
• headache, sleep problems (insomnia);
• nausea, diarrhea;
• breast tenderness or swelling;
• changes in your menstrual periods; or
• urinating more than usual.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.
After you stop taking Metoclopramide, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
If you take too much
Symptoms of overdosage may include drowsiness, disorientation and extrapyramidal reactions. Anticholinergic or antiparkinson drugs or antihistamines with anticholinergic properties may be helpful in controlling the extrapyramidal reactions. Symptoms are self-limiting and usually disappear within 24 hours.
Hemodialysis removes relatively little metoclopramide, probably because of the small amount of the drug in blood relative to tissues. Similarly, continuous ambulatory peritoneal dialysis does not remove significant amounts of drug. It is unlikely that dosage would need to be adjusted to compensate for losses through dialysis. Dialysis is not likely to be an effective method of drug removal in overdose situations.
Unintentional overdose due to misadministration has been reported in infants and children with the use of metoclopramide oral solution. While there was no consistent pattern to the reports associated with these overdoses, events included seizures, extrapyramidal reactions, and lethargy.
Additional information
You should not take Metoclopramide if you are allergic to metoclopramide, or if you have bleeding or blockage in your stomach or intestines, epilepsy or other seizure disorder, or an adrenal gland tumor (pheochromocytoma).
Before taking Metoclopramide, tell your doctor if you have kidney or liver disease, congestive heart failure, diabetes, or a history of depression.
Drug interactions
Before taking Metoclopramide, tell your doctor if you are taking any of the following medicines:
• acetaminophen (Tylenol);
• cyclosporine (Gengraf, Neoral, Sandimmune);
• digoxin (digitalis, Lanoxin);
• glycopyrrolate (Robinul);
• levodopa (Larodopa, Atamet, Parcopa, Sinemet);
• mepenzolate (Cantil);
• tetracycline (Brodspec, Panmycin, Robitet, Sumycin, Tetracap, and others);
• atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
• bladder or urinary medications such as darifenacin (Enablex), tolterodine (Detrol), or solifenacin (Vesicare);
• bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);
• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), or propantheline (Pro-Banthine); or
• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
This list is not complete and there may be other drugs that can interact with Metoclopramide. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
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Metoclopramide
