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Metoclopramide is a gastrointestinal stimulant used to treat nausea, vomiting, heartburn, or prolonged fullness after meals in patients with diabetes. It is also used to treat gastroesophageal reflux and other conditions as determined by your doctor.
Why is Metoclopramide prescribed?
Metoclopramide increases the contractions of the stomach and small intestine, helping the passage of food. It is given to treat the symptoms of diabetic gastroparesis, a condition in which the stomach does not contract. These symptoms include vomiting, nausea, heartburn, feeling of indigestion, persistent fullness after meals, and appetite loss. Metoclopramide is also used, for short periods, to treat heartburn in people with gastroesophageal reflux disorder (backflow of stomach contents into the esophagus). In addition, it is given to prevent nausea and vomiting caused by cancer chemotherapy and surgery.
Most important fact about Metoclopramide
Metoclopramide may cause mild to severe depression. If you have suffered from depression in the past, make sure your doctor is aware of it. Metoclopramide may not be the best drug for you.
How should you take Metoclopramide?
Metoclopramide is usually taken 30 minutes before a meal. If you suffer from heartburn that occurs only intermittently or only at certain times of day, your doctor may want you to schedule your Metoclopramide therapy around those times. You will probably take Metoclopramide for only 4 to 12 weeks. Continuous treatment beyond 12 weeks is not recommended. If you have diabetic "lazy stomach" (gastric stasis) that tends to recur, your doctor may want you to take Metoclopramide at the first sign of a recurrence. --If you miss a dose...Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once. --Storage instructions...
Store at room temperature.
What Metoclopramide side effects may occur?
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Metoclopramide.
More common side effects may include:
Drowsiness, fatigue, restlessness
Less common or rare side effects may include:
Breast development in males, confusion, congestive heart failure, continual discharge of milk from the breasts, depression, diarrhea, dizziness, fluid retention, frequent urination, hallucinations, headache, high or low blood pressure, high fever, hives, impotence, inability to hold urine, insomnia, menstrual irregularities, nausea, rapid or slow heartbeat, rash, rigid muscles, slow movement, swollen tongue or throat, tremor, vision problems, wheezing, yellowed eyes and skin
In addition, Metoclopramide may cause symptoms similar to those of Parkinson's disease, such as slow movements, rigidity, tremor, or a mask-like facial appearance. Especially in older people, Metoclopramide may produce tardive dyskinesia, a syndrome of jerky or writhing involuntary movements, particularly of the tongue, face, mouth, or jaw. In children and adults under 30, Metoclopramide may cause involuntary movements of the arms and legs, and sometimes loud or labored breathing, usually in the first day or two of treatment.
Metoclopramide may cause intense restlessness with associated symptoms such as anxiety, agitation, foot-tapping, pacing, inability to sit still, jitteriness, and insomnia. These symptoms may disappear as your body gets used to Metoclopramide, or if your dosage is reduced.
Why should Metoclopramide not be prescribed?
Do not take Metoclopramide if you are sensitive to it or have ever had an allergic reaction to it. You should not take Metoclopramide if you have a condition such as obstruction, perforation, or hemorrhage of the stomach or small bowel that might be aggravated by increased stomach and small-bowel movement. If you have pheochromocytoma (a nonmalignant tumor that causes hypertension), do not take Metoclopramide; it could trigger a dangerous jump in blood pressure. Do not take Metoclopramide if you have epilepsy; it could increase the frequency and severity of seizures. If you are taking a drug that is likely to cause side effects such as tremors, jerks, grimaces, or writhing movements, do not take Metoclopramide; it could make such symptoms more severe.
Metoclopramide is not recommended for patients under 18 years of age.
Special warnings
If you have Parkinson's disease, you should be given Metoclopramide cautiously or not at all, since the drug may make your Parkinson's symptoms worse. Because Metoclopramide may make you drowsy and impair your coordination, you should not drive, climb, or perform hazardous tasks until you know how the medication affects you.
Use Metoclopramide with caution if you have high blood pressure. Be careful, too, if you have cirrhosis or congestive heart failure. Under these conditions, Metoclopramide may cause fluid retention and heart problems. If this happens during the first few weeks of Metoclopramide therapy, you'll have to stop taking the drug.
Possible food and drug interactions
If Metoclopramide is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Metoclopramide with the following:
Acetaminophen (Tylenol)
Alcoholic beverages
Antispasmodic drugs such as Bentyl and Pro-Banthine
Cimetidine (Tagamet)
Cyclosporine (Sandimmune)
Digoxin (Lanoxin)
Insulin
MAO inhibitor antidepressants such as Nardil and Parnate
Levodopa (Sinemet)
Narcotic painkillers such as Percocet and Demerol
Sleeping pills such as Dalmane, Halcion, and Restoril
Tetracycline (Sumycin, others)
Tranquilizers such as Valium and Xanax
If you take insulin for diabetes, your insulin dosage or dosing schedule may have to be adjusted while you are taking Metoclopramide.
Special Metoclopramide information if you are pregnant or breastfeeding
The effects of Metoclopramide during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Metoclopramide should be used during pregnancy only if it is clearly needed. Metoclopramide appears in breast milk. Your doctor may recommend that you discontinue Metoclopramide while you are breastfeeding your baby.
Recommended dosage
ADULTS Symptoms of Gastroesophageal Reflux
The usual dose is 10 milligrams to 15 milligrams of Metoclopramide, up to 4 times a day, 30 minutes before each meal and at bedtime, depending upon the symptoms being treated and the effectiveness of the dose. Treatment usually lasts no longer than 12 weeks. If symptoms occur only intermittently or at specific times of the day, your doctor may give you a single dose of up to 20 milligrams as a preventive measure. Symptoms Associated with Diabetic Gastroparesis or Gastric Stasis The usual dose is 10 milligrams 30 minutes before each meal and at bedtime for 2 to 8 weeks.
OLDER ADULTS Relief of Symptomatic Gastroesophageal Reflux
Older adults may need only 5 milligrams per dose.
Overdosage
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.
Symptoms of Metoclopramide overdose may include:
Disorientation, drowsiness, involuntary movements
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