Effectiveness of Metoclopramide: It’s Dosage & Side Effects

Taking higher dosages or intake of metoclopramide for longer periods can result in serious movement disorder which may be irreversible. The disorder symptoms may include uncontrollable muscle movements of your tongue, eyes, lips, arms, legs, or face. You are more probable to develop a serious movement disorder, the more you use metoclopramide. Its side effect risk is higher in diabetics, women and older adults.

How Effective is Metoclopramide?

How Effective is Metoclopramide?

Metoclopramide is a medication used effectively for esophageal and stomach problems.

Metoclopramide augments the contractions of the muscle in the upper digestive tract. This results in effective speeding up of the rate of the stomach emptying into the intestines.

Metoclopramide is used for a short period of time for effective treatment of heartburn which typically occurs because of the gastroesophageal reflux in people who have taken other medicines without any relief of symptoms.

Metoclopramide is also used for effective treatment for slow emptying of gastric in diabetes patients. This condition is also known as diabetic gastroparesis which can cause vomiting, nausea, heartburn, feeling of fullness after meals and loss of appetite.

Important information

Do not take metoclopramide in higher amounts than recommended or for more than 12 weeks.

Intake of this medicine is strictly prohibited in case you are allergic to metoclopramide or if you have blockage or bleeding in your intestines or stomach, a tumor in the adrenal gland (pheochromocytoma) or any other seizure disorder or epilepsy.

It is advisable to inform your doctor in prior to taking metoclopramide if you have any liver or kidney disease, high blood pressure, congestive heart failure, Parkinson’s disease, diabetes or a record of depression.

Drinking alcohol is strictly prohibited as it can increase certain side effects of metoclopramide.

There are numerous other medications which can interact with metoclopramide. Inform your doctor regarding all the medicines you take. This comprises of the vitamin, over-the-counter, herbal products and prescription. It is not good to start up a new medicine without informing your doctor. You need to have a list of all your medications and you need to show it to the healthcare provider who treats you.

Before Taking Metoclopramide

Intake of this medicine is strictly prohibited in case you are allergic to metoclopramide or if you have the following:

  • Blockage or bleeding in your intestines or stomach;
  • A hole or perforation in your intestines or stomach;
  • Any other seizure disorder or epilepsy; or
  • Pheochromocytoma or a tumor in the adrenal gland.

In order to ensure your safety for taking metoclopramide, inform your doctor if you have any of the following conditions:

  • Liver disease, especially cirrhosis;
  • A disorder in the heart rhythm or congestive heart failure;
  • Kidney disease;
  • Breast cancer;
  • Mental illness or depression;
  • Diabetes which requires adjusting of insulin dosage;
  • High blood pressure; or
  • Parkinson’s disease.

It is not expected that FDA pregnancy (category B. Metoclopramide) to harm your unborn child. Inform your doctor in prior if you are planning to become pregnant or if you are pregnant during treatment. There are possibilities of metoclopramide to harm a nursing baby by passing into breast milk. It is strictly prohibited to intake this medicine without informing your doctor when you are breast-feeding your child.

The metoclopramide ODT (orally disintegrating tablet) might contain phenylalanine. Before intaking this form of metoclopramide inform your doctor in case you have PKU (phenylketonuria).

Metoclopramide must not be given to a baby.

How Should I Take Metoclopramide?

You need to take metoclopramide as per your doctor’s prescription accurately. Metoclopramide is typically taken for 4 to 12 weeks only. You need to strictly adhere to the directions in the prescription label.

Long-term usage or higher dosages of metoclopramide can cause serious disorder in movement which is irreversible. These disorder symptoms may include uncontrollable muscle movements of your tongue, lips, arms, legs, face or eyes. You are more probable to develop a severe movement disorder, the longer you use metoclopramide. Its side effects risk is higher in diabetics, older adults and women.

You need to take metoclopramide at least 30 minutes before food. Metoclopramide is typically taken before food and at bedtime. Your doctor might want you to intake the medicine as required only with food which typically causes heartburn. Stick on to the instructions of your doctor.

Measuring the liquid medicine has to be done with a special dosage-measuring cup or spoon and not a regular table spoon. You need to ask your pharmacist for a dosage-measuring device if you don’t have one.

To take metoclopramide ODT (orally disintegrating tablet):

Use Blister Pack: You need to keep the tablet in its blister pack or bottle till you take this medicine. Ensure that your hands are dry before taking a tablet. In case the table melts or breaks down in your hand, you need to throw it away and take a new tablet from the pack.

Do not Swallow Whole Tablet: You have to place the tablet on your tongue and it will start melting instantaneously. Swallowing the tablet as whole is not advisable. The tablet has to melt down in your mouth without being chewed.

Let the Tablet Melt: You need to swallow the melting tablet several times and drinking liquid is not allowed for melting the tablet.

Intake of two different forms of metoclopramide like oral syrup and tablets simultaneously is strictly prohibited. Store it in a place away from heat and moisture at room temperature. When not in use, keep the bottle tightly closed. You are most probable to have unpleasant withdrawal symptoms like dizziness, headache or nervousness after you stop the intake of metoclopramide. You need to consult your doctor regarding how to prevent the withdrawal symptoms when ceasing the intake of this medicine.

What is the Recommended Dosage of Metoclopramide?

Usual Adult Metoclopramide Dosage for Vomiting/ Nausea:

Metoclopramide for postoperative vomiting and nausea:

Parenteral: 10-20 mg IM at or close to the end of surgery.

Usual Adult Metoclopramide Dosage for Gastroesophageal Reflux Disease:

Oral: 10-15 mg up to 4 times per day at least 30 minutes before food and at bedtime depends on the symptoms treated and clinical response. Therapy must not go beyond 12 weeks.

Usual Adult Metoclopramide Dosage for Small Intestine Intubation:

If the tube does not pass the pylorus in 10 minutes with the conventional methods, an undiluted or a single dosage metoclopramide can be administered slowly for 1-2 minutes:

Pediatric patients and adults above or equal to 14 years of age: 10 mg IV as a single dosage is administered for 1-2 minutes.

Usual Adult Metoclopramide Dosage for Radiographic Exam:

Pediatric patients and adults above or equal to 14 years of age: 10 mg IV as a single dosage is administered for 1-2 minutes for facilitating gastric emptying where detained emptying of gastric interferes with radiological examination of the small intestine or stomach.

Usual Adult Metoclopramide Dosage for Gastroparesis:

Oral administration of metoclopramide can be initiated during the initial manifestations of diabetic gastric stasis. In case of severe symptoms, therapy must begin with IV administration or IM for up to 10 days till the symptoms reduce during, which time the patient can be changed over to oral therapy. The therapy must be reintroduced at the initial manifestation since diabetic gastric stasis is often recurring.

Parenteral: 10 mg 4 times every day, IV gradually over a 1-2 minute period or IM for up to 10 days.

Oral: 10 mg 4 times every day, 30 minutes before food and at bedtime for 2-8 weeks depending on clinical response.

Treatment for Vomiting/Nausea — Chemotherapy Induced – Regular adult dosage

IV infusion: 1-2 mg/kg/dosage (mainly depends on the emetogenic potential of the agent) IV (infused in a period of not lesser than 15 minutes) 30 minutes prior to chemotherapy administration. This dosage can be repeated two times at 2 hour intervals following the primary dosage. If the vomiting is still not reduced, the same dosage can be administered 3 more times at an interval of 3 hours.

For metoclopramide dosages greater than 10 mg, the injection must be diluted in 50 ml of parenteral solution. The preferred diluents are normal saline.

In case of occurrence of acute dystonic reactions, 50 mg of diphenhydramine hydrochloride can be injected IM.

Usual Adult Metoclopramide Dosage for Migraine:

FDA has not approved the migraine headaches treatment using metoclopramide though metoclopramide has proved effective in studies at a dosage of 10-20 mg IV once used in combination with ergot derivatives or analgesics.

Usual Pediatric Metoclopramide Dosage for Gastroesophageal Reflux Disease:

Metoclopramide is not approved by the FDA in pediatric patients for the treatment of gastroesophageal reflux disease; however the dosages which have been studied are as follows:

Oral, IM, IV:

Children and Infants: 0.4-0.8 mg/kg/day in 4 divided dosages

Usual Pediatric Metoclopramide Dosage for Small Intestine Intubation:

Metoclopramide IV is approved by the FDA for facilitating small bowel intubation for pediatrics by way of causing gastric emptying where prolonged emptying of gastric interferes with the radiological examination of the small intestine or stomach.

In case the tube has not passed the pylorus in 10 minutes with conventional methods, an undiluted or single dosage may be administered IV gradually for 1-2 minutes:

Less than 6 years of age: 0.1 mg/kg IV as a single dosage.

6-14 years of age: 2.5- 5 mg IV as a single dosage.

Children above 14 years of age: 10 mg of metoclopramide as a single dosage.

Usual Pediatric Metoclopramide Dosage for Nausea/Vomiting — Chemotherapy Induced:

FDA has not approved metoclopramide for the chemotherapy induced vomiting and nausea in pediatric patients however, the following dosages have been studied:
IV:

1-2 mg/kg/dosage IV every 30 minutes in prior to chemotherapy and every 2- 4 hours.

Usual Pediatric Metoclopramide Dosage for Nausea/Vomiting — Postoperative:

FDA has not approved Metoclopramide for postoperative nausea and vomiting in pediatric patients though the following dosages are studied:
IV:

Children lesser than or equal to 14 years: 0.1- 0.2 mg/kg/dosage (maximum dosage: 10 mg/dosage); repeat every 6-8 hours as needed

Children greater than 14 years and Adults: 10 mg; repeat metoclopramide every 6-8 hours as needed

What are the Side Effects of Metoclopramide?

You need to get urgent medical help if you are allergic to metoclopramide or if you have the following symptoms of allergic reaction to metoclopramide namely breathing difficulty, hives, swelling of your lips, face, throat or tongue.

Do not take metoclopramide and contact your doctor immediately in case you have any of these signs or symptoms of a serious movement disorder that might arise within the first two days of treatment:

Shaking in your legs or arms or tremors;

Uncontrolled muscle movements in your face which include lip smacking, chewing, frowning, tongue movement, eye movement or blinking; or

Any unusual or new movements of your muscle you cannot control.

Stop the intake of metoclopramide and contact your doctor immediately in case you have any of the following serious side effects of metoclopramide:

  • Problems in walking or balancing, jerky or slow muscle movements;
  • Mask-like appearance (a face which is more like a mask than a normal face) in your face;
  • Very rigid or stiff muscles, sweating, high fever, confusion, uneven or fast heartbeats, feeling like you might pass out, tremors;
  • Suicidal thoughts or hurting yourself or depression;
  • Anxiety, hallucinations, agitation, trouble staying still, jittery feeling;
  • Swelling, rapid increase in weight, feeling short of breath;
  • Jaundice – yellowing of your eyes or skin; or
  • Seizure or convulsions.

General side effects of metoclopramide may include:

More urinating than normal is also a side effect of metoclopramide;

  • Tenderness of your breast or swelling; or
  • Menstrual periods changes.

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