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Metoclopramide: Uses, dosage, side and effects

by Alivia Nyhan
Published: Last Updated on

Vomiting is a common and annoying symptom as a result of a gastrointestinal condition, either from a dietary problem or as a side effect of a medication. The good news is that there are drugs, called antiemetics, that can improve these symptoms. One of the main ones is metoclopramide, a drug used worldwide since 1982, but only under medical prescription due to the side effects that can occur after its administration.

In this FastlyHealarticle, we explain what metoclopramide is for, its dosages, side effects, and contraindications.

Metoclopramide: what it is for and presentations

Metoclopramide is a drug belonging to the group of antiemetics and stimulates intestinal motility. This drug has a benzamidic structure that binds to dopamine and serotonin receptors, exerting its antagonistic (blocking) action on them, triggering an action similar to serotonin.

It acts at two levels, the first one at the brain level , blocking the response of the activation of the vomiting center to the manifestation of stimuli produced by irritating substances in the stomach or blood. The second level where it acts is directly in the gastrointestinal system , stimulating motility or movements of both the stomach and the intestine (as serotonin exerts its action).

In this sense, metoclopramide serves to:

  • Prevent and treat nausea and vomiting of gastrointestinal origin or due to adverse effects of medications.
  • Treat postoperative vomiting.
  • Treat nausea and vomiting caused by cancer treatment.
  • Diagnostic procedures, so that intestinal mobility is accelerated.
  • Treat hiccups.
  • Gastroesophageal reflux therapy , used short-term in case previous treatment has not worked.

The available presentations of metoclopramide are:

  1. 10 mg tablets.
  2. Syrup 5mg / 5ml.
  3. 10mg / 2ml and 100mg / 20ml ampoules.

Metoclopramida: dosis

Under indication and medical supervision, the recommended doses of metoclopramide are:

  • In case of short-term gastroesophageal reflux 10-15 mg orally 4 times a day before meals for 4 weeks or until directed by the doctor.
  • As a treatment for hiccups, metoclopramide is used 10–0 mg orally, intramuscularly, or intravenously 4 times a day for 7 days.
  • In the case of treatment for emesis induced by drugs used in anticancer treatment, the ideal dose is 2 mg / Kg of body weight intravenously 30 minutes before starting chemotherapy and then every 3 hours depending on the patient’s response and under medical surveillance.
  • For the symptomatic relief of nausea or vomiting, treatment is recommended for a maximum of 5 days in adults with a dose of 10 mg 3 times a day.
  • In children the treatment is: 0.1 to 0.15 mg / kg of body weight 3 times a day maximum 0.5 mg / kg of body weight in 24 hours.
  • In children 6–14 years old, the recommended dose is 2.5–5 mg.

Metoclopramide is indicated only in children older than 1 year.

Metoclopramide: side effects

Metoclopramide is a drug that has various side effects, hence the importance of being administered under medical supervision.

Among those that are included as side effects , are:

  • Drowsiness, fatigue and restlessness in most cases.
  • Diarrhea.
  • Shaking chills.
  • Difficulty speaking
  • Dizziness
  • Tachycardia.
  • Fever.
  • Intense headache.

Other side effects are also associated such as:

  • Acute dystonic reactions: a movement disorder in which involuntary muscle contractions occur, such as twisting and repetitive movements.
  • Parkinsonian symptoms: slow movement, inflexibility in one limb, tremor at rest and postural instability.
  • Methemoglobinemia: the skin and mucous membranes tend to be bluish in color.
  • Akathisia: restlessness that is accompanied by the need to move, the movements are of variable complexity.

In a study conducted on the efficacy and adverse effects of intravenous metoclopramide in the treatment of migraine attacks [1] , it was shown that metoclopramide is certainly an effective treatment in migraine attacks, but it very frequently produces adverse effects such as concern. , drowsiness, insomnia and dizziness. This result was the case in 92.1% of the patients studied.

Metoclopramide: contraindications

On the other hand, metoclopramide is contraindicated in:

  1. Children under 1 year.
  2. People with hypersensitivity to metoclopramide.
  3. Lactation period.
  4. In case of gastrointestinal bleeding.
  5. In conjunction with the use of other drugs such as phenothiazines, which can cause extrapyramidal reactions.
  6. Patients with epilepsy.
  7. Gastrointestinal perforation.
  8. Pheochromocytoma.

Metoclopramide drug interactions

Metoclopramide can interact with other medications and impair their action, this happens for example with:

  1. Levodopa : both are antagonists.
  2. Anticholinergics and morphine derivatives: these have the opposite effect to that of metoclopramide on gastrointestinal motility.
  3. Neuroleptics: in conjunction with metoclopramide, its effect can be enhanced and there is a greater risk of adverse effects, such as extra-pyramidal alterations.

On the other hand, metoclopramide can interfere with the action of drugs such as:

  1. Digoxin : decreasing its blood concentration.
  2. Cimetidine : decreasing its action after being administered with metoclopramide. Cimetidine should be administered 2 hours before metoclopramide.
  3. Fluoxetine and sertraline: Metoclopramide in conjunction with these medications increases the risk of extrapyramidal symptoms.

Metoclopramide is a drug of delicate administration, that is why it is sold under medical prescription. The adverse effects and contraindications are varied, so it is essential not to self-medicate.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Metoclopramide: what it is for, dosage, side effects and contraindications , we recommend that you enter our Medication and medical tests category .

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