Metoclopramide

Brand names of metoclopramide

• Apo-Metoclop
• Clopra
• Emex
• Gastrobid
• Maxeran
• Maxolon
• Nu-Metoclopramide
• Octamide
• PMS-Metoclopramide
• Reclomide
• Reglan

Usage

To prevent nausea and vomiting caused by anticancer medicines or to treat impaired emptying of food from the stomach (gastroparesis) as a complication of diabetes. Also used as a short-term treatment for heartburn (gastroesophageal reflux, a backflow of stomach acid into the esophagus).

How it works

Metoclopramide increases the contractions or movements of the stomach and small intestine. It decreases nausea by blocking the effect of the chemical dopamine in the vomiting center of the brain.

Side effects

Serious:

• crawling sensation in lower legs
• difficulty swallowing or speaking
• difficulty walking
• dizziness
• fainting
• fatigue
• irregular heartbeat
• irritability
• lip puckering or smacking
• loss of balance
• muscle spasms
• panic attacks
• restlessness
• severe headache
• shaking of fingers and hands
• uncontrolled chewing movements
• uncontrolled movements or stiffness of legs or arms
• unusual nervousness
• unusual tongue movements

Common:

• diarrhea
• drowsiness
• restlessness

Less common:

• breast swelling and tenderness
• constipation
• depression
• dryness of mouth
• increased flow of breast milk
• insomnia
• menstrual changes
• nausea
• skin rash

Possible interactions

Other medicaments:

Metoclopramide may decrease the effects of:

• cimetidine (Tagamet).
• digoxin (slow-dissolving dose forms) and reduce its effectiveness.

Metoclopramide taken concurrently with:

• acetaminophen may increase the absorption of this medicament; decreased doses are prudent if chronic acetaminophen use will continue with metoclopramide therapy.
• major antipsychotic medicaments (phenothiazines, thiothixenes, haloperidol, etc.) may increase the risk of developing Parkinson-like reactions.
• cyclosporine (Sandimmune) may result in increased cyclosporine levels and toxicity.
• morphine (slow release) may result in faster onset and increased sedation.
• penicillin may result in decreased therapeutic benefits of the antibiotic; increased doses may be needed.
• quinidine (Quinaglute, others) may result in decreased therapeutic benefits from quinidine; increased blood level testing and adjustment of dosing to levels is indicated.
• serolimus (Rapamune) or tacrolimus (Prograf) may result in toxicity.
• sertraline (Zoloft) may increase risk of movement disorders.
• zalcitabine (Hivid) may blunt zalcitabine levels and benefits.

The following medicaments may decrease the effects of metoclopramide:

• atropinelike medicaments.
• opioid analgesics.
• ritonavir (Norvir).

Herbal medicines or minerals:

Valerian and kava kava may intensify drowsiness. Aloe, cascara and senna may increase possibility of diarrhea. Using chromium may change the way your body is able to use sugar. Some health food stores advocate vanadium as mimicking the actions of insulin, but possible toxicity and need for rigorous studies presently preclude recommending it. DHEA may change sensitivity to insulin or insulin resistance. Hawthorn, ginger, garlic, ginseng and licorice, nettle and yohimbe may change blood sugar. Since this may require adjustment of hypoglycemic medicine dosing, talk to your doctor before combining any of these herbal medicines with metoclopramide. Echinacea pupurea (injectable) and blonde psyllium seed or husk should not be taken by people living with diabetes.

Alcohol:

Combined effects can result in excessive sedation and marked intoxication. Alcohol is best avoided.

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