WARNING

While metoclopramide can be effective for certain gastrointestinal conditions, it is associated with some risks and potential side effects. It’s important to be aware of these risks and discuss them with your healthcare provider before starting metoclopramide. Some of the risks include:

• Tardive Dyskinesia: This is a serious and potentially irreversible movement disorder characterized by involuntary movements, especially of the face. Long-term use of metoclopramide, especially in older adults, has been linked to an increased risk of tardive dyskinesia.
• Extrapyramidal Symptoms (EPS): These are neurological side effects that can include involuntary movements, tremors, and muscle stiffness. EPS is more common with higher doses and long-term use of metoclopramide.
• Neurological Effects: Metoclopramide can cross the blood-brain barrier, potentially causing neurological side effects such as restlessness, drowsiness, dizziness, and confusion.
• Interaction with Other Medications: Metoclopramide may interact with other medications, including those affecting the central nervous system. It’s important to inform your healthcare provider about all the medications you are taking to avoid potential interactions.
• Gastrointestinal Issues: While metoclopramide is used to treat gastrointestinal issues, it may also cause diarrhea as a side effect in some individuals.
• Cardiovascular Effects: Metoclopramide may prolong the QT interval in the heart’s electrical activity, potentially leading to serious irregular heart rhythms.
• Contraindications: Metoclopramide is contraindicated in certain situations, such as a history of seizures, pheochromocytoma (a rare tumor of the adrenal glands), and gastrointestinal bleeding.

It’s crucial to use metoclopramide under the guidance of a healthcare professional, and they will carefully weigh the potential benefits against the risks for your specific situation. If you experience any unusual or severe side effects while taking metoclopramide, it’s important to contact your healthcare provider promptly.

This information is a brief overview, and it does not replace the need for a thorough discussion with a healthcare professional about the risks and benefits of metoclopramide in your individual case.

Why is this medication prescribed?

Metoclopramide is prescribed for various gastrointestinal conditions, and its use depends on the specific condition being treated. Here are common guidelines for how metoclopramide is used:

• Gastroesophageal Reflux Disease (GERD): Typically, the recommended adult dose is 10 to 15 milligrams (mg) taken 30 minutes before meals and at bedtime. The duration of treatment is usually short-term, ranging from 4 to 12 weeks.
• Nausea and Vomiting: The dosage for nausea and vomiting can vary. It may be administered as a single dose or divided into smaller doses. The usual adult dose is 10 to 20 mg, up to four times a day.
• Diabetic Gastroparesis: The usual adult dose is 10 mg taken 30 minutes before each meal and at bedtime. Treatment duration is determined by the healthcare provider and the specific needs of the patient.
• Functional Gastrointestinal Disorders: The dosage may vary depending on the specific functional disorder being treated. Consultation with a healthcare professional is necessary to determine the appropriate dosage.
• Migraine Headaches: Metoclopramide may be used at the onset of a migraine or to enhance the absorption of other migraine medications. The usual adult dose is 10 mg, repeated after 30 minutes if necessary, up to a maximum of 30 mg in 24 hours.

How should this medicine be used?

The use of metoclopramide depends on the specific condition being treated, and it’s crucial to follow the instructions provided by your healthcare provider. Here are general guidelines for the use of metoclopramide:

• Dosage: The recommended dosage can vary based on the specific condition being treated. It’s important to take the prescribed amount and not exceed the recommended dose.
• Administration: Metoclopramide is typically taken orally, either in tablet or liquid form. It can be taken with or without food, but taking it before meals may enhance its effectiveness in treating certain gastrointestinal conditions.
• Frequency: The frequency of dosing depends on the condition. For example, in the treatment of GERD, it may be taken 30 minutes before meals and at bedtime. For diabetic gastroparesis, it may be taken before each meal and at bedtime.
• Duration of Treatment: The duration of treatment with metoclopramide varies based on the condition being addressed. It is often prescribed for short-term use, and the duration will be determined by your healthcare provider.
• Missed Dose: If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses to make up for a missed one.
• Follow-up Appointments: Attend all scheduled follow-up appointments with your healthcare provider to monitor your response to the medication and address any concerns or side effects.
• Interaction with Other Medications: Inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medications, and supplements, as metoclopramide may interact with certain medications.
• Special Precautions: Follow any special precautions or considerations provided by your healthcare provider, especially if you have a history of seizures, are pregnant, or have other underlying health conditions.

Always communicate openly with your healthcare provider about your symptoms, any changes in your health, and any side effects you may be experiencing. If you have questions about how to use metoclopramide or concerns about its effects, discuss them with your healthcare provider. This information is a general guide, and individual circumstances may require specific adjustments to the recommended use of metoclopramide.

Other uses for this medicine

In addition to its primary uses for gastrointestinal issues, metoclopramide may have some other off-label uses, though these uses are less common and should be prescribed by a healthcare professional. For example, it might be used to promote milk production in breastfeeding women or to manage symptoms of certain movement disorders.

What special precautions should I follow?

Here are some special precautions and considerations to keep in mind when taking metoclopramide:

• Pregnancy and Breastfeeding: Pregnant women should use metoclopramide only if clearly needed and under the guidance of a healthcare provider. Metoclopramide may pass into breast milk, and breastfeeding mothers should discuss the risks and benefits with their healthcare provider.
• Neurological and Psychiatric Effects: Metoclopramide can cause neurological and psychiatric effects, including drowsiness, dizziness, restlessness, and rarely, extrapyramidal symptoms. Individuals with a history of seizures or other neurological disorders should use metoclopramide with caution.
• Elderly Population: Elderly individuals may be more sensitive to the side effects of metoclopramide, including the risk of tardive dyskinesia. Lower doses and careful monitoring may be necessary.
• Liver and Kidney Function: Individuals with impaired liver or kidney function may require dose adjustments. It’s important to inform your healthcare provider about any pre-existing liver or kidney conditions.
• Interaction with Other Medications: Metoclopramide may interact with certain medications, including those that affect the central nervous system or drugs that prolong the QT interval. Inform your healthcare provider about all the medications you are taking.
• Contraindications: Metoclopramide is contraindicated in individuals with a history of hypersensitivity to the drug, gastrointestinal bleeding, mechanical obstruction or perforation, and pheochromocytoma.
• Cardiovascular Issues: Individuals with a history of heart rhythm disorders or other cardiovascular issues may require close monitoring, as metoclopramide may prolong the QT interval.
• Diabetes: Metoclopramide may affect blood sugar levels, and individuals with diabetes should monitor their blood glucose levels closely.

It’s essential to follow your healthcare provider’s instructions carefully, report any side effects promptly, and attend follow-up appointments to monitor your response to the medication. Always inform your healthcare provider about your medical history, current medications, and any changes in your health status.

What special dietary instructions should I follow?

Metoclopramide can be taken with or without food. However, taking it before meals may enhance its effectiveness, especially in the treatment of certain gastrointestinal conditions.

What should I do if I forget a dose?

• If you forget to take a dose of metoclopramide, take it as soon as you remember.
• If it’s almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
• Do not double up on doses to make up for a missed one.

What side effects can this medication cause?

Metoclopramide, like any medication, can cause side effects. It’s important to note that not everyone will experience these side effects, and the severity can vary from person to person. Common side effects may include:

• Extrapyramidal Symptoms (EPS): These are neurological side effects that can include involuntary movements, tremors, and muscle stiffness. EPS is more common with higher doses and long-term use.
• Tardive Dyskinesia: This is a serious and potentially irreversible movement disorder characterized by involuntary movements, especially of the face. Long-term use, especially in older adults, has been associated with an increased risk of tardive dyskinesia.
• Neurological and Psychiatric Effects: Restlessness, drowsiness, dizziness, and confusion are possible neurological and psychiatric side effects.
• Gastrointestinal Issues: Diarrhea is a possible side effect of metoclopramide.
• Cardiovascular Effects: Metoclopramide may prolong the QT interval in the heart’s electrical activity, potentially leading to serious irregular heart rhythms.
• Allergic Reactions: While rare, allergic reactions such as rash, itching, swelling, severe dizziness, or difficulty breathing may occur.
• Endocrine Effects: Metoclopramide may affect prolactin levels, leading to menstrual irregularities and breast enlargement or discharge in some individuals.
• Other: Other potential side effects may include headache, fatigue, and changes in blood pressure.

It’s important to seek medical attention if you experience severe or persistent side effects. Additionally, let your healthcare provider know about any pre-existing conditions, allergies, or medications you are taking, as metoclopramide may interact with other drugs.

People at higher risk for certain side effects include the elderly, those with a history of seizures, and individuals with pre-existing neurological conditions. Always follow your healthcare provider’s instructions, attend follow-up appointments, and communicate openly about any concerns or side effects you may be experiencing. This list is not exhaustive, and individual responses to medications can vary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Metoclopramide:

• Storage:
  • Store metoclopramide at room temperature, away from moisture and heat.
  • Keep the medication in its original packaging and out of reach of children.
• Disposal:
  • Dispose of unused or expired metoclopramide as instructed by your healthcare provider or pharmacist.
  • Do not flush medications down the toilet unless instructed to do so. Check with your local pharmacy or municipality for proper disposal guidelines.

In case of emergency/overdose

• If you suspect an overdose or experience severe symptoms, seek emergency medical attention immediately.
• Symptoms of overdose may include confusion, seizures, uncontrollable movements, severe drowsiness, and difficulty breathing.

What other information should I know?

• Follow Healthcare Provider’s Instructions: Take metoclopramide exactly as prescribed by your healthcare provider. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
• Regular Monitoring: Attend all scheduled follow-up appointments to monitor your response to the medication and discuss any concerns.
• Avoid Alcohol: Limit or avoid alcohol consumption while taking metoclopramide, as alcohol can enhance certain side effects.
• Driving and Machinery: Be cautious when driving or operating machinery, as metoclopramide may cause drowsiness or dizziness.
• Inform Healthcare Provider: Notify your healthcare provider of any side effects or changes in health status promptly.
• Allergies: Inform your healthcare provider of any known allergies to medications.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits with your healthcare provider.
• Medical Alert Bracelet: If you have a history of seizures or other serious medical conditions, consider wearing a medical alert bracelet to inform emergency medical personnel.

Always consult with your healthcare provider or pharmacist if you have specific questions about storage, disposal, or any other aspects of your medication. This information is a general guide and may not cover all individual circumstances.