Generic Name: metoclopramide

What is metoclopramide?
Metoclopramide increases muscle contractions in upper digestive tract. This speeds up the rate at which the stomach empties into the intestines. Metoclopramide is used short-term to treat heartburn caused by gastroesophageal reflux in people who have used other medications without relief of symptoms. Metoclopramide is also used to treat slow gastric emptying in people with diabetes (also called diabetic gastroparesis), which can cause nausea, vomiting, heartburn, loss of appetite, and a feeling of fullness after meals.

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What is the price of this medication and similar alternatives?

Pricing information provided by drugstore.com.

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What are the possible side effects of metoclopramide?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using metoclopramide and call your doctor at once if you have any of these serious side effects:

• tremors, or restless muscle movements in your eyes, tongue, jaw, or neck;

• mask-like appearance of the face;

• fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing;

• depressed mood, thoughts of suicide or hurting yourself;

• hallucinations, anxiety, agitation, jittery feeling, trouble staying still;

• swelling, fluid retention;

• jaundice (yellowing of your skin or eyes); or

• seizure (convulsions).

Less serious side effects may include:

• feeling restless, drowsy, tired, or dizzy;

• headache, sleep problems (insomnia);

• nausea, diarrhea;

• breast tenderness or swelling;

• changes in your menstrual periods; or

• urinating more than usual.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

After you stop taking metoclopramide, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

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How should I take metoclopramide?
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label. Take this medicine with a full glass of water. Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. The oral concentrate form of metoclopramide must be mixed with another liquid, such as water, fruit juice, soda, or a soft food like applesauce or pudding. Carefully follow mixing directions to make sure you get the correct dose.

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What is the most important information I should know about metoclopramide?
You should not take this medication if you are allergic to metoclopramide, or if you have bleeding or blockage in your stomach or intestines, epilepsy or other seizure disorder, or an adrenal gland tumor (pheochromocytoma). Before taking metoclopramide, tell your doctor if you have kidney or liver disease, congestive heart failure, diabetes, or a history of depression. Avoid drinking alcohol. It can increase some of the side effects of metoclopramide. There are many other medicines that can interact with metoclopramide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

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What other drugs will affect metoclopramide?
Before taking metoclopramide, tell your doctor if you are taking any of the following medicines: acetaminophen (Tylenol); cyclosporine (Gengraf, Neoral, Sandimmune); digoxin (digitalis, Lanoxin); glycopyrrolate (Robinul); levodopa (Larodopa, Atamet, Parcopa, Sinemet); mepenzolate (Cantil); tetracycline (Brodspec, Panmycin, Robitet, Sumycin, Tetracap, and others); atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Metoclopramide has been assigned to pregnancy category B by the FDA. Animal studies have failed to reveal evidence of fetal harm. There are no controlled data in human pregnancy. However, metoclopramide has been used during pregnancy for its antiemetic and gastric prokinetic effects. Metoclopramide is only recommended for use during pregnancy when benefit outweighs risk.

Metoclopramide rapidly crosses the placenta near term. Fetal plasma concentrations are approximately 60% to 70% of maternal serum concentrations. While administration of metoclopramide at term is associated with significant increases in maternal serum prolactin levels, no changes were noted in cord arterial or venous plasma prolactin levels. In addition, metoclopramide does not affect maternal plasma TSH or estradiol levels. A case of acute porphyria in a female patient treated for hyperemesis gravidarum with metoclopramide in the 10th, 12th, and 18th week of pregnancy is reported in the literature. A normal infant was delivered at term. Data on the safety and efficacy of metoclopramide during pregnancy are primarily limited to the last trimester. More data are needed to evaluate safety in the first and second trimesters. Until then, the use of metoclopramide should typically be limited to the management of severe nausea and vomiting in the last trimester and to decrease gastric emptying time in the prevention of Mendelson's syndrome during labor and delivery. Data collected by five teratogenic information centers on women (n=126) that had taken metoclopramide (range, 10 to 40 mg) for nausea and vomiting during the first trimester of pregnancy (range duration of therapy, 1 to 35 days) suggests that the administration of metoclopramide during the first trimester of pregnancy is probably not associated with an increased risk of fetal malformations, decreased birth weight, or spontaneous abortions.

Metoclopramide is excreted into human milk. The American Academy of Pediatrics considers metoclopramide use during lactation to be of concern, citing the potent nervous system effects of the drug. The manufacturer recommends caution.

In one study involving 23 women, metoclopramide milk concentrations ranged from 20 to 157 ng/mL following the oral administration of metoclopramide 10 mg three times a day for two weeks. Milk concentrations were consistently higher than corresponding serum concentrations. The estimated maximum exposure of the infant ranged from 6 to 24 mcg/kg/day in the early puerperium and from 1 to 13 mcg/kg/day in the late puerperium. Metoclopramide was detected in the serum of only one infant. In four of seven infants studied, plasma prolactin levels were elevated during maternal metoclopramide treatment compared to prolactin levels of control infants. Plasma thyrotropin concentrations in the infants were unaffected. In another study, infant serum prolactin, TSH, and free thyroxine concentrations were unaffected by maternal metoclopramide therapy (10 mg three times a day for 3 weeks).

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Who should NOT use this medication?

• Mechanical obstruction or perforation or other situations in which stimulation of GI motility might be dangerous.
• GI hemorrhage (however, has been used to empty the stomach of blood prior to endoscopy in patients with acute upper GI hemorrhage).
• Pheochromocytoma (due to potential for hypertensive crisis).
• History of seizure disorders.
• Concomitant therapy with drugs likely to cause extrapyramidal reactions (e.g., phenothiazines, butyrophenones).
• Known intolerance to metoclopramide.
• Known hypersensitivity to metoclopramide or any ingredient in the formulation.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include drowsiness, confusion, tremors or uncontrolled muscle movements in face or neck, or seizure (convulsions).

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What should I discuss with my healthcare provider before taking metoclopramide?
You should not take this medication if you are allergic to metoclopramide, or if you have: bleeding or blockage in your stomach or intestines; a perforation (hole) in your stomach or intestines; epilepsy or other seizure disorder; or an adrenal gland tumor (pheochromocytoma). Before taking this medication, tell your doctor if you have kidney disease; liver disease (especially cirrhosis); congestive heart failure; diabetes (your insulin dose may need adjusting); or a history of depression.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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