From the Guidelines
For post-anesthesia dizziness and to promote gut peristalsis, Reglan (metoclopramide) is typically administered at a dose of 5-20 mg tid-qid, as recommended by the most recent guidelines 1. The dose and administration of Reglan (metoclopramide) may vary depending on the patient's condition and response to treatment.
- The medication can be administered intravenously or intramuscularly, with a recommended dose of 10 mg every 6-8 hours as needed 1.
- For elderly patients or those with renal impairment, a reduced dose of 5 mg is recommended to minimize the risk of adverse reactions.
- Treatment duration should be limited to 48-72 hours post-surgery when possible to minimize the risk of tardive dyskinesia, a potentially irreversible movement disorder associated with prolonged use 1.
- Metoclopramide works by blocking dopamine receptors in the chemoreceptor trigger zone to reduce nausea and vomiting, while also increasing acetylcholine release in the gut to enhance gastric emptying and intestinal motility.
- Common side effects include drowsiness, restlessness, and fatigue.
- Patients should be monitored for extrapyramidal symptoms such as muscle stiffness or involuntary movements, which may require immediate discontinuation of the medication. It is essential to note that metoclopramide is the only FDA-approved medication for gastroparesis, and its use should be reserved for severe cases that are unresponsive to other therapies 1.
- The level of evidence regarding the benefits of metoclopramide for the management of gastroparesis is weak, and given the risk for serious adverse effects, its use in the treatment of gastroparesis beyond 12 weeks is no longer recommended by the FDA 1.
- Other treatment options, such as domperidone and erythromycin, may be considered, but their effectiveness and safety profiles vary 1.
From the FDA Drug Label
For the Prevention of Postoperative Nausea and Vomiting Metoclopramide Injection, USP should be given intramuscularly near the end of surgery. The usual adult dose is 10 mg; however, doses of 20 mg may be used To Facilitate Small Bowel Intubation If the tube has not passed the pylorus with conventional maneuvers in 10 minutes, a single dose (undiluted) may be administered slowly by the intravenous route over a 1 to 2 minute period. The recommended single dose is: Pediatric patients above 14 years of age and adults – 10 mg metoclopramide base.
The recommended dose and administration of Reglan (metoclopramide) for post-anesthesia dizziness and gut peristalsis is:
- 10 mg intramuscularly near the end of surgery for the prevention of postoperative nausea and vomiting
- 10 mg intravenously over a 1 to 2 minute period to facilitate small bowel intubation in adults and pediatric patients above 14 years of age 2
From the Research
Reglan (Metoclopramide) Dosage and Administration
- The recommended dose of Reglan (metoclopramide) for post-anesthesia dizziness and gut peristalsis is not explicitly stated in the provided studies.
- However, the studies suggest that metoclopramide can be effective in preventing postoperative nausea and vomiting (PONV) when given in doses of 10 mg intravenously 3 or 20 mg intravenously at the end of surgery 4.
Efficacy of Metoclopramide
- A meta-analysis found that 10 mg of systemic metoclopramide reduced the incidence of 24-hour PONV compared to control, with an odds ratio of 0.58 (95% CI 0.43-0.78) and a number needed to treat (NNT) of 7.8 3.
- Another study found that metoclopramide 20 mg given at the end of laparoscopic cholecystectomy resulted in a similar incidence of PONV compared to ondansetron 8 mg 4.
Comparison with Other Antiemetics
- Metoclopramide was found to be less effective than ondansetron in preventing PONV in some studies 5, 6.
- However, metoclopramide was found to be more effective than droperidol and perphenazine in preventing PONV in other studies 7, 6.