What is the recommended dose of metoclopramide (antiemetic medication) for an 8-year-old child?

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Metoclopramide Dosing for an 8-Year-Old Child

The recommended dose of metoclopramide for an 8-year-old child is 0.1 mg/kg per dose given orally every 6 hours, not to exceed 0.5 mg/kg/day. 1, 2

Dosing Guidelines

  • For children 6-14 years of age: 2.5-5 mg per dose 1
  • For children under 6 years: 0.1 mg/kg per dose 1
  • For an 8-year-old (who falls in the 6-14 years category), the appropriate dose would be in the 2.5-5 mg range, calculated based on weight 1
  • Maximum duration of treatment should not exceed 5 days due to risk of adverse effects 3

Route of Administration

  • Oral administration is preferred for mild symptoms 1
  • For severe symptoms, initial therapy may begin with injectable form (IM or IV) before transitioning to oral medication 1
  • When given intravenously, administer slowly over 1-2 minutes 1

Important Safety Considerations

  • Extrapyramidal symptoms (EPS) are the most common adverse effects in children, occurring in approximately 9% of pediatric patients 3
  • Risk of EPS increases with:
    • Higher doses (≥2 mg/kg) 4
    • Longer duration of treatment 3
    • Multiple consecutive days of administration 4
  • Other common adverse effects include:
    • Diarrhea (6% of pediatric patients) 3
    • Sedation (6% of pediatric patients on multiple doses) 3
    • Akathisia (restlessness) 4

Monitoring and Management of Adverse Effects

  • Monitor for signs of extrapyramidal reactions, which can be confused with other neurological conditions 5
  • If acute dystonic reactions occur, diphenhydramine (1-2 mg/kg or 25-50 mg/dose parenterally) can be administered 6
  • Metoclopramide is not intended for long-term use; oral preparations are recommended for no more than 4-12 weeks of therapy 7

Special Considerations

  • For patients with renal impairment (creatinine clearance <40 mL/min), start with approximately half the recommended dose 1
  • Metoclopramide should not be used in children under 1 year of age 3
  • Use with caution in children under 5 years of age 3

Practical Application

  • For an average 8-year-old weighing approximately 25-30 kg:
    • Starting dose would be approximately 2.5-3 mg per dose given every 6 hours 1, 2
    • Daily maximum would be 10-15 mg divided into 4 doses 1
    • Diphenhydramine can be given concomitantly to reduce the risk of extrapyramidal reactions 4

Remember that metoclopramide should be used cautiously in children due to the higher risk of extrapyramidal side effects compared to adults, and the benefit should outweigh the potential risks 3.

References

Research

Metoclopramide: dose-related toxicity and preliminary antiemetic studies in children receiving cancer chemotherapy.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 1985

Research

Metoclopramide induced dystonia in children: two case reports.

European journal of emergency medicine : official journal of the European Society for Emergency Medicine, 2005

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Metoclopramide: a dopamine receptor antagonist.

American family physician, 1990

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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