Buscogast (Metoclopramide) Injection Dosage and Frequency
The recommended dose of Buscogast (metoclopramide) injection for treating nausea and vomiting is 10 mg administered intramuscularly, which can be repeated every 6-8 hours as needed. 1
Standard Dosing Regimen
- For adults with nausea and vomiting, administer 10 mg intramuscularly as a single dose 1
- For persistent symptoms, the dose can be repeated every 6-8 hours as needed 2, 1
- Intravenous administration should be done slowly over 1-2 minutes if this route is chosen 1
Special Dosing Considerations
- For patients with renal impairment (creatinine clearance below 40 mL/min), start with approximately half the recommended dose (5 mg) 1
- For elderly patients, consider starting with lower doses due to increased risk of adverse effects 3
- For prevention of chemotherapy-induced nausea and vomiting, higher doses (1-2 mg/kg) may be used, but these should be administered intravenously over at least 15 minutes 1
Duration of Treatment
- Short-term use is recommended to minimize the risk of adverse effects 3
- For persistent nausea and vomiting, administration for up to one week may be considered, after which the need for continued therapy should be reassessed 4
- If symptoms persist despite 2-3 doses, consider adding or switching to an antiemetic from a different class 2
Monitoring and Precautions
- Monitor for extrapyramidal symptoms (EPS), which can occur even with short-term use 3
- Be aware that sedation, dizziness, and drowsiness may occur as side effects 5
- Consider prophylactic diphenhydramine (50 mg IM) if acute dystonic reactions occur 1
Alternative Approaches
- If metoclopramide is ineffective or contraindicated, consider 5-HT3 antagonists (e.g., ondansetron 8 mg IV or 16-24 mg orally) 2, 6
- For refractory nausea and vomiting, adding a corticosteroid (e.g., dexamethasone) may enhance antiemetic effect 2
- For opioid-induced nausea and vomiting, evidence suggests limited efficacy of prophylactic metoclopramide 7
Common Pitfalls
- Avoid high doses in young patients, especially females, who are at higher risk for extrapyramidal side effects 3
- Do not administer rapidly intravenously as this increases the risk of adverse effects; slow administration over 1-2 minutes is recommended 1
- Be cautious with prolonged use as it increases the risk of tardive dyskinesia, which can be irreversible 3
- Metoclopramide has not shown superior efficacy at intermediate doses (0.4 mg/kg) compared to standard 10 mg dosing 8