From the Guidelines
Metoclopramide should be reserved for severe cases of gastroparesis that are unresponsive to other therapies, with treatment duration limited to 12 weeks or less due to the risk of serious adverse effects. The primary uses of metoclopramide include treating nausea, vomiting, and certain gastrointestinal disorders, such as diabetic gastroparesis and gastroesophageal reflux disease (GERD) 1. It works by blocking dopamine receptors in the brain's chemoreceptor trigger zone and enhancing gastrointestinal motility through its effects on acetylcholine release. Some key points to consider when using metoclopramide include:
- The typical adult dose ranges from 5-10 mg taken up to four times daily 1.
- Potential side effects include drowsiness, restlessness, and rarely, tardive dyskinesia with long-term use 1.
- The medication should be used cautiously in elderly patients, those with kidney or liver impairment, and is contraindicated in conditions where increased gastrointestinal motility could be harmful, such as gastrointestinal obstruction or hemorrhage 1.
- Other treatment options for gastroparesis include domperidone, erythromycin, and gastric electrical stimulation using a surgically implantable device 1. It's essential to weigh the benefits of metoclopramide against its potential risks, particularly when considering long-term use or in patients with certain comorbidities 1.
From the FDA Drug Label
Metoclopramide is a prescription medicine used to: • relieve symptoms of slow stomach emptying in people with diabetes • prevent nausea and vomiting that can happen with cancer chemotherapy • prevent nausea and vomiting that may happen after surgery, if your doctor decides that you should not be treated with a stomach tube and suction • help make it easier to insert a tube into the small intestine in both adults and children, if the tube does not pass into the stomach normally. • to help empty stomach contents or to help barium move through your intestine, when you get an X-ray examination of the stomach or small intestine.
Metclopromide uses include:
- Relieving symptoms of slow stomach emptying in people with diabetes
- Preventing nausea and vomiting caused by cancer chemotherapy
- Preventing nausea and vomiting after surgery
- Facilitating the insertion of a tube into the small intestine
- Aiding in the emptying of stomach contents or movement of barium through the intestine for X-ray examinations 2
From the Research
Metoclopramide Uses
- Metoclopramide is used to prevent postoperative nausea and vomiting (PONV) 3
- It is also used as an antiemetic and gastroprokinetic agent 4
- Metoclopramide is used to treat symptoms of acute and recurrent diabetic gastroparesis in adults 5
- It is used to manage nausea and vomiting in adult emergency department patients 6
- Metoclopramide is used to reduce nausea and vomiting after laparoscopic cholecystectomy 7
Specific Uses
- Prevention of early PONV (within 6 h after operation) and late PONV (48 h) 3
- Treatment of gastroparesis, with a nasal spray formulation available for this indication 5
- Management of undifferentiated emergency department nausea and vomiting 6
- Reduction of nausea and vomiting after laparoscopic cholecystectomy 7