Tab Perinorm (Metoclopramide) Side Effects
Metoclopramide commonly causes restlessness, drowsiness, fatigue, and lassitude, with rare but serious extrapyramidal symptoms occurring particularly with high doses or prolonged use. 1
Common Side Effects
The most frequently reported adverse effects include:
- Restlessness, drowsiness, fatigue, and lassitude are the most common reactions 1
- Gastrointestinal symptoms including nausea, vomiting, and diarrhea 2
- Dizziness and muscle weakness may occur 2
Serious Neurological Side Effects
Extrapyramidal reactions represent the most concerning adverse effects:
- Dystonic reactions can develop, particularly in younger patients 2
- Akathisia (motor restlessness) may manifest 2
- Pseudo-parkinsonism with tremor and rigidity 2
- Tardive dyskinesia with chronic use, which may be irreversible 2
These neurological side effects occur rarely but are more likely with:
Cardiovascular Effects
- Hypotension can occur, especially with IV administration 2
- Tachycardia and arrhythmias have been reported 2
Other Notable Side Effects
Duration and Dosing Considerations
Metoclopramide is not intended for long-term use:
- Oral preparations are recommended for 4-12 weeks maximum 1
- Parenteral use should be limited to 1-2 days 1
- The drug is typically administered 10-20 mg IV or orally, 20-30 minutes before meals or with analgesics 2
Key Clinical Pitfalls
The primary concern is avoiding prolonged therapy, as extrapyramidal symptoms are dose- and duration-dependent 1. Patients should be counseled about neurological warning signs (involuntary movements, restlessness, tremor) and instructed to discontinue the medication and seek medical attention if these develop. Special caution is warranted in elderly patients who have increased susceptibility to both sedation and movement disorders 2.