From the Guidelines
Clopemon and metoclopramide are essentially the same medication, with no difference in terms of active ingredient, mechanism of action, or clinical effects, as metoclopramide is the generic name and Clopemon is likely a brand name or variation of the spelling. The medication metoclopramide, as discussed in the study 1, is a prokinetic agent used in the treatment of gastroparesis, among other conditions. It works by blocking dopamine receptors and stimulating motility in the upper gastrointestinal tract. According to the study 1, metoclopramide is the only prokinetic agent approved by the FDA for the treatment of gastroparesis, but its use is recommended to be limited to severe cases that are unresponsive to other therapies and for no longer than 12 weeks due to the risk of serious adverse effects such as extrapyramidal signs.
Some key points to consider when prescribing or taking metoclopramide (or its equivalent, Clopemon) include:
- The medication should be used with caution due to the risk of adverse effects, particularly with prolonged use.
- The typical dosage and administration schedule may vary based on the specific condition being treated, but it is often prescribed as 10 mg taken up to four times daily before meals and at bedtime.
- Patients should be monitored for side effects, which can include drowsiness, restlessness, and in rare cases, tardive dyskinesia.
- It is crucial for patients to inform their healthcare provider about any other medications they are taking to avoid potential drug interactions, as noted in the context of managing gastroparesis and other conditions 1.
From the Research
Comparison of Clopemon and Metoclopramide
- There is no direct mention of "clopemon" in the provided studies, suggesting it may be a misspelling or variation of a different medication, possibly "domperidone".
- Assuming "clopemon" refers to "domperidone", the following comparisons can be made between domperidone and metoclopramide:
Mechanism of Action and Side Effects
- Domperidone is a dopamine-2 receptor antagonist that acts as an antiemetic and prokinetic agent, with minimal penetration through the blood-brain barrier, reducing the risk of adverse neurological symptoms 2.
- Metoclopramide also acts as an antiemetic and prokinetic agent but can cause adverse neurological symptoms due to its ability to cross the blood-brain barrier 2, 3.
Efficacy in Gastroparesis
- Both metoclopramide and domperidone are effective in treating gastroparesis, with metoclopramide being commercially available in the United States 3.
- Domperidone has been shown to stimulate gastric motility and possess antiemetic properties, improving symptoms in patients with diabetic gastroparesis 3.
Safety Profile
- A population-based cohort study found no significant difference in the risk of ventricular arrhythmia between metoclopramide and domperidone, but metoclopramide was associated with a higher risk of death and cardiovascular mortality 4.
- Another study found that both controlled release metoclopramide and domperidone significantly reduced symptoms of nausea and vomiting, with no significant differences in efficacy or side effects 5.