Does Maxeran (Metoclopramide) increase gastric emptying speed?

From the Guidelines

Maxeran (metoclopramide) does increase gastric emptying speed and improves digestion. This medication works as a prokinetic agent that enhances gastrointestinal motility by blocking dopamine receptors and stimulating serotonin receptors in the digestive tract 1. Typical dosing is 5-20 mg taken 30 minutes before meals and at bedtime, though dosages may vary based on the specific condition being treated. Maxeran helps move food more quickly from the stomach into the intestines, making it useful for conditions like gastroparesis, gastroesophageal reflux disease (GERD), and functional dyspepsia. The medication accomplishes this by increasing the strength of gastric contractions while relaxing the pyloric sphincter, which is the valve between the stomach and small intestine.

Some key points to consider when using Maxeran include:

• It is the only FDA-approved medication for gastroparesis, with other agents being considered off-label use 1
• The level of evidence regarding the benefits of metoclopramide for the management of gastroparesis is weak, and given the risk for serious adverse effects, its use in the treatment of gastroparesis beyond 12 weeks is no longer recommended by the FDA 1
• Common side effects may include drowsiness, restlessness, and fatigue
• Patients should be aware of the risk of tardive dyskinesia with prolonged use

It's also important to note that other treatment options are available, including domperidone (available outside the U.S.) and erythromycin, which is only effective for short-term use due to tachyphylaxis 1. Gastric electrical stimulation using a surgically implantable device has received approval from the FDA, although there are very limited data in diabetic neuropathy and the results do not support gastric stimulation as an effective therapy in diabetic gastroparesis 1.

From the FDA Drug Label

Metoclopramide increases the tone and amplitude of gastric (especially antral) contractions, relaxes the pyloric sphincter and the duodenal bulb, and increases peristalsis of the duodenum and jejunum resulting in accelerated gastric emptying and intestinal transit. Increased rate of stomach emptying has been observed with single oral doses of 10 mg. Metoclopramide also abolishes the slowing of gastric emptying caused by apomorphine

Key Points:

• Metoclopramide increases gastric emptying speed
• It accelerates gastric emptying by increasing the tone and amplitude of gastric contractions and relaxing the pyloric sphincter
• A single oral dose of 10 mg has been shown to increase the rate of stomach emptying 2, 2

From the Research

Maxeran and Digestion Speed

• Maxeran, also known as metoclopramide, is a medication used to treat gastroparesis, a condition characterized by delayed gastric emptying 3, 4, 5, 6.
• The medication acts as a dopamine receptor antagonist, which helps to improve gastric emptying and reduce symptoms of gastroparesis 3, 4, 5, 6.
• Studies have shown that metoclopramide can increase digestion speed and improve gastric emptying in patients with gastroparesis 3, 4, 5, 6.

Gastric Emptying and Metoclopramide

• Metoclopramide has been shown to improve gastric emptying in patients with diabetic gastroparesis, with a significant reduction in symptoms such as nausea and vomiting 3, 4, 5, 6.
• The medication works by increasing the motility of the stomach and improving the coordination of muscle contractions, which helps to speed up gastric emptying 3, 4, 5, 6.
• However, metoclopramide can also cause side effects such as tardive dyskinesia, a movement disorder that can be irreversible 3, 4, 5, 6, 7.

Safety and Efficacy of Metoclopramide

• The safety and efficacy of metoclopramide have been evaluated in several studies, with results showing that the medication can be effective in improving gastric emptying and reducing symptoms of gastroparesis 3, 4, 5, 6.
• However, the medication can also cause significant side effects, including tardive dyskinesia, which can be a major concern for patients taking the medication long-term 3, 4, 5, 6, 7.
• The FDA has issued a black box warning for metoclopramide due to the risk of tardive dyskinesia, and patients should be closely monitored for signs of this condition 3, 4, 5, 6, 7.