Metoclopramide

Metoclopramide is used to treat certain conditions of the stomach and intestines. Metoclopramide is used as a short-term treatment (4 to 12 weeks) for persistent heartburn when the usual medicines do not work well enough. It is used mostly for heartburn that occurs after a meal or during the daytime. Treating persistent heartburn can decrease the damage done by stomach acid to the swallowing tube (esophagus) and help healing.

Metoclopramide is also used in diabetic patients who have poor emptying of their stomachs (gastroparesis). Treating gastroparesis can decrease symptoms of nausea, vomiting, and stomach/abdominal fullness. Metoclopramide works by blocking a natural substance (dopamine). It speeds up stomach emptying and movement of the upper intestines.

Metoclopramide is not recommended for use in children younger than 1 year due to an increased risk of serious side effects (such as muscle spasms/uncontrolled muscle movements). Ask the doctor or pharmacist for details.

Metoclopramide may also be used to prevent nausea/vomiting from chemotherapy or radiation treatments for cancer.

Metoclopramide is available under the following different brand names: Reglan, and Metozolv ODT.

Dosage Forms and Strengths

Injectable solution

• 5 mg/mL

Syrup

• 5 mg /5 mL

Tablet

• 5 mg
• 10 mg

Dispersible tablets

• 5 mg
• 10 mg

Dosage Considerations – Should be Given as Follows:

Chemotherapy-Induced Nausea and Vomiting

Adult

• 2 mg/kg intravenously (IV) (infused over at least 15 minutes) 30 minutes before chemotherapy, then repeated 2 more times every 2 hours (after initial dose)
• Vomiting suppressed: Decrease to 1 mg/kg IV every 3 hours for 3 doses
• Vomiting not suppressed: Continue same dose every 3 hours for 3 doses

Pediatric

• 1-2 mg/kg intravenously (IV) (infused over at least 15 minutes) 30 minutes before chemotherapy; repeat every 2-4 hours; pretreatment with diphenhydramine decreases risk of extrapyramidal adverse effects

Diabetic Gastroparesis

• Adult: 10 mg intravenously/intramuscularly/orally every 6 hours 30 minutes before meals and at bedtime; use injectable dosing only if severe symptoms are present
• Children under 6 years old: 0.1 mg/kg orally every 8 hours; not to exceed 0.1 mg/kg
• Children 6 years and older: 0.5 mg/kg/day orally divided every 8 hours

Small Bowel Intubation/Radiologic Examination of Upper GI Tract

• Adult: 10 mg intravenously (IV) over 1-2 minutes
• Children under 6 years old: 0.1 mg/kg IV over 1-2 minutes
• Children 6-14 years old: 2.5-5 mg IV over 1-2 minutes
• Children 14 years and older: 10 mg IV over 1-2 minutes

Gastroesophageal Reflux Disease (GERD)

• Adult: 10-15 mg orally every 6 hours 30 minutes before meals and at bedtime; not to exceed 80 mg/day
• Neonate: 0.15 mg/kg intravenously (IV) every 6 hours
• Infant: 0.1 mg/kg IV/IM/orally every 6-8 hours 30 minutes before meals and at bedtime
• Not to exceed 0.3-0.75 mg/kg/day

Postoperative Nausea & Vomiting (Off-label)

• Adult: 10-20 mg intramuscularly (IM) administered near end of procedure; may be repeated postoperatively every 4-6 hours as needed
• Pediatric: 0.1-2 mg/kg intravenously (IV) every 6-8 hours as needed

Dosing Modifications

• Renal impairment: CrCl less than 40 mL/min, decrease dose by 50%; CrCl less than 10 mL/min, decrease dose by 75%