Metoclopramide

Brand names of metoclopramide

  • Apo-Metoclop
  • Clopra
  • Emex
  • Gastrobid
  • Maxeran
  • Maxolon
  • Nu-Metoclopramide
  • Octamide
  • PMS-Metoclopramide
  • Reclomide
  • Reglan

Metoclopramide is called a 'prokinetic' drug that helps in invigorating the muscles in the gastrointestinal tract, counting the muscles in the stomach, lower esophageal sphincter, as well as the small intestine by means of acting together with the dopamine and acetylcholine receptors on the nerves and the gastrointestinal muscles.

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It may be noted here that the lower esophageal sphincter is positioned between the stomach and the esophagus and it generally puts off the reflex of acids as well as other substances in the stomach from going back into the esophagus. In people suffering from gastroesophageal reflux disease (GERD), a debilitated lower esophageal sphincter allows the backward flow of stomach acid into the esophagus resulting in heartburn as well as esophagitis (a condition wherein the esophagus is damaged). Metoclopramide helps in reducing the reflux or backward flow of stomach acid by means of fortifying the lower esophageal sphincter muscle. In addition, this medication excites the stomach muscles and, by this means, speeds up evacuating the solid as well as fluid meals from the stomach into the intestines.

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In a number of patients, especially people having diabetes, injuries to the nerves present in the stomach may possibly hinder the functioning of the muscles and result in delaying the evacuation of the substances in the stomach. This often causes vomiting, nausea, heartburn (also known as diabetic gastroparesis) and a feeling of fullness as well as distention in the abdomen. Using metoclopramide may prove to be helpful in alleviating the symptoms associated with diabetic gastroparesis by encouraging faster evacuation of the stomach, in addition to restricting the stomach acid from flowing back into the esophagus. Dopamine receptors found on the nerves within the brain are vital in generating a queasy feeling. Metoclopramide works in conjunction with the dopamine receptors and may prove to be helpful in treating queasiness. Metoclopramide was approved for sale and use by the Food and Drug Administration in June 1985.

Things you need to tell your physician before taking metoclopramide

As in the case of taking any prescription drug for the first time, prior to starting treatment with metoclopramide, you should tell your physician as well as pharmacist whether you have allergies to this medication, any constituent of metoclopramide liquid or tablets or any other medicines. If you are not sure about the contents of metoclopramide, ask your physician or pharmacist about it. Alternately, you may also go through the Medication Guide for a list of the ingredients of this medication.

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Before taking metoclopramide, it is important to inform your physician as well as pharmacist about all the prescription and over-the-counter drugs, herbal remedies, dietary supplements and vitamins you are already taking or intend to take.

In addition, you should also keep your physician abreast regarding your entire medical history, especially if you have ever sufferer or a suffering from any bleeding, blockage or split/ scratch in the stomach or intestines; seizures; and/ or a tumor on any small gland close to the kidneys (pheochromocytoma). Also tell your physician if you ever endured or are enduring high blood pressure (hypertension); heart, kidney and/ or liver ailment; Parkinson's disease (an ailment of the nervous system that results in problems in movements, balance and muscle control); breast cancer; NADH cytochrome B5 reductase deficiency (a hereditary blood disorder); asthma; and/ or glucose-6-phosphate dehydrogenase (G-6PD) deficiency (a hereditary blood disorder).

Women who intend to take metoclopramide should tell their physician if they are pregnant or planning to get pregnant. New mothers should tell their physician if they are breast feeding.

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In case you require undergoing a surgery, including any dental operation, tell your surgeon/ dentist beforehand that you are taking metoclopramide.

Before you start taking metoclopramide, you ought to know that this medicament may result in drowsiness. Hence, it is advisable that while undergoing treatment with metoclopramide, you should not undertake any activity that requires alertness, such as driving a vehicle or operating a machine, till such time when you are certain about the effects of the medication on your body and when you are able to perform such activities safely.

In addition, it is advisable that you consult your physician regarding the use of alcohol while undergoing treatment with metoclopramide. You should know that consuming alcoholic beverages or any food containing alcohol has the potential to worsen the side effects of this medication.

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Usage

Metoclopramide is used to put off vomiting and nausea induced by anti-cancer medications or to treat weakened evacuation of solid as well as fluid food contents from the stomach (gastroparesis), which may occur in the form of a problem due to diabetes. In addition, this medication is also employed in the form of a temporary treatment for gastroesophageal reflux (heartburn caused by the flow of stomach acid back into the esophagus).

How to use metoclopramide

Metoclopramide is available in tablet form, as an orally disintegrating (dissolving) tablet as well as in liquid form. This medication is taken orally, generally four times every day on an empty stomach, 30 minutes prior to every meal as well as before retiring to bed at night.

If you are using metoclopramide to cure the symptoms related to GERD, you may take it at longer intervals, particularly if the symptoms appear at specific times of the day. It is important that you stick to the instructions on the prescription label. In case you are unable to understand any instruction or have any questions, seek the help of your physician or pharmacist. You should strictly take metoclopramide as per the directions of your physician. Never take this medication in excess, lesser dose or more frequently than what your physician has prescribed.

On the other hand, if you are using metoclopramide to cure the symptoms associated with sluggish evacuation of the contents of the stomach as a result of diabetes, you ought to be aware of the fact that your symptoms will not be alleviated suddenly or very soon. It is likely that you will notice your nausea improving during the initial stage of treatment with metoclopramide and it will keep on improving over the subsequent three weeks. In addition, you will also notice that your loss of appetite as well as vomiting will improve during the early stage of treatment. However, it is likely to take some time before your feeling of being full goes away completely. Even if you start feeling better following few weeks of treatment with metoclopramide, it is essential that you continue taking the medication for the complete regimen.

In case you are using the orally disintegrating tablet form of metoclopramide, dry your hands prior to removing the tablet from the package only before taking your dosage of the medication. If you find the tablet broken or crumbled, discard it right away and take another tablet from the package. Remove the tablet from the package gently and place it over your tongue immediately. Generally, the tablet will dissolve in approximately one minute and you can swallow it along with saliva.

How metoclopramide works

Metoclopramide, a 'prokinetic' drug, works by increasing the movements or tightening of the stomach as well as the small intestine. This medication helps in lessening nausea by means of obstructing the consequences of the chemical called dopamine in the brain segment that causes vomiting.

Side effects

Serious:
  • crawling sensation in lower legs
  • difficulty swallowing or speaking
  • difficulty walking
  • dizziness
  • fainting
  • fatigue
  • irregular heartbeat
  • irritability
  • lip puckering or smacking
  • loss of balance
  • muscle spasms
  • panic attacks
  • restlessness
  • severe headache
  • shaking of fingers and hands
  • uncontrolled chewing movements
  • uncontrolled movements or stiffness of legs or arms
  • unusual nervousness
  • unusual tongue movements
Common:
Less common:

Possible interactions

Herbal medicines or minerals:
Specific herbal remedies or mineral supplements may interact with metoclopramide and, hence, it is advisable that they should not be used in combination. For instance, using the herbs valerian and kava kava in conjunction with this medication may increase drowsiness, while cascara sagrada, aloe vera and senna may possibly enhance the chances of developing diarrhea. Taking supplements containing chromium while undergoing treatment with metoclopramide may alter the manner in which the body can use sugar. A number of stores selling health foods recommend the use of vanadium because it imitates the activities of insulin. However, since this mineral may produce toxic results, intensive studies are essential before the use of this mineral can be recommended.
In addition, DHEA (dehydroepiandrosterone) may possibly alter the patient's sensitivity to insulin or resistance to it. Use of other herbs like garlic, ginger, ginseng, hawthorn, nettle, licorice and yohimbe may also possibly alter the blood sugar levels. As taking these herbs may necessitate adjusting the dose of hypoglycemic medication, it is advisable that you consult your physician prior to using any of these herbal remedies in conjunction with metoclopramide. People taking this medication and also having diabetes should strictly avoid taking Echinacea (in the form of injections) as well as seed of blonde psyllium or husk.
Alcohol:
Using metoclopramide in combination with alcoholic beverages may cause extreme drowsiness as well as a noticeable inebriation. Therefore, it is advisable that people using this medication should stay away from alcohol.

Discontinuation

People taking metoclopramide should not discontinue it without consulting their physician. When one stops taking this medication abruptly, they are likely to experience withdrawal symptoms that may include headaches, nervousness and dizziness.

Storage instructions

Metoclopramide should always be kept in the container in which it was available. Seal the container tightly and keep it in a place that is away from accessibility to children. Always store this medication at room temperature and in a place free from too much heat and dampness. Never keep metoclopramide in your bathroom, which is mostly humid. When any medication becomes outdated or is needed no longer discard it in a proper and safe manner. If necessary, consult your pharmacist or any neighbourhood waste disposal firm regarding the safe and appropriate way to discard all such medications.

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