Metoclopramide

General

• Type: anti-emetic
• Dosage Forms: 5, 10; 5/5 mL; IM; IV
• Common Trade Names: Reglan

Special Populations

• Pregnancy Rating:
• Lactation risk:
• Renal Dosing
  • Adult
  • Pediatric
• Hepatic Dosing
  • Adult
  • Pediatric

Contraindications

• Allergy to class/drug
• pheochromocytoma
• seizure disorder
• GI bleeding or perforation
• GI obstruction
• caution if depression
• caution if Parkinson dz
• caution if NADH methemoglobin reductase deficiency
• caution if HTN
• caution if CHF
• caution if cirrhosis
• caution if dibetes mellitus
• caution if renal impairment
• caution if neonates
• caution if pediatric pts
• caution if elderly pts, esp. female

Adverse Reactions

Serious

• extrapyramidal sx
• dystonia, acute
• parkinsonism
• tardive dyskinesia
• neuroleptic malignant syndrome
• seizures
• depression
• suicidality
• hallucinations
• leukopenia
• neutropenia
• agranulocytosis
• methemoglobinemia
• CHF, acute
• AV block
• SVT
• HTN
• angioedema
• hepatotoxicity
• withdrawal sx if abrupt D/C

Common

• drowsiness
• restlessness
• fatigue
• anxiety
• insomnia
• headache
• confusion
• dizziness
• depression
• extrapyramidal sx
• galactorrhea
• amenorrhea
• gynecomastia
• hyperprolactinemia
• impotence
• hyperaldosteronism
• fluid retention
• hypotension
• HTN
• bradycardia
• nausea
• diarrhea
• urinary frequency
• incontinence
• rash
• urticaria
• visual disturbance

Pharmacology

• Half-life: 5-6h
• Metabolism: liver minimally; CYP450: unknown
• Excretion: urine 85% (20% unchanged), bile/feces 5%
• Mechanism of Action: exact mechanism of action unknown; sensitizes tissues to acetylcholine, stimulating upper GI tract motility; antagonizes central and peripheral dopamine receptors, producing antiemetic effects