Metoclopramide (HCl)

Metoclopramide (HCl) is antiemetic with dopamine antagonist action in brain and peripheral effect on gastro-intestinal tract where it stimulates motility to improve gastric emptying and intestinal transit. Metoclopramide (HCl) is used to treat nausea, and vomiting of most causesand as an adjunct to X-ray examination of the gut. Metoclopramide (HCl) is given both orally and parentrally.


Adult Dose
Dose: 10 to 15 mg
Single Dose: 12 (12.5)
Frequency: 6 hourly
Route: PO,IV,IM
Instructions: Renal dysfunction: decrease dose.
Neonatal
Dose: 0.1 mg/kg
Single Dose: 0.1 (0.1)
Frequency: 8 hourly
Route: Intramuscular
Instructions:
Paedriatic
Dose: 0.1 to 0.2 mg/kg
Single Dose: 0.15 (0.15)
Frequency: 8 hourly
Route: Intra Muscular
Instructions: -
Characteristics
Metoclopramide is the derivative of Metoclopramide (HCl). It is of Synthetic origin and belongs to Benzamide. It belongs to D2 antagonist pharmacological group on the basis of mechanism of action and also classified in Histamine (H-2) Antagonists and GI Agent, Prokinetic pharmacological group.The Molecular Weight of Metoclopramide (HCl) is 354.30. Its pKa is 4.45, 9.2.
Contraindications
Metoclopramide (HCl) is contraindicated in conditions like Parkinsonism,Phaeochromocytoma,Pyloric stenosis,Dystonia.
Effects
The severe or irreversible adverse effects of Metoclopramide (HCl), which give rise to further complications include Tardive dyskinesia, Parkinsonism, Acute dystonia, Acute porphyria, Acute dyskinesia, Extrapyramidal reactions.The signs and symptoms that are produced after the acute overdosage of Metoclopramide (HCl) include Tachycardia, Drowsiness, Dystonia.The symptomatic adverse reactions produced by Metoclopramide (HCl) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Drowsiness, Diarrhea, Akathisia, Skin rash, Impotence, Hypotension, Gynecomastia, Galactorrhea, Hypertension, Increase in heart rate, Hyperprolactinemia, Mental disturbances, neuroleptic disorder.
Indications
Metoclopramide (HCl) is primarily indicated in conditions like Delayed gastric emptying, Diagnostic procedures, Flatulence, Gastritis, GI motality disorder, Heart burn, Hiccup in palliative care, Migraine, Nausea and vomiting, Nausea and vomiting (chemotherapy induced), Reflux oesophagitis, and can also be given in adjunctive therapy as an alternative drug of choice in Defective lactation, Hiccup due to gastric distension in palliative care, Postural hypotension, Psychosis.
Interactions
Metoclopramide (HCl) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAspirinAtovaquonePlasma concentration of Atovaquone reduced by Metoclopramide. Atropine (Sulphate)Barium SulphateBenorylateBiperiden (HCl)Bromocriptine (Mesylate)Hypoprolactenamic effect of bromocriptine possibly antagonized by Metoclopramide.CabergolineHypoprolactinemic effect of Cabergoline possibly antagonized by Metoclopramide.Chlordiazepoxide (HCl)ChlorothiazideChlorpromazine (HCl)ChlorprothixeneCholine Magnesium TrisalicylateCimetidine (HCl)ClozapineCyclosporin AMetoclopramide increases the bioavailability of cyclosporinby increasing gastric emptying and may interfere with gastrointestinal degradation of cyclosporin, thus increases the risk of toxicity.ModerateCarefully monitor cyclosporin level, renal function and serum creatinine level of patient.DigitoxinDigoxinDroperidolFlupenthixol (HCl and Decanoate)FluphenazineFosfomycinFosinopril (Na)Gonadorelin (HCl)HaloperidolLevodopaMetoclopramide antagonize the pharmacological effect of levodopa. Central nervous system depressent effect of both of these agents synergistically increased.ModeratePatient should be alerted to drowsiness.LevosulpirideLithiumMolindoneConcurrent use with Molindone increases certain serious side effects.OlanzapineOxycodoneParacetamolPergolidePiribedilMetoclopramide (HCl) reduce the effect of piribedil.PramipexoleMetoclopramide (HCl) may decrease the efficiency of pramipexole due to dopamine antagonism.PrazepamQuetiapineRisperidoneZopicloneZuclopenthixol These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to patients suffering from Liver Malfunction, and Geriatrics.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj (reconstituted soln) Store at room temperature. Use within 24 hrs if kept at room temperature. Syrup, Inj Store Below 40°C. Do not Freeze. Protect from Sunlight. Tab, Oral Soln Store in a well closed container, Below 40°C. Protect from Sunlight.
Warnings
Patient should observe caution while driving or performing other tasks requiring alertness because it may produce drowsiness. Metoclopramide should be used with caution in patients with previously detected breast cancer.Children, Young adults & elderly should be treated with care as they are at increased risk of extrapyramidal reactions. Care should be taken when metoclopramide is given to pateints with renal or hepatic impairment.
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