Metoclopramide

Metoclopramide is a drug used to relieve nausea and vomiting . This drug can be used in patients with stomach acid or in patients undergoing surgery, chemotherapy, or radiotherapy.

Metoclopramide works by increasing the movement of the stomach in processing food so that it speeds up gastric emptying. That way, nausea and vomiting can be prevented. This drug should not be used in the long term and should only be used as prescribed by a doctor.

Trademarks of metoclopramide: Damaben , Norvom , Piralen, Primperan, Sotatic, Vopram

What is Metoclopramide

Warning Before Using Metoclopramide

Metoclopramide should not be used carelessly. Pay attention to the following:

• Do not use metoclopramide if you are allergic to this drug.
• Do not use metoclopramide for more than 12 weeks, because it can increase the risk of side effects such as tardive dyskinesia .
• Do not use metoclopramide if you have previously had muscle problems or tardive dyskynesia after taking this drug.
• Tell your doctor if you have epilepsy, pheochromocytoma , or digestive tract disorders, such as stomach pain other than stomach acid, difficulty passing wind, or bloody or black stools.
• Tell your doctor if you have had or currently have liver disease, kidney disease, movement disorders, congestive heart failure, arrhythmias , hypertension, breast cancer , diabetes, mental disorders, or Parkinson's disease .
• Consult your doctor about administering metoclopramide to the elderly or children, because this age group requires a dose adjustment.
• Do not immediately drive a vehicle or operate heavy machinery while being treated with metoclopramide, because this drug can cause dizziness and drowsiness.
• Do not consume alcoholic beverages while being treated with metoclopramide, because it can increase the risk of side effects.
• Immediately see a doctor if there is an allergic drug reaction or overdose after using metoclopramide.

Dosage and Rules for Using Metoclopramide

The following is the dosage of metoclopramide based on the purpose of administration, the form of the drug, and the age of the patient:

Purpose: Prevent nausea and vomiting due to chemotherapy

Form: Oral medicine (tablet, caplet, or syrup)

• Adult: 10 mg, 3 times a day. The maximum dose is 30 mg per day. The maximum duration of treatment is 5 days.
• Children: 0.1–0.15 mg/kg, 3 times a day. The maximum duration of treatment is 5 days.

Purpose: Prevent nausea and vomiting due to radiotherapy

Form: Oral medicine

• Adult: 10 mg, 3 times a day. The maximum dose is 30 mg per day. The maximum duration of treatment is 5 days.

Purpose: Treating gastric acid disease ( GERD )

Form: Oral medicine

• Adult: 10–15 mg, 1–4 times daily, 30 minutes before meals or at bedtime. The maximum dose is 60 mg per day. The maximum duration of treatment is 3 months.

Purpose: Treating diabetic gastric stasis

Form: Oral medicine

• Adult: 10 mg 30 minutes before each meal and at bedtime. The maximum dose is 40 mg per day. Treatment duration is 2–8 weeks.

Aim: Prevention of nausea or vomiting prior to radiological examination of the upper digestive tract

Form: Oral medicine

• Adult: 10−20 mg as a single dose, given before examination

Goal: Prevention of nausea or vomiting due to radiotherapy, chemotherapy, or surgical procedures

Shape: Syringe

• The dosage of the drug in the form of an injection will be given by the doctor according to the patient's condition.

How to Use Metoclopramide Properly

Be sure to read the instructions on the drug packaging and follow your doctor's recommendations for using metoclopramide. Injectable metoclopramide will be given by a doctor or medical officer under the supervision of a doctor.

Metoclopramide in tablet form is taken 30 minutes before meals and at bedtime. This drug can also be taken with food that usually triggers stomach ulcers to prevent heartburn and nausea due to excess stomach acid.

Take metoclopramide regularly at around the same time every day. Do not reduce or increase the dose without doctor's advice. If taking metoclopramide in syrup form, use a special spoon that comes in the package so that the dosage is correct.

Store metoclopramide in a dry place away from direct sunlight. Keep out of reach of children.

Interactions of Metoclopramide with Other Drugs

The following interactions can occur when metoclopramide is used with certain drugs:

• Decreased effectiveness of metoclopramide when used with levodopa , and vice versa
• Increased drowsiness when used with sedatives
• Increased risk of developing extrapyramidal syndromes, such as tardive dyskinesia , when used with antipsychotic drugs
• Prolongs the effect of muscle relaxants on the drugs mivacurium and suxamethonium
• Increased risk of serotonin syndrome when used with SSRI antidepressant drugs
• Enhanced effect of the drug ciclosporin
• Decreased effect of the drug bromocriptine

Side Effects and Dangers of Metoclopramide

There are several side effects that may arise after using metoclopramide, including:

• Drowsiness
• Headache
• Dizzy
• Diarrhea
• Tired
• Hard to sleep
• Worried

Consult a doctor if these side effects do not subside or get worse. See a doctor immediately if you experience  a drug allergic reaction  or more serious side effects, such as:

• Uncontrollable movements, including tremors
• Decreased sexual desire
• Drastic mood changes, such as depression or suicidal thoughts
• Swelling of the hands and feet
• Menstrual disorders
• Milk discharge from the nipples (galactorrhea)
• Enlarged breasts in males ( gynecomastia )

Although it rarely happens, the use of metoclopramide can also cause neuroleptic malignant syndrome, which is characterized by high fever (> 39 ⁰ C), muscle stiffness, excessive sweating or salivation, shortness of breath, or irregular heartbeat.