Metoclopramide (Metoclopramide Hydrochloride) - Summary

METOCLOPRAMIDE SUMMARY

Metaclopramide Injection, USP
Rx Only

Metoclopramide hydrochloride is a white crystalline, odorless substance, freely soluble in water.

Diabetic Gastroparesis (Diabetic Gastric Stasis)

Metoclopramide Injection is indicated for the relief of symptoms associated with acute and recurrent diabetic gastric stasis.

The Prevention of Nausea and Vomiting Associated with Emetogenic Cancer Chemotherapy

Metoclopramide Injection is indicated for the prophylaxis of vomiting associated with emetogenic cancer chemotherapy.

The Prevention of Postoperative Nausea and Vomiting

Metoclopramide Injection is indicated for the prophylaxis of postoperative nausea and vomiting in those circumstances where nasogastric suction is undesirable.

Small Bowel Intubation

Metoclopramide Injection may be used to facilitate small bowel intubation in adults and pediatric patients in whom the tube does not pass the pylorus with conventional maneuvers.

Radiological Examination

Metoclopramide Injection may be used to stimulate gastric emptying and intestinal transit of barium in cases where delayed emptying interferes with radiological examination of the stomach and/or small intestine.

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NEWS HIGHLIGHTS

Published Studies Related to Metoclopramide

A trial of midazolam vs diphenhydramine in prophylaxis of metoclopramide-induced akathisia. [2012.01]
STUDY OBJECTIVE: The study aimed to evaluate the effects of midazolam and diphenhydramine for the prevention of metoclopramide-induced akathisia... CONCLUSION: Coadministered midazolam reduced the incidence of akathisia induced by metoclopramide compared to placebo but increased the rate of sedation. No difference was detected from diphenhydramine. Routine coadministered 20 mg diphenhydramine did not prevent metoclopramide-induced akathisia. Copyright (c) 2012 Elsevier Inc. All rights reserved.

Metoclopramide to augment lactation, does it work? A randomized trial. [2011.11]
OBJECTIVES: The objective of this study was to investigate the efficacy of metoclopramide on augmentation of milk production in mothers of premature newborns... CONCLUSION: In mothers with preterm babies, metoclopramide treatment does not augment (sample size had 80% power for detection of 50% difference) the breast milk production. Maternal interest, education, and support are recognized as mainstay in accomplishing successful lactation.

Intramuscular injection of metoclopramide decreases the gastric transit time and does not increase the complete examination rate of capsule endoscopy: a prospective randomized controlled trial. [2011.09]
CONCLUSIONS: Intramuscular injection of metoclopramide decreases the gastric transit time, but it does not change the SBTT or CER of capsule endoscopy in our study.

Metoclopramide as an analgesic in severe migraine attacks: an open, single-blind, parallel control study. [2011.05.01]
Metoclopramide is a well-known anti-emetic drug with central and peripheral pharmacological effects. Some authors have reported metoclopramide as an adjunct therapy to other analgesics in patients with migraine attacks...

Comparison of the pharmacokinetics of a new 15-mg modified-release tablet formulation of metoclopramide versus a 10-mg immediate-release tablet: a single- and multiple-dose, randomized, open-label, parallel-group study in healthy Mexican male volunteers. [2011.05]
BACKGROUND: Metoclopramide is a prokinetic and antiemetic agent. OBJECTIVE: The goal of this study was to assess the pharmacokinetics of a new, modified-release metoclopramide tablet and compare it with an immediate-release tablet to obtain marketing approval from the Mexican regulatory agency... CONCLUSIONS: This study in a sample of selected healthy Mexican male volunteers suggests that the metoclopramide15-mg modified-release tablets have features compatible with the slow-release formulation (lower C(max) and longer T(max)) compared with immediate-release tablets. Copyright (c) 2011 Elsevier HS Journals, Inc. All rights reserved.

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Clinical Trials Related to Metoclopramide

MgSO4 vs Metoclopramide for Headache in Pregnant Women [Recruiting]
The study will compare effectiveness of intravenous magnesium sulfate to that of intravenous metoclopramide (Reglan®) for acute headache in pregnant women. We will randomize pregnant women who present to our emergency department with chief complaint of headache to magnesium sulfate 2 grams intravenously or metoclopramide 10 mg intravenously; both groups will receive acetaminophen (Tylenol®) 1 gram orally and normal saline 1 liter intravenously. Headaches are common during pregnancy, related to hormonal changes, altered sleep patterns and psychosocial stressors. Common medications for headache such as non-steroidal antiinflammatories or triptans are typically avoided during pregnancy due to concern for fetal effects. Women, and their physicians, are often uncertain regarding available medication options with justifiable safety profiles during pregnancy.

Pharmacogenetic Factors and Side Effects of Metoclopramide and Diphenhydramine [Recruiting]

Metoclopramide Versus Ketorolac for Tension-type Headache [Recruiting]
Occasionally, episodic tension-type headache may be severe enough to require an emergency department (ED) visit. The purpose of this study is to compare two commonly used medications to see which is better for tension type headache. Patients who present to the ED with an acute tension-type headache requiring treatment with injectable medication will be randomized to metoclopramide or ketorolac.

Intravenous Ketorolac and Metoclopramide for Pediatric Migraine in the Emergency Department [Not yet recruiting]
Migraine headaches are a common problem for children. When treatment at home fails, children may benefit from intravenous treatment administered in a hospital setting like the Emergency Department. Most treatments used however have only been tested in adults and the best treatment strategy for children is not always clear. The combination of more than one medication is frequently prescribed in Canadian Emergency Departments. The purpose of this study is to investigate whether the combination of ketorolac (an anti-inflammatory pain medication) and metoclopramide (an anti-nauseant that may also relieve migraine headaches) is better than metoclopramide by itself.

Comparison of Metoclopramide and Ibuprofen for the Treatment of Acute Mountain Sickness [Not yet recruiting]
The objective of this study is to determine the efficacy of metoclopramide in relieving the symptoms of Acute Mountain Sickness (AMS).

It is our hypothesis that the combined antiemetic and analgesic effects of metoclopramide (which has been study-proven to be effective in relieving symptoms of migraine headache) will prove to be more efficacious in relieving symptoms of acute mountain sickness than the standard, previously-studied analgesic medication, ibuprofen.

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Reports of Suspected Metoclopramide Side Effects

Tardive Dyskinesia (4167),  Extrapyramidal Disorder (3383),  Dystonia (3045),  Nervous System Disorder (1341),  Economic Problem (329),  Tremor (248),  Akathisia (242),  Emotional Disorder (233),  Pain (212),  Dyskinesia (194), more >>

PATIENT REVIEWS / RATINGS / COMMENTS

Metoclopramide review by 56 year old female patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		Severe Side Effects
		Treatment Info
Condition / reason:		nausea
Dosage & duration:		10mg oral taken every 6 hours for the period of 1 day
Other conditions:		Nil
Other drugs taken:		No other drugs
		Reported Results
Benefits:		There were no treatment benefits from this particular drug. My nausea was not controlled at all, in fact I felt more nauseaus after taking the medication.
Side effects:		I had severe restlessness, developed an intense feeling of anxiety, had an extreme desire to sit down, then lay down and went on to develop a dystonic reaction. I developed an intense feeling of doom, my stomach had feelings of cramps, knotting and pain. My neck felt tense and the ambulance was called and I was taken to the emergency dept of local hospital.
Comments:		Ambulance officers gave me pain relief and this settled my stomach of the knotting and cramping/pain. This also settled the feeling of doom. In emergency, after numerous examinations and questionning, abdo xray, I was given IV hydration x 2 litres and Ondansetron IV x 2 - 8 hours apart. I was observed in emergency overnight and went home the next morning with no side effects at all. Never will I take maxalon again!