METOCLOPRAMIDE

Antiemetics, GIT Regulator, Antiflatulants & anti inflamatories

Dose and  Use

Adult: PO Diabetic gastric stasis 10 mg 4 times/day. Usual duration: 2-8 wk.

Nausea and vomiting associated w/ cancer chemotherapy or radiotherapy 2 mg/kg 1 hr before start of treatment. Repeat dose 3 times at 2-hrly intervals. May repeat 2 additional doses at 3-hrly intervals if needed. Max: 12 mg/kg/day.

Gastro-oesophageal reflux disease 10-15 mg up to 4 times/day, depending on severity of symptoms. Delayed emesis following chemotherapy 20-40 mg 2-4 times/day for 3-4 days. IV Nausea and vomiting associated w/ cancer chemotherapy Highly emetogenic regimens: 2 mg/kg 30 mins before start of treatment. Repeat twice at 2-hrly intervals. Less emetogenic regimens: 1 mg/kg. If vomiting is not well-controlled, 3 additional doses at 2 mg/kg/dose 3-hrly. If vomiting is well-controlled w/ the 1st 3 doses, may reduce dose to 1 mg/kg 3-hrly for 3 additional doses. Intubation of the small intestine; Premed for radiologic examination of the upper GI tract 10 mg as a single direct inj. IV/IM Diabetic gastric stasis 10 mg 4 times/day. Convert to PO when possible. Usual duration: 2-8 wk. IM Post-op nausea and vomiting 10 mg near the end of the procedure. Repeat 4-6 hrly when needed.

4-amino-5-chloro-N-(2-(diethylamino)ethyl)-2-methoxybenzamide

REGLAN , PERINOM

…….

Metoclopramide is used to relieve heartburn and speed the healing of ulcers and sores in the esophagus (tube that connects the mouth to the stomach) in people who have gastroesophageal reflux disease (GERD; condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus) that did not get better with other treatments. Metoclopramide is also used to relieve symptoms caused by slow stomach emptying in people who have diabetes. These symptoms include nausea, vomiting, heartburn, loss of appetite, and feeling of fullness that lasts long after meals. Metoclopramide is in a class of medications called prokinetic agents. It works by speeding the movement of food through the stomach and intestines.

How should this medicine be used?

Metoclopramide comes as a tablet, an orally disintegrating (dissolving) tablet, and a solution (liquid) to take by mouth. It is usually taken 4 times a day on an empty stomach, 30 minutes before each meal and at bedtime. When metoclopramide is used to treat symptoms of GERD, it may be taken less frequently, especially if symptoms only occur at certain times of day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take metoclopramide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are taking the orally disintegrating tablet, use dry hands to remove the tablet from the package just before you take your dose. If the tablet breaks or crumbles, throw it away and remove a new tablet from the package. Gently remove the tablet and immediately place it on the top of your tongue. The tablet will usually dissolve in about one minute and can be swallowed with saliva.

If you are taking metoclopramide to treat the symptoms of slow stomach emptying caused by diabetes, you should know that your symptoms will not improve all at once. You may notice that your nausea improves early in your treatment and continues to improve over the next 3 weeks. Your vomiting and loss of appetite may also improve early in your treatment, but it may take longer for your feeling of fullness to go away.

Continue to take metoclopramide even if you feel well. Do not stop taking metoclopramide without talking to your doctor. You may experience withdrawal symptoms such as dizziness, nervousness, and headaches when you stop taking metoclopramide.

Other uses for this medicine

Metoclopramide is also sometimes used to treat the symptoms of slowed stomach emptying in people who are recovering from certain types of surgery, and to prevent nausea and vomiting in people who are being treated with chemotherapy for cancer. Ask your doctor about the risks of using this medication to treat your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

IMPORTANT WARNING:

Taking metoclopramide may cause you to develop a muscle problem called tardive dyskinesia. If you develop tardive dyskinesia, you will move your muscles, especially the muscles in your face in unusual ways. You will not be able to control or stop these movements. Tardive dyskinesia may not go away even after you stop taking metoclopramide. The longer you take metoclopramide, the greater the risk that you will develop tardive dyskinesia. Therefore, your doctor will probably tell you not to take metoclopramide for longer than 12 weeks. The risk that you will develop tardive dyskinesia is also greater if you are taking medications for mental illness, if you have diabetes, or if you are elderly, especially if you are a woman. Call your doctor immediately if you develop any uncontrollable body movements, especially lip smacking, mouth puckering, chewing, frowning, scowling, sticking out your tongue, blinking, eye movements, or shaking arms or legs.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with metoclopramide and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.

Talk to your doctor about the risks of taking metoclopramide.

SIDE EFFECTS

Metoclopramide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

·         drowsiness

·         excessive tiredness

·         weakness

·         headache

·         dizziness

·         diarrhea

·         nausea

·         vomiting

·         breast enlargement or discharge

·         missed menstrual period

·         decreased sexual ability

·         frequent urination

·         inability to control urination

Some side effects can be serious. If you experience any of the following symptoms, or those mentioned in the IMPORTANT WARNING section, call your doctor immediately:

·         tightening of the muscles, especially in the jaw or neck

·         speech problems

·         depression

·         thinking about harming or killing yourself

·         fever

·         muscle stiffness

·         confusion

·         fast, slow, or irregular heartbeat

·         sweating

·         restlessness

·         nervousness or jitteriness

·         agitation

·         difficulty falling asleep or staying asleep

·         pacing

·         foot tapping

·         slow or stiff movements

·         blank facial expression

·         uncontrollable shaking of a part of the body

·         difficulty keeping your balance

·         rash

·         hives

·         swelling of the eyes, face, lips, tongue, mouth, throat, arms, hands, feet, ankles, or lower legs

·         sudden weight gain

·         difficulty breathing or swallowing

·         high-pitched sounds while breathing

·         vision problems

Metoclopramide may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].