metoclopram Side Effects

 Drowsiness

ide (Reglan)  Restlessness

 Fatigue
 Anxiety
PHARMACOLOGIC CLASS:  Insomnia
Dopamine – 2 receptor antagonist  Depression
 Sedation
Method of Action
Metoclopramide is a "prokinetic" drug that
stimulates the muscles of the gastrointestinal
tract by interacting with receptors for
acetylcholine
and dopamine on gastrointestinal muscles and
nerves. It also stimulates the muscles of the
stomach and thereby hastens emptying of solid
and liquid meals from the stomach and into
the intestines.

Indications
 Chemotherapy-induced nausea &
vomiting
 Diabetic Gastroparesis
 Small Bowel Intubation
 Gastroesophageal Reflux Disease
 Post-op nausea and vomiting

Contraindications
 History of tardive dyskinesia (TD)
 Dystonic reaction to metoclopramide
 GI obstruction, perforation or
hemorrhage
 Pheochromocytoma
 Epilepsy
Adverse Effects Special Precautions
 Parkinsonism  Patients with Parkinson’s disease can
experience worsening of the symptoms
 Akathisia with metoclopramide.
 Seizures  Metoclopramide may impair the mental
 Hallucinations or physical abilities to drive or operate
heavy machinery.
 Hypertension
 Metoclopramide may decrease the
 Fluid retention concentrations of digoxin and
 Hyperprolactinemia cimetidine in the blood if taken
together.
 Hypersensitivity reactions
 Nursing mothers should avoid
metoclopramide during pregnancy since
it is also excreted in human milk.
Patient Teaching
 Store tablets and syrups between 15
degrees Celsius to 30 degrees Celsius.
Injectable metoclopramide should be
stored at room temperature (20 degrees
Celsius to 25 degrees Celsius)
 The usual dose of metoclopramide for
treating GERD is 10 – 15 mg, four
times daily and 30 minutes before each
meal.
 Gastroparesis is treated with 10 mg
administered orally four times daily, 30
minutes before each meal and at
bedtime.
 Do not take with anticholinergic drugs
as it can decrease the effectiveness of
metoclopramide.