Metoclopramide (Metoclopramide)
Class and Category of Drug
Before you buy Metoclopramide online, read common information about the medication.
Chemical class: Benzamide
Therapeutic class: Antiemetic, upper gastrointestinal stimulant
Pregnancy category: B
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Drug Indications and Dosages
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To treat diabetic gastroparesis
Oral Solution, Oral Solution Concentrate,Tablets
Adults and adolescents. 10 mg 30 min before meals and at bedtime up to q.i.d.
Intravenous or Intramuscular Injection
Adults and adolescents. 10 mg t.i.d. or q.i.d. for severe symptoms; dosage adjusted as needed.
To treat gastroesophageal reflux disease
Oral Solution, Oral Solution Concentrate,Tablets
Adults and adolescents. 10 to 15 mg 30 min before meals and at bedtime.
To prevent chemotherapy-induced vomiting
Intravenous Infusion
Adults and adolescents. 3 mg/kg before chemotherapy and then 0.5 mg/kg/hr for 8hr.
Intravenous Injection
Adults and adolescents. 1 to 2 mg/kg 30 min before chemotherapy and then repetead every 2 to 3 hr, as needed.
Children. 1 mg/kg as a single dose, repeated in 1 hr. Maximum: 2 mg/kg.
To prevent postoperative nausea and vomiting
I.M. Injection
Adults and adolescents. 10 to 20 mg near end of procedure.
Dosage Adjustment
Reduced by half if creatinine clearance is less than 40 ml/min/1.73 m2.
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Incompatibilities
Don't administer metoclopramide through same intravenous line as calcium gluconate, cephalothin sodium, chloramphenicol sodium, cisplatin, erythromycin lactobionate, furosemide, methotrexate, penicillin G potassium, or sodium bicarbonate.
Contraindications of Drug
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Concurrent use of butyrophenones, phenothiazines, or other drugs that may cause extrapyramidal reactions; gastrointestinal hemorrhage, mechanical obstruction, or perforation; hypersensitivity to metoclopramide or its components; pheochromocytoma; seizure disorders
Generic Drug Interactions
Drugs
anticholinergics, opioid analgesics: Possibly decreased metoclopramide effects apomorphine: Possibly decreased antiemetic effect of apomorphine, possibly increased CNS depression
bromocriptine, pergolide: Possibly decreased therapeutic effects of these drugs cimetidine: Possibly decreased absorption and therapeutic effects of cimetidine CNS depressants: Possibly increased CNS depression
cyclosporine: Increased cyclosporine level digoxin: Decreased gastric digoxin absorption
levodopa: Possibly decreased levodopa effects
MAO inhibitors: Increased risk of severe hypertension if patient has essential hypertension
mexiletine: Possibly faster mexiletene absorption
succinylcholine: Possibly prolonged therapeutic action of succinylcholine
Activities
alcohol use: Risk of excessive sedation
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Drugs Adverse Reactions
Central Nervous System: Agitation, anxiety, depression, dizziness, drowsiness, extrapyramidal reactions (motor restlessness, parkinsonism, tardive dyskinesia), fatigue, headache, insomnia, irritability, lassitude, neuroleptic malignant syndrome, panic reaction, restlessness
Cardiovascular: atrioventricular block, fluid retention, heart failure, hypertension, hypotension, supraventricular tachycardia
Eyes, Ears, Nose, And Throat: Dry mouth
Endocrine: Galactorrhea, gynecomastia
Gastrointestinal: Constipation, diarrhea, nausea
Genitourinary: Menstrual irregularities
Hematologic: Agranulocytosis
Skin: Rash
Other: Restless leg syndrome
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Nursing Considerations for Generic Drugs
• Use metoclopramide cautiously in patients with hypertension because it may increase catecholamine levels.
WARNING Watch closely for tardive dyskinesia, especially in the elderly, women, and patients with diabetes, because this serious adverse effect is often irreversible even after therapy stops. Therapy lasting longer than 12 weeks isn't recommended because risk of tardive dyskinesia increases the longer the patient takes metoclopramide. Risk also has been linked to total cumulative dose so prescriber must take this into account when setting dosage. At first sign of involuntary movements of face, tongue, or limbs, notify prescriber and expect to discontinue drug.
• Monitor patient with NADH-cytochrome b5 reductase deficiency because metoclopramide increases risk of methemoglobinemia and sulfhemoglobinemia, and patient can't receive methylene blue.
• Assess patient for signs of intestinal obstruction, such as abnormal bowel sounds, diarrhea, nausea, and vomiting, before administering metoclopramide. Notify prescriber if you detect them.
• For intravenous use, you need not dilute doses of 10 mg or less. Give drug over 1 to 2 minutes. For doses larger than 10 mg, dilute in 50 ml normal saline solution, half-normal (0.45) saline solution, D5W, orlactated Ringer's solution and infuse over at least 15 minutes.
• Avoid rapid intravenous delivery because it may cause anxiety, restlessness, and drowsiness.
WARNING Notify prescriber if patient shows signs of toxicity, such as disorientation, drowsiness, and extrapyramidal reactions.
• Monitor patient, especially one with heart failure or cirrhosis, for possible fluid retention or volume overload due to transient increase in plasma aldosterone level.
• Monitor patient closely for neuroleptic malignant syndrome, a rare but potentially fatal disorder characterized by hyperthermia, muscle rigidity, altered level of consciousness, irregular pulse or blood pressure, tachycardia, diaphoresis, and arrhythmias.
• Store drug in a light-resistant container; discard if discolored or contains particulate.
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