Metoclopramide is an antiemetic drug of central action.
Release form and composition
Metoclopramide Dosage Forms:
- Tablets (10 pieces in blisters, 5 or 10 blisters in cartons; 5000 pieces in plastic bags, 1 package in plastic jars);
- Solution for injection (2 ml in dark glass ampoules, 5 ampoules in plastic pallets, 1 or 2 pallets in cardboard boxes).
1 tablet contains:
- Active ingredient: metoclopramide hydrochloride - 10 mg;
- Auxiliary components: corn starch, magnesium stearate, sodium starch glycolate, purified talcum, anhydrous colloidal silicon, lactose.
In 1 ml of solution contains:
- Active ingredient: metoclopramide hydrochloride - 5 mg;
- Auxiliary components: sodium metabisulfite, glacial acetic acid, sodium acetate, ethylenediaminetetraacetic acid disodium salt, water for injection.
Indications for use
Metoclopramide is prescribed in the following cases:
- Nausea, vomiting and hiccups of various origins (in some cases, the drug is effective in vomiting caused by the administration of cytotoxic drugs or radiation therapy);
- Postoperative hypotonia and atony of the intestine and stomach;
- Reflux esophagitis;
- Dyskinesia of the biliary tract by hypomotor type;
- Functional pyloric stenosis;
- Exacerbation of gastric ulcer and 12 duodenal ulcer (as part of complex therapy).
In addition, Metoclopramide is used when conducting radiopaque studies of the gastrointestinal tract in order to enhance peristalsis, as well as during duodenal intubation to accelerate gastric emptying and promote food through the small intestine.
- Stenosis of the pylorus;
- Perforation of the wall of the stomach or intestines;
- Bleeding from the gastrointestinal tract;
- Mechanical intestinal obstruction;
- Vomiting due to the use or overdose of neuroleptics in patients with breast cancer;
- Parkinson's disease;
- Extrapyramidal disorders;
- Prolactin-dependent tumors;
- Bronchial asthma in patients with hypersensitivity to sulfites;
- Period after pyloroplasty and intestinal anastomosis;
- I trimester of pregnancy;
- Children's age up to 2 years - for solution, up to 6 years - for tablets;
- Hypersensitivity to the drug.
Relative (requires special care due to the risk of complications):
- Arterial hypertension;
- Renal / hepatic impairment;
- Parkinson's disease;
- Bronchial asthma;
- Child and elderly (over 65 years) age;
- II and III trimesters of pregnancy (the drug can be used only in the presence of vital indications).
Dosing and Administration
Metoclopramide tablets should be taken orally, with a small amount of water, 30 minutes before meals.
- Adults: 5–10 mg 3–4 times daily;
- Children over 6 years: 5 mg 1-3 times a day.
The maximum allowable dose for adults: single - 20 mg daily - 60 mg.
Metoclopramide Solution is intended for intravenous or intramuscular administration.
Adults appoint 10-20 mg 1-3 times a day (no more than 60 mg / day), children over 6 years old - 5 mg 1-3 times a day. The daily dose for children aged 2-6 years is 0.5-1 mg / kg, it is divided into 1-3 introductions.
When conducting an x-ray examination by an adult, 5–20 minutes of the procedure are administered intravenously 10–20 mg of metoclopramide.
For the treatment and prevention of nausea and vomiting caused by cytostatics or radiation therapy, the drug is administered at a dose of 2 mg / kg intravenously 30 minutes before irradiation or the use of cytostatics. If necessary, after 2-3 hours do a second injection.
In patients with clinically severe renal-hepatic insufficiency, the initial dose is reduced by 2 times from the usual one, then the dose is determined individually depending on the efficacy and tolerability of metoclopramide.
- Allergic reactions: bronchospasm, urticaria, angioedema;
- Nervous system: extrapyramidal disorder (rhythmic protrusion of tongue, lockjaw, bulbar type of speech, facial muscles spasm, opisthotonos, spasmodic torticollis, muscular hypertonicity, spasm of the extraocular muscles, including oculogyric crisis), parkinsonism (muscle rigidity, hyperkinesis), dyskinesia (in elderly and patients with chronic renal failure), anxiety, headache, fatigue, confusion, tinnitus, drowsiness, depression;
- Digestive system: diarrhea or constipation; rarely, dry mouth;
- Blood system: leukopenia, neutropenia, sulfhemoglobinemia in adults;
- Cardiovascular system: atrioventricular block;
- Metabolism: porphyria;
- Endocrine system: rarely (with long-term treatment with high doses) - galactorrhea, gynecomastia, menstrual disorders;
- Other: at the beginning of treatment - agranulocytosis; rarely (when using the drug in high doses) - hyperemia of the nasal mucosa.
Most of these side effects occur in the first 36 hours after the start of the drug and disappears within 24 hours after discontinuation.
Metoclopramide is ineffective in vomiting of vestibular origin.
Treatment, if possible, should be short-term.
During the period of use of the drug is recommended to refrain from the use of alcoholic beverages, be careful when driving or performing tasks that require quick reactions and high concentration of attention.
Metoclopramide enhances the sedative effect of hypnotic drugs, the effect of ethyl alcohol on the central nervous system, the effectiveness of H2-histamine receptor blockers.
The drug slows down the absorption of cimetidine and digoxin, enhances the absorption of ethanol, acetylsalicylic acid, paracetamol, ampicillin, tetracycline and diazepam.
Cholinesterase inhibitors weaken the action of metoclopramide.
With the simultaneous use of neuroleptics increases the likelihood of extrapyramidal symptoms.
Terms and conditions of storage
Store at a temperature not exceeding 25 ºС in a place protected from moisture (tablets) and light, out of reach of children.
Shelf life - 3 years.