View source for Metoclopramide

==General==
*Type: [[antiemetics]]
*Dosage Forms: 5mg, 10mg; 5mg/5 mL; IM; IV
*Common Trade Names: Reglan

==Adult Dosing==
===[[GERD]]===
*Chronic symptoms: 10-15mg PO/IM/IV qac and qhs
*Max: x12wk; intermittent symptoms: up to 20mg PO/IM/IV x 1 before symptoms

===[[Diabetic gastroparesis]]===
*10mg PO/IM/IV qac and qhs
*Max: x12wk

===[[Nausea/vomiting]] prevention, chemo-related===
*1-2mg/kg IV q2-3h

===[[Nausea/vomiting]] prevention, postop===
*10mg IM/IV x 1

===small bowel intubation===
*10mg IV x 1 

===Radiologic exam===
*10mg IV x 1

===Palliative medicine===
*10mg subcutaneously or orally 6-hourly and/or 30mg via [[CSCI]] over 24 hours

==Pediatric Dosing==
===GERD===
*0.1-0.2mg/kg PO/IM/IV QID
*Max: 0.8mg/kg/24h x 12wk

===[[Nausea and vomiting (peds)|Nausea/vomiting]] prevention, chemo-related===
*1-2mg/kg IV q2-4h

===[[Nausea and vomiting (peds)|Nausea/vomiting]] prevention, postop===
*0.1-0.2mg/kg IV x1

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*[[Lactation risk categories|Lactation risk]]: Safety Unknown
*Renal Dosing
**Adult: CrCl 41-50: decrease dose 25%; CrCl 10-40: decrease dose 50%; CrCl <10: decrease dose 75%; HD/PD: no supplement
**Pediatric: CrCl 41-50: decrease dose 25%; CrCl 10-40: decrease dose 50%; CrCl <10: decrease dose 75%; HD/PD: no supplement
*Hepatic Dosing
**Adult: no adjustment
**Pediatric: no adjustment

==Contraindications==
*Allergy to class/drug
*pheochromocytoma
*seizure disorder
*GI bleeding or perforation
*GI obstruction
*caution if depression
*caution if Parkinson disease
*caution if NADH methemoglobin reductase deficiency
*caution if hypertension
*caution if CHF
*caution if cirrhosis
*caution if dibetes mellitus
*caution if renal impairment
*caution if neonates
*caution if pediatric patients
*caution if elderly patients, esp. female

==Adverse Reactions==
===Serious===
*extrapyramidal symptoms
*dystonia, acute
*parkinsonism
*tardive dyskinesia
*[[neuroleptic malignant syndrome]]
*seizures
*depression
*suicidality
*hallucinations
*leukopenia
*neutropenia
*agranulocytosis
*methemoglobinemia
*[[CHF]], acute
*AV block
*SVT
*hypertension
*angioedema
*hepatotoxicity
*withdrawal symptoms if abrupt discontinuation

===Common===
*drowsiness
*restlessness
*fatigue
*anxiety
*insomnia
*headache
*confusion
*dizziness
*depression
*extrapyramidal symptoms
*galactorrhea
*amenorrhea
*gynecomastia
*hyperprolactinemia
*impotence
*hyperaldosteronism
*fluid retention
*hypotension
*hypertension
*bradycardia
*nausea
*diarrhea
*urinary frequency
*incontinence
*rash
*urticaria
*visual disturbance

==Pharmacology==
*Half-life: 5-6h
*Metabolism: liver minimally; CYP450: unknown
*Excretion: urine 85% (20% unchanged), bile/feces 5%
*Mechanism of Action: exact mechanism of action unknown;  sensitizes tissues to acetylcholine, stimulating upper GI tract motility; antagonizes central and peripheral dopamine receptors, producing antiemetic effects

==Comments==


==Indications by Condition==
''The following table is automatically generated from disease/condition pages across WikEM.''

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 |?Has Indication=Indication
 |?Has Dose=Dose
 |?Has Context=Context
 |?Has Route=Route
 |?Has Population=Population
 |format=table
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}}

==See Also==

==References==
<references/>
[[Category:Pharmacology]]
[[Category:GI]]