Metoclopramide: Difference between revisions
(→Common) |
|||
| Line 9: | Line 9: | ||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: Safety Unknown | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: CrCl 41-50: decr. dose 25%; CrCl 10-40: decr. dose 50%; CrCl <10: decr. dose 75%; HD/PD: no supplement | ||
**Pediatric | **Pediatric: CrCl 41-50: decr. dose 25%; CrCl 10-40: decr. dose 50%; CrCl <10: decr. dose 75%; HD/PD: no supplement | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: no adjustment | ||
**Pediatric | **Pediatric: no adjustment | ||
==Contraindications== | ==Contraindications== | ||
Revision as of 20:30, 30 June 2015
General
- Type: anti-emetic
- Dosage Forms: 5, 10; 5/5 mL; IM; IV
- Common Trade Names: Reglan
Adult Dosing
Pediatric Dosing
Special Populations
- Pregnancy Rating: B
- Lactation risk: Safety Unknown
- Renal Dosing
- Adult: CrCl 41-50: decr. dose 25%; CrCl 10-40: decr. dose 50%; CrCl <10: decr. dose 75%; HD/PD: no supplement
- Pediatric: CrCl 41-50: decr. dose 25%; CrCl 10-40: decr. dose 50%; CrCl <10: decr. 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 dz
- caution if NADH methemoglobin reductase deficiency
- caution if HTN
- caution if CHF
- caution if cirrhosis
- caution if dibetes mellitus
- caution if renal impairment
- caution if neonates
- caution if pediatric pts
- caution if elderly pts, esp. female
Adverse Reactions
Serious
- extrapyramidal sx
- dystonia, acute
- parkinsonism
- tardive dyskinesia
- neuroleptic malignant syndrome
- seizures
- depression
- suicidality
- hallucinations
- leukopenia
- neutropenia
- agranulocytosis
- methemoglobinemia
- CHF, acute
- AV block
- SVT
- HTN
- angioedema
- hepatotoxicity
- withdrawal sx if abrupt D/C
Common
- drowsiness
- restlessness
- fatigue
- anxiety
- insomnia
- headache
- confusion
- dizziness
- depression
- extrapyramidal sx
- galactorrhea
- amenorrhea
- gynecomastia
- hyperprolactinemia
- impotence
- hyperaldosteronism
- fluid retention
- hypotension
- HTN
- 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