Products
Metoclopramide is commercially available in tablet, solution, and solution for injection (Primpéran, Paspertin). It has been approved in many countries since 1967. The drops and suppositories for children were withdrawn from the market in November 2011 because of the risk for extrapyramidal side effects.
Structure and properties
Metoclopramide (C14H22ClN3O2, Mr = 299.8 g/mol) is a benzamide. It exists as a white powder that is practically insoluble in water. Metoclopramide hydrochloride, which is also used, is very soluble in water. Metoclopramide is a structural analog of the local anesthetic procaine.
Effects
Metoclopramide (ATC A03FA01) has prokinetic properties, particularly in the upper gastrointestinal tract. It is antiemetic, antidopaminergic, peripherally antiserotonergic (5-HT3) and indirectly cholinergic. Unlike domperidone, it crosses the blood–brain barrier and can cause central adverse effects in the CNS like the neuroleptics.
Indications
Metoclopramide is used to treat motility disorders such as irritable stomach, heartburn, in diabetic gastroparesis, postoperative gastric atony, for nausea, nausea, and vomiting of various causes, in the setting of diagnostic studies, and in reflux esophagitis.
Dosage
According to the drug label. Oral intake is usually 30 minutes before meals.
Contraindications
- Hypersensitivity
- Intestinal obstruction, intestinal perforation, bleeding in the digestive tract.
- Pheochromocytoma
- Prolactinoma
- Patients with increased seizures, epilepsy.
- Extrapyramidal motor disorders
- Combination with levodopa
- Infants under 1 year
Use in children and adolescents between 1 and 18 years is not recommended. Full details of precautions and drug interactions can be found in the SmPC.
Adverse effects
The most common possible adverse effects include fatigue, headache, dizziness, insomnia, anxiety, restlessness, and diarrhea.
