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Metoclopramide

Metoclopramide is an anti-emetic medication that helps to reduce the risk of nausea and vomiting in certain conditions. The active ingredient in this drug influences the way that the vomiting centre of the brain works, impacting the reactions of the stomach.

What is metoclopramide?

Metoclopramide is a prescription-only drug that comes in both branded and non-branded versions. It is available in a range of different forms, including tablets, capsules and an oral solution. In rare cases, metoclopramide may be given in intravenous form, though this will only be possible in hospital situations.

Metoclopramide belongs to a group of drugs called prokinetics and anti-emetics, designed to reduce your risk of vomiting and nausea as well as helping you to empty the contents of your stomach when necessary to reduce acid. These drugs work by emptying the contents of your stomach through your intestines, speeding up muscle contractions. At the same time, the tightness of your lower oesophageal sphincter is increased, which means that stomach acid cannot flow back into the oesophagus. Metoclopramide also prevents nausea and vomiting by blocking the receptors in the human body that often cause nausea and vomiting.

When is metoclopramide used?

Metoclopramide can be used to treat a range of conditions associated with the intestines and stomach and is often a short- term treatment option for heartburn when other medicines do not work properly. It is usually used for heartburn instances that occur during the day or after a meal. Treating persistent acid reflux can reduce the amount of damage done to the oesophagus by stomach acid.

Metoclopramide can also be used in patients with diabetes who usually have problems emptying their stomach. Treating this condition can help to reduce symptoms of vomiting and nausea, and reduce abdominal fullness. Metoclopramide works by blocking dopamine in the body and speeding the movement of the upper intestines. This medication should not usually be given to children because the risk of muscle spasms and other side effects will often be greater.

How do you use metoclopramide?

Metoclopramide comes with a patient leaflet to be read carefully before the start of treatment. You should speak to a doctor or pharmacist if you have any questions on how to take this substance. Take the medication by mouth up to 30 minutes before meals and at bedtime when told to do so by your doctor. Follow your doctor’s instructions carefully.

If you are taking the suspension form, you will need to measure it using the device that is provided as a household spoon will not give you the correct dose. If you are using the disintegrating tablet, you should not remove the tablet from the packaging before you are ready to take your dose. Do not use the tablet if it is broken.

If heartburn only occurs at certain times, your doctor might tell you to take your dose at those times rather than using it constantly throughout the day. This could reduce your risk of side effects. Take this medication regularly to get the best benefit from it. To help you take it consistently, it is best to use the medication at the same time each day.

If you suddenly stop taking this medication, you might suffer from withdrawal symptoms such as headaches, nervousness and dizziness. To help prevent this, your doctor is likely to reduce your dose gradually.

What dosages are there?

Metoclopramide will be given to you in a dose based on your medical condition. Response to treatment and age will also be taken into account. Because of the higher risk of various side effects, it is not a good idea to take this medication more often than necessary. Treatment is usually for maximum of five days.

The most common dosage is metoclopramide tablets of 10 mg that are taken one to three times every day, after a bout of acid reflux begins. However, your treatment will depend on your condition. To treat the issue of diabetic gastroparesis, this medication may be taken for up to eight weeks until your gut is working properly again. Take this medication exactly as directed to get the most benefit from it. Tell your doctor if you feel that your conditions are persisting or getting worse when you are taking metoclopramide.

What are the side effects of metoclopramide?

Along with the effects that are intended with this drug, you may find that you occasionally suffer from unintended side effects such as dizziness, trouble with your sleeping, headaches or tiredness. Some people also suffer from diarrhoea. There is a good chance that these side effects will diminish on their own when your body gets used to the medication. However, you should seek help from a medical professional if you are concerned that your side effects are getting worse.

Make sure that you speak to your doctor immediately if you have any more serious side effects when taking metoclopramide tablets¸ including:

  • Changes to your mood, including anxiety, depression, confusion, or thoughts of committing suicide;
  • Issues with your sexual ability, including an inability to maintain an erection;
  • Inability to keep still, or uncontrolled muscle movements and spasms;
  • Parkinson-like issues, such as shaking, difficult movement, slowed movement, or a mask-like facial expression;
  • Abnormal production of breast milk, enlarged breasts, and swelling in the hands and feet;
  • Changes to menstruation in women.

In rare conditions, this medication could cause an issue called neuroleptic malignant syndrome, which presents with symptoms such as muscle stiffness, fever, sweating and an irregular heartbeat. Speak to a doctor immediately if you experience any of these side effects.

A serious allergic reaction to metoclopramide tablets or suspension is not common. However, you should seek medical attention immediately if you experience swelling in the face, throat and lips, or a rash and itching.

When should you not use metoclopramide?

You should not use metoclopramide tablets or suspension without the approval of a doctor or consultant. Before you begin taking this medication, it is important to answer any questions that your doctor or consultant may have about both your condition and your medical history. You may also be asked questions about your family history of certain ailments. Tell your doctor or consultant if you are allergic to this or any other medications. You should also mention any other allergies that may be aggravated by the inactive ingredients in this medication.

Tell your doctor if you have any history of:

  • Muscle disorders;
  • Issues with blockages, bleeding or holes in the intestine;
  • Breast cancer;
  • High blood pressure;
  • Kidney problems;
  • Mental or mood problems;
  • Heart failure;
  • Depression;
  • Parkinson’s disease;
  • Liver disease;
  • Blood enzyme issues;
  • Seizures;
  • Pheochromocytoma.

Metoclopramide tablets and suspension can increase your chances of feeling drowsy or dizzy. Other substances such as alcohol can increase your risk of this side effect. It is important to remember that the liquid version of this medication may include alcohol. Speak to your doctor if you are suffering with liver disease, alcohol dependence or diabetes.

The disintegrating tablets of metoclopramide can include phenylalanine. If you need to avoid this substance in your diet, you may need to ask your doctor to switch to a different kind of treatment. Additionally, remember that if you have diabetes, this medication can make it harder to control your blood sugar. You may be asked to monitor your blood sugar regularly to check for any signs of high or low blood sugar. Your doctor may also ask you to adjust your treatment plan.

Children and older adults are likely to be more sensitive to the side effects that metoclopramide tablets and suspension can cause, particularly when it comes to uncontrolled muscle movements and spasms. Older adults are also more likely to experience problems such as drowsiness and muscle problems. Depending on your circumstances, you may need to agree to regular check-ups with your doctor to ensure that it is safe for you to continue taking this medication.

Does metoclopramide interact with other medications?

Metoclopramide tablets and suspension can interact with other medications that you already have in your system. You should always tell your doctor or consultant about any other substances that you are taking when you are about to begin using a new medication. This includes any over-the-counter drugs that you are using, as well as prescription medications. Make sure that your doctor or consultant is also aware of any supplements or herbal medications that you may be taking.

Antipsychotic drugs such as aripiprazole can interact negatively with metoclopramide. You should also avoid atovaquone and dopamine antagonists such as pergolide. Do not use fosfomycin, phenothiazines, ciclosporin, suxamethonium, SSRI antidepressants or pramlintide with metoclopramide without approval from your doctor.

Metoclopramide tablets and suspension can cause medication and food to move through your stomach and intestines at a greater speed than usual. This could affect the way that other crucial drugs are absorbed. Speak to your doctor about how you should time your medication intake to ensure that you get the right treatment for any and all conditions. Tell your doctor or consultant if you are taking other drugs that may make you drowsy, including narcotic pain relievers, muscle relaxants and drugs for anxiety or sleep.

Where can you buy metoclopramide?

Metoclopramide tablets and suspension are available offline or online from any reputable pharmacy. You will need to get approval from a doctor and a prescription to get this treatment.

Can I get metoclopramide without a prescription?

Metoclopramide tablets and suspension are not safe to take without a prescription.

Sources:

Drugs.com, metoclopramide, accessed 29 February 2020, retrieved from: https://www.drugs.com/metoclopramide.html

Medline online, metoclopramide, accessed 29 February 2020, retrieved from: https://medlineplus.gov/druginfo/meds/a684035.html

Mayo Clinic, metoclopramide (Oral Route), accessed 29 February 2020, retrieved from: https://www.mayoclinic.org/drugs-supplements/metoclopramide-oral-route/description/drg-20064784

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