Metoclopramide

Generic Name

Brand Name Apo-Metoclop, Reglan

Drug Therapeutic: Dopamine receptor antagonist.

Classification Clinical: GI emptying adjunct, peristaltic stimulant, antiemetic.

Stimulates motility of upper GI tract. Blocks dopamine/serotonin

Mechanism of receptors in chemoreceptor trigger zone. Enhances acetylcholine
Action response in upper GI tract; increase lower esophageal sphincter
tone.
Injection Solution: 5mg/ml. Solution, Oral: 5mg/ml. Tablets 5mg,
Route & Dosage
10mg.
Prevention of Chemotherapy-Induced Nausea/Vomiting, Postop

Indication Nausea/Vomiting, Gastroparesis, Gastroesophageal Reflux

Disease (GERD) and Facilitate Small Bowel Intubation.
Hypersensitivity to metoclopramide. Concurrent use of
medications like to produce extrapyramidal reactions. Situations in
Contraindication which GI motility may be dangerous (e.g., GI hemorrhage, GI
perforation/obstruction), history of seizure disorder,
pheochromocytoma.
Frequent (10%): Drowsiness, restlessness, fatigue, lethargy.
Occasional (3%): Dizziness, anxiety headache, insomnia, breast
Side Effects tenderness, altered menstruation, constipation, rash, dry mouth,
galactorrhea, gynecomastia. Rare (less than 3%): Hypotension,
hypertension, tachycardia.
Extrapyramidal reactions occur most frequently in children, young
adults (18-30 yrs) receiving large dose (2mg/kg) during
chemotherapy and usually are limited to akathisia (involuntary
Adverse Effects
limb movement, facial grimacing, motor restlessness). Neuroleptic
malignant syndrome (diaphoresis, fever, unstable BP, muscular
rigidity) has been reported.
Drug Interaction Drug: Alcohol, other CNS depressants (e.g., lorazepam,
 morphine, zolpidem, may increase CNS depressant effect.
Anticholinergics (e.g., scopolamine), opioid analgesics (e.g.,
morphine, Hydromorphone) may decrease effects on GI motility.
Lab values: may increase serum aldosterone, prolactin.
Monitor for anxiety, restlessness, extrapyramidal symptoms (EPS)
during IV administration. Monitor daily pattern of bowel
Nursing
activity, stool consistency. Assess skin for rash. Evaluate for
Responsibilities
therapeutic response from gastroparesis (nausea, vomiting,
bloating). Monitor renal function, B/P, heart rate.