Metoclopramide hydrochloride (metoclopramide)
Composition and release form of the drug
Tablets white or white with a yellowish tinge, beveled, marbling is allowed.
Excipients: lactose monohydrate 60 mg, potato starch "Extra" 28.47 mg, 0.53 mg, calcium stearate 1 mg.
10 pieces. - contour cell packaging (1) - cardboard packs.
10 pieces. - contour cell packaging (5) - cardboard packs.
pharmachologic effect
Means, helps to reduce nausea, hiccups; stimulates gastrointestinal motility. The antiemetic effect is due to the blockade of dopamine D 2 receptors and an increase in the threshold of the trigger zone chemoreceptors; it is a blocker of serotonin receptors. It is believed that metoclopramide inhibits dopamine-induced relaxation of gastric smooth muscles, thereby enhancing the cholinergic responses of gastrointestinal smooth muscles. Helps to accelerate gastric emptying by preventing relaxation of the stomach body and increasing the activity of the antrum and upper small intestine. Reduces the reflux of the contents into the esophagus by increasing the pressure of the esophageal sphincter at rest and increases the clearance of acid from the esophagus due to an increase in the amplitude of its peristaltic contractions.
Metoclopramide stimulates the secretion of prolactin and causes a transient increase in circulating aldosterone levels, which may be accompanied by short-term fluid retention.
Pharmacokinetics
After oral administration, it is rapidly absorbed from the gastrointestinal tract. Protein binding is about 30%. Biotransformed in the liver. It is excreted mainly by the kidneys both unchanged and in the form of metabolites. T 1/2 is from 4 to 6 hours.
Indications
Vomiting, nausea, hiccups of various origins. Atony and hypotension of the stomach and intestines (including postoperative); biliary dyskinesia; reflux esophagitis; flatulence; as part of complex therapy exacerbations of gastric ulcer and duodenum; acceleration of peristalsis during radiopaque studies of the gastrointestinal tract.
Contraindications
Bleeding from the gastrointestinal tract, mechanical intestinal obstruction, perforation of the stomach or intestines, pheochromocytoma, extrapyramidal disorders, epilepsy, prolactin-dependent tumors, glaucoma, pregnancy, lactation, simultaneous use of anticholinergic drugs, hypersensitivity to metoclopramide.
Dosage
For adults inside - 5-10 mg 3-4 times / day. With vomiting, severe nausea, metoclopramide is administered intramuscularly or intravenously at a dose of 10 mg. Intranasally - 10-20 mg in each nostril 2-3 times / day.
Maximum doses: single ingestion - 20 mg; daily - 60 mg (for all modes of administration).
The average single dose for children over 6 years of age is 5 mg 1-3 times / day orally or parenterally. For children under 6 years old daily dose for parenteral administration is 0.5-1 mg / kg, the frequency of administration is 1-3 times / day.
Side effects
From the digestive system: at the beginning of treatment, constipation, diarrhea are possible; rarely dry mouth.
From the side of the central nervous system: at the beginning of treatment, a feeling of fatigue, drowsiness, dizziness, headache, depression, akathisia are possible. It is possible that extrapyramidal symptoms occur in children and young people (even after a single use of metoclopramide): spasm of the facial muscles, hyperkinesis, spastic torticollis (usually disappear immediately after stopping metoclopramide). With prolonged use, more often in elderly patients, the phenomena of parkinsonism, dyskinesia are possible.
From the hematopoietic system: at the beginning of treatment, agranulocytosis is possible.
From the endocrine system: rarely, with prolonged use in high doses - galactorrhea, gynecomastia, menstrual irregularities.
Allergic reactions: rarely - skin rash.
Drug interactions
With simultaneous use with anticholinergics, mutual weakening of the effects is possible.
With simultaneous use with antipsychotics (especially the phenothiazine series and butyrophenone derivatives), the risk of extrapyramidal reactions increases.
With simultaneous use, absorption of paracetamol, ethanol is enhanced.
When administered intravenously, metoclopramide increases the rate of absorption of diazepam and increases its maximum concentration in blood plasma.
With simultaneous use with a slowly dissolving dosage form of digoxin, it is possible to reduce the concentration of digoxin in the blood serum by 1/3. With simultaneous use with in a liquid dosage form or in the form of a rapidly dissolving dosage form, no interaction was noted.
When used simultaneously with zopiclone, absorption is accelerated; with cabergoline - a decrease in the effectiveness of cabergoline is possible; with ketoprofen - the bioavailability of ketoprofen decreases.
Due to antagonism against dopamine receptors, metoclopramide can reduce the antiparkinsonian effect of levodopa, while the bioavailability of levodopa may increase due to the acceleration of its evacuation from the stomach under the influence of metoclopramide. Interaction results are mixed.
With simultaneous use with mexiletine, the absorption of mexiletine is accelerated; with mefloquine - the rate of absorption of mefloquine and its concentration in the blood plasma increase, while its side effects may decrease.
With simultaneous use with morphine, the absorption of morphine when taken orally is accelerated and its sedative effect is enhanced.
With simultaneous use with nitrofurantoin, the absorption of nitrofurantoin decreases.
When using metoclopramide immediately before the introduction of propofol or thiopental, it may be necessary to reduce their induction doses.
In patients receiving metoclopramide, the effects of suxamethonium chloride are enhanced and prolonged.
With simultaneous use with tolterodine, the effectiveness of metoclopramide decreases; with fluvoxamine - a case of the development of extrapyramidal disorders has been described; with fluoxetine - there is a risk of developing extrapyramidal disorders; with cyclosporine - the absorption of cyclosporine increases and its concentration in the blood plasma increases.
special instructions
It is used with caution in patients with bronchial asthma, arterial hypertension, impaired liver and / or kidney function, and Parkinson's disease.
Use with extreme caution in children, especially early age since they have a significantly higher risk of dyskinetic syndrome. In some cases, metoclopramide can be effective for vomiting caused by taking cytostatics.
Against the background of the use of metoclopramide, distortions of the data of laboratory indicators of liver function and determination of the concentration of aldosterone and prolactin in blood plasma are possible.
Influence on the ability to drive vehicles and use mechanisms
During the period of treatment, you should avoid potentially hazardous activities that require increased attention, rapid psychomotor reactions.
Pregnancy and lactation
Contraindicated in pregnancy.
When used during lactation ( breastfeeding) it should be borne in mind that metoclopramide passes into breast milk.
Use in the elderly
When used in elderly patients, it should be borne in mind that with prolonged use of metoclopramide in high or medium doses, the most common side effects are extrapyramidal disorders, especially parkinsonism and tardive dyskinesia.
The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!
The drug metoclopramide
Metoclopramide- medicinal antiemetic drug, used for vomiting of various origins.Other reactions:
- increased urination or urinary incontinence;
- gynecomastia (unilateral or bilateral exaggeration in men mammary glands by the type of women);
- menstrual irregularities;
- galactorrhea (discharge of milk or milky fluid from the mammary glands);
- porphyria (violation of pigment metabolism);
- bronchospasm;
- hyperemia (redness) of the nasal mucosa.
Treatment with metoclopramide
How to take metoclopramide?Metoclopramide is taken 15-30 minutes before meals, without chewing; drink a pill with a little water. Metoclopramide in solution for injection can be administered both intravenously and intramuscularly. This solution can also be used as nasal drops.
During treatment with metoclopramide, alcoholic beverages should be avoided, as they increase the risk of complications.
Given the decrease in concentration and a slower reaction when taking metoclopramide, you should stop driving a car during the course of treatment, and also avoid working with the use of potentially dangerous equipment.
Dosage of metoclopramide
Tablets
For adults, it is prescribed 5-10 mg (0.5-1 tablet) 3-4 times a day. The maximum single dose for adults is 20 mg (2 tablets), the maximum daily dose is 60 mg (6 tablets).
The average duration of the course of treatment in adults is 4-6 weeks.
Injection
Intramuscularly or intravenously, adults are prescribed:
- with paresis of the stomach and intestines, 10-15 mg up to 4 times a day;
- for the prevention and treatment of vomiting (nausea) during chemotherapy or radiation therapy - intravenous dose is administered at the rate of 1-2 mg per 1 kg of body weight half an hour before a session of chemotherapy (or radiation therapy) and then every 2-4 hours (if necessary) ;
- 5-15 minutes before X-ray examination or before the introduction of the probe, 10-20 mg of metoclopramide is administered intravenously to adult patients.
With intranasal administration, metoclopramide solution is instilled into each nasal passage at 10-20 mg of the drug several times a day.
An overdose of the drug will be indicated by the following signs: hypersomnia (severe drowsiness during the day or a very long night's sleep), confusion and the appearance of extrapyramidal disorders (disorders muscle tone and movements from involuntary twitching to immobility). If such signs appear, you should stop taking metoclopramide. Symptoms will disappear within a day after stopping the intake.
Metoclopramide for children
In the early childhood(up to 2 years) metoclopramide is contraindicated in any dosage form.Children under 6 years old can only use tablet forms according to strict indications and with caution. The dosage is 0.5-1 mg per 1 kg of the child's body weight per day. The daily dose is divided into 3 doses. Older children are prescribed 5 mg (0.5 tablets) 3 times a day.
During chemotherapy and radiation therapy, 1-2 mg of metoclopramide per 1 kg of body weight is administered intravenously half an hour before the treatment session, then repeated if necessary after 3-4 hours.
The course of treatment with metoclopramide in children should be as short as possible.
Before X-ray examination of the gastrointestinal tract or before the introduction of the probe for 5-15 minutes, the drug is administered intravenously: children under 6 years old - 0.1 mg per 1 kg of body weight, and children over 6 years old - 2.5-5 mg per 1 kg body weight.
Metoclopramide during pregnancy
In the first trimester of pregnancy, metoclopramide is contraindicated. In the second and third trimesters, the use of metoclopramide is allowed only for health reasons, because studies were carried out only on animals, although the adverse effect of the drug on the fetus was not revealed. Since metoclopramide passes into breast milk, if it is necessary to prescribe it during lactation, breastfeeding should be stopped.
Interaction of metoclopramide with other drugs
Metoclopramide enhances the effect of sleeping pills, the effect of alcohol on the central nervous system; increases the absorption of Ampicillin, Tetracycline, Levodopa, Paracetamol, Aspirin (acetylsalicylic acid); increases the effectiveness of drugs that reduce the acidity of gastric juice - such as Ranitidine, Famotidine; slows down the absorption of Cimetidine and Digoxin (dose adjustment of these drugs may be required).The action of metoclopramide can be weakened by cholinesterase inhibitors (Galantamine, Eserin or Physostigmine, Proserin, Pyrofos, Armin, Fosfacol). The effect of the drug on the motility of the gastrointestinal tract can be blocked by drugs containing opioids.
The simultaneous use of metoclopramide and antipsychotics (especially derivatives of butyformenone and phenothiazines) is undesirable, because at the same time, the risk of developing extrapyramidal disorders increases (changes in muscle tone and movement disorders from hyperkinesis or twitching to immobility).
Analogues of metoclopramide
There are many structural analogs (synonyms) of metoclopramide:Raglan, Metoclopramide hydrochloride, Klomethol, Cerucal, Reliverin, Perinorm, Primperil, Bimaral, Primperan, Comportan, Pramin, Viscal, Gastrobids, Plastil, Peraprin, Imperal, Paspertin, Maxolon, Clopan, Metoclol, Macrodisse, Eusmethran , Regastrol, Terperan, Rimetin.
Preparations of similar action (but with a different chemical composition):
Domrid, Domstal, Motorikum, Dimetkarb, Dimetpramid.
ATX code: A03FA01
Trade name: Metoclopramide International non-proprietary name: Metoclopramide / Metoclo-pramide. Release form: solution for injection 5 mg / ml. Composition: one ampoule (2 ml solution) contains - active substance: metoclopramide hydrochloride - 10 mg; excipients: sodium chloride, sodium sulfite anhydrous E 221, disodium edetate, propylene glycol, hydrochloric acid, water for injection. Description: clear, colorless liquid. Pharmacotherapeutic group: agents for the treatment of functional disorders of the gastrointestinal tract; prokinetics.
Adults. For the prevention of postoperative nausea and vomiting.
For the symptomatic treatment of nausea and vomiting, including nausea and vomiting in acute migraines.
For the prevention of nausea and vomiting induced by radiation therapy.
The injection course of treatment should be as short as possible. The patient should be transferred to the oral or rectal route of administration as soon as possible.
Children aged 1 to 18 years. For the prevention of delayed (mild) nausea and vomiting due to chemotherapy, as a second-line drug. The maximum course of treatment is 5 days.
For the treatment of established postoperative nausea and vomiting, as a second-line drug. The maximum course of treatment is 48 hours.
Hypersensitivity to metoclopramide or drug components, gastrointestinal bleeding, gastric pyloric stenosis, mechanical intestinal obstruction, perforation of the stomach or intestines, 3-4 days after surgery on the stomach and / or intestines, pheochromocytoma (confirmed or suspected due to the risk of severe hypertensive complications), Parkinson's disease, extrapyramidal disorders (including neuroleptic or metoclopramide-induced tardive dyskinesia in history), epilepsy, prolactin-dependent tumors, a history of methemoglobinemia episodes of metoclopramide or with a deficiency of NADP-cytoplasmic NADPH receptors, pregnancy, children under 1 year of age, lactation.
Due to the content of sodium sulfite, metoclopramide solution should not be prescribed to patients with bronchial asthma with hypersensitivity to sulfite.
The maximum duration of drug use is no more than 5 days!
The solution for injection is administered intramuscularly or intravenously as a bolus for at least 3 minutes. Adults at a dose of 10 mg up to 3 times a day (the maximum single dose is 10 mg, the maximum daily dose is 30 mg or 0.5 mg / kg).
Children. The dose is calculated in accordance with the table or based on the calculation of 0.10 - 0.15 mg / kg of body weight up to 3 times a day. The maximum daily dose is 0.5 mg / kg of body weight.
| Age (in years) | Weight, kg) | Dose (mg) | Frequency |
| 1 - 3 | 10 - 14 | 1 | up to 3 times a day |
| 3 - 5 | 15 - 19 | 2 | up to 3 times a day |
| 5 - 9 | 20 - 29 | 2,5 | up to 3 times a day |
| 9 - 18 | 30 - 60 | 5 | up to 3 times a day |
| 15 - 18 | More than 60 | 10 | up to 3 times a day |
The maximum duration of therapy is 5 days. With repeated vomiting, the minimum interval between injections of metoclopramide should not be less than 6 hours.
With reduced renal function, the drug is prescribed:
- with creatinine clearance less than 15 ml / min - in doses reduced by 75%;
- with creatinine clearance from 15 to 60 ml / min - in doses reduced by 50%.
In severe hepatic impairment, the dose of metoclopramide should be reduced by 50%.
For elderly patients, dosing is carried out taking into account changes in liver and kidney function, as indicated above.
Metoclopramide belongs to drugs, which has an antiemetic effect.
Pharmacological action of Metoclopramide
According to the instructions, Metoclopramide soothes hiccups, has an antiemetic effect, and in some cases relieves nausea. In addition, it has a normalizing and regulating effect on the functions of the gastrointestinal tract, helps to reduce the motor activity of the esophagus, accelerate gastric emptying and the movement of food through the small intestine. In this case, the occurrence of diarrhea or a significant increase in peristalsis is not observed.
The drug is fast-acting. After intravenous administration, the effect is noted after a few minutes, and with intramuscular administration, it occurs after ten to fifteen minutes. The duration of the antiemetic effect lasts up to twelve hours.
Forms of release and composition of Metoclopramide
The drug is produced in the form of metoclopramide tablets and a solution for intramuscular and intravenous injections.
Flat, round, with beveled edges and scored tablets can be of different shades: from almost white to white.
One tablet of the drug contains: ten milligrams of the active ingredient - metoclopramide hydrochloride. Excipients: starch, lactose, magnesium stearate, talc, sodium starch glycolate, colloidal anhydrous silicon.
A colorless, transparent solution for injection is available in ampoules of two milliliters. One milliliter of the drug contains five milligrams of metoclopramide hydrochloride and excipients: sodium metabisulfate and sodium acetate, disodium EDTA, glacial acetic acid, water for injection.
Indications for the use of Metoclopramide
Metoclopramide is used according to indications: hiccups, nausea or vomiting of various origins (with radiation therapy, toxemia, taking medications such as morphine, apomorphine, violation of the diet).
The drug is also used for biliary dyskinesia, hypotension and atony of the intestines and stomach, including postoperative, reflux esophagitis and flatulence.
As one of the components of complex therapy, metoclopramide, according to indications, is used for exacerbation of duodenal ulcer and stomach ulcer. The drug is also used to accelerate peristalsis in X-ray contrast studies of the gastrointestinal tract.
Contraindications
According to the instructions, Metoclopramide is contraindicated in case of intestinal or stomach perforation, bleeding from the gastrointestinal tract, glaucoma, pheochromocytoma, epilepsy, extrapyramidal disorders, prolactin-dependent tumors, mechanical intestinal obstruction.
The drug is not recommended to be taken simultaneously with anticholinergic drugs, as well as in case of hypersensitivity to the active or auxiliary components of metoclopramide. The drug is prohibited for use by women who are pregnant and lactating.
Metoclopramide is used with caution in bronchial asthma, functional disorders in the kidneys and liver, arterial hypertension, Parkinson's disease.
With extreme caution, metoclopramide is prescribed to children, since there is a possibility of the onset and development of dyskinetic syndrome (especially in young children).
Method of administration and dosage
In tablets, metoclopramide is prescribed for adults in a dose of five to ten milligrams three to four times a day. With vomiting and severe nausea, the drug is administered intramuscularly or intravenously at a dose of ten milligrams. In addition, metoclopramide is used intranasally, instilled into each nasal passage from ten to twenty milligrams several times a day. For all routes of administration, a single maximum dose should not exceed twenty milligrams, the daily dose should not exceed sixty milligrams.
The dose of Metoclopramide for children is prescribed depending on age. The recommended dose of Metoclopramide tablets for children under six years of age is from half to one milligram per kilogram of body weight three times a day. Metoclopramide for children from six years old - five milligrams three times a day.
Dosage in drops of Metoclopramide for children under one year of age - five to ten drops, from one to three years - eight to twelve drops, from three to six - from ten to fifteen drops. The recommended frequency of admission is three times a day.
Metoclopramide is also prescribed for vomiting triggered by the intake of cytostatics.
Drug Interactions Metoclopramide
Thanks to the use of Metoclopramide, the absorption of acetylsalicylic acid, ethanol, paracetamol, tetracycline, levodopa, ampicillin is enhanced.
It is undesirable to use the drug simultaneously with anticholinergics (mutual weakening of the effects is possible), fluvoxamine and fluoxetine, as well as with neuroleptics, including derivatives of butyrophenone and phenothiazine series, (due to the risk of developing extrapyramidal disorders), with digoxin (namely, its slowly dissolving dosage form).
Metoclopramide is used with caution with mexiletine, zopiclone, mefloquine, cabergoline, nitrofurantoin, ketoprofen, tolterodine, morphine due to a change in the expected therapeutic effect.
Side effects of Metoclopramide
Instruction Metoclopramide indicates the possibility of constipation or diarrhea at the beginning of treatment, sometimes dry mouth, drowsiness, dizziness, fatigue, depression, headache, akathisia, agranulocytosis.
With prolonged use in high doses, in rare cases, the drug causes side effects in the form of gynecomastia, galactorrhea, menstrual irregularities, skin rash... In older people, dyskinesia and parkinsonism are possible.
Metoclopramide in children can provoke a spasm of hyperkinesis and facial muscles, as well as the occurrence of extrapyramidal symptoms, manifested as spastic torticollis.
During treatment with metoclopramide, the patient should know that the drug has a negative effect on the speed of psychomotor reactions and concentration of attention, therefore, activities such as driving vehicles, work at height should be avoided.
Conditions and shelf life
Metoclopramide is only available with a doctor's prescription. The shelf life of the drug is up to four years.
The antiemetic drug is metoclopramide. Instruction for use informs that 10 mg tablets, injections in ampoules for injection in solution stimulate the peristalsis of the digestive tract. According to gastroenterologists, this medication helps in the treatment of nausea, vomiting and flatulence.
Release form and composition
Metoclopramide is available in the following dosage forms Oh:
- Tablets: flat-cylindrical, round, with a chamfer, almost white or white, marbling is allowed (50 pcs. In blisters, 1 package in a cardboard box; 10 pcs. In blisters or blisters, 1-5, 10 each) packages or blisters in a cardboard box; 14 pcs. in blisters, 4 packages in a cardboard box; 50 pcs. in polymer or dark glass jars, 1 jar in a cardboard box).
- Solution for intravenous and intramuscular injection(in ampoules of 2 ml, 5 or 10 ampoules in a cardboard box, or 5 or 10 ampoules in plastic or cellular contour packages (pallets), 1 or 2 packages in a cardboard box).
The composition of 1 tablet of Metoclopramide contains - active substance: metoclopramide hydrochloride - 10 mg (in the form of metoclopramide hydrochloride monohydrate in terms of dry matter).
The composition of 1 ml of metoclopramide injection solution contains the active substance: metoclopramide hydrochloride - 5 mg.
Indications for use
What does metoclopramide help with? Tablets are indicated for various pathological conditions, which are accompanied by the development of nausea and the appearance of vomiting, these include:
- Complex therapy of gastric ulcer or duodenal ulcer.
- Reflux esophagitis is an inflammation of the mucous membrane of the esophagus, which is the result of the reflux of acidic gastric contents into it.
- Vomiting, nausea or hiccups of various origins, including those associated with disorders in the structures of the central nervous system.
- Atony or hypotension of the hollow structures of the digestive tract (stomach, small intestine) is a pronounced decrease in smooth muscle tone after surgery, taking or using certain medications.
- Biliary dyskinesia is a violation of the tone of the hollow structures of the hepatobiliary system ( gall bladder, hepatic and bile ducts), which is accompanied by severe nausea and vomiting.
- Flatulence - increased gas production in the intestine, provoked by a decrease in its peristaltic movements.
Also, metoclopramide tablets are used to enhance intestinal motility, which is necessary for some diagnostic studies (X-ray examination using contrast agents).
Instructions for use
Metoclopramide tablets
Take 30 minutes before meals with a little water. Adults - 5-10 mg 3-4 times a day. The maximum single dose is 20 mg, the daily dose is 60 mg. Children over 6 years old - 5 mg 1-3 times a day.
Ampoules
Intravenous or intramuscular. Adults at a dose of 10-20 mg 1-3 times a day (the maximum daily dose is 60 mg). Children over 6 years old - 5 mg 1-3 times a day.
For the prevention and treatment of nausea and vomiting caused by taking cytostatics or radiation therapy, the drug is administered intravenously at a dose of 2 mg / kg body weight 30 minutes before the use of cytostatics or radiation; if necessary, the introduction is repeated after 2-3 hours.
Before X-ray examination, adults are injected intravenously 10-20 mg 5-15 minutes before the start of the study.
Patients with clinically expressed hepatic and / or renal insufficiency are prescribed a dose half the usual dose, the subsequent dose depends on the patient's individual response to the drug.
See also: How to take a close analogue.
pharmachologic effect
Metoclopramide has an antiemetic effect, has a stimulating effect on the peristalsis of the digestive tract, reduces the severity of hiccups and nausea. The mechanism of action is based on blocking dopamine D2 receptors, on increasing the threshold of chemoreceptors located in the trigger region, on blocking serotonin receptors.
There is an assumption that the active substance is able to inhibit the relaxation of gastric smooth muscle tissue, which is caused by Dopamine.
The drug accelerates gastric emptying by relaxing its body, increasing the activity of the upper sections small intestine and the antrum of the stomach. By increasing the pressure of the esophageal sphincter at rest, it reduces the throwing of contents into the lumen of the esophagus.
An increase in the amplitude of peristaltic contractions increases acid clearance. It is noticed that the active ingredient stimulates the production of prolactin, increases the level of aldosterone, which can lead to fluid retention in the body (the effect is reversible).
Contraindications
- diagnosed glaucoma, suspicion of it;
- bleeding in the digestive system;
- individual hypersensitivity;
- stenosis of the pylorus of the stomach;
- Parkinson's disease;
- perforation of the walls of the intestine, stomach;
- prolactin-dependent neoplasms;
- pheochromocytoma;
- bronchial asthma in patients with hypersensitivity to sulfites;
- epilepsy;
- vomiting during treatment with antipsychotics in patients with breast cancer;
- extrapyramidal disorders;
- intestinal obstruction of a mechanical nature.
Medicine not used in the postoperative period in patients with pyloroplasty and intestinal anastomosis, because vigorous muscle contractions impair healing.
Relative contraindications: 
- advanced age (65 years and older);
- bronchial asthma;
- hypertonic disease;
- Parkinson's disease;
- diseases of the renal and hepatic system;
- childhood (development of dyskinetic syndrome is possible);
Side effects
- Central nervous system: extrapyramidal disorders - trismus, spasm of the facial muscles, spastic torticollis, bulbar type of speech, rhythmic protrusion of the tongue, spasm of extraocular muscles (including oculogyric crisis), muscular opisthotonus, hypertonicity.
- Parkinsonism (muscle rigidity, hyperkinesis - a manifestation of dopamine-blocking action, the risk of development in children increases when the dose of 0.5 mg / kg per day is exceeded), dyskinesis (in chronic renal failure and in elderly patients), depression, headache, drowsiness, anxiety, fatigue, confusion, tinnitus.
- Metabolism: porphyria.
- Endocrine system: rarely (with prolonged therapy in high doses) - galactorrhea, gynecomastia, menstrual irregularities; Digestive system: diarrhea, constipation; rarely dry mouth.
- Allergic reactions: angioedema, bronchospasm, urticaria.
- Hematopoietic system: leukopenia, neutropenia, sulfhemoglobinemia in adults.
- Cardiovascular system: atrioventricular block.
- Others: at the beginning of treatment - agranulocytosis; rarely (when using high doses) - hyperemia of the nasal mucosa. In the event of the appearance of the above symptoms, their aggravation or the development of other side effects, you should consult a doctor.
Children, during pregnancy and breastfeeding
Metoclopramide is contraindicated for use in the 1st trimester of pregnancy. Application in the 2nd and 3rd trimesters of pregnancy is possible only for health reasons. If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be resolved.
Application in children
Contraindicated in early childhood (for children under 2 years of age - the use of metoclopramide in the form of any dosage forms is contraindicated, for children under 6 years of age - parenteral administration is contraindicated). The use of the drug in children causes an increased risk of developing dyskinetic syndrome.
special instructions
With vomiting of vestibular genesis, Metoclopramide is not effective. When using it, the data of laboratory parameters of liver function and determination of the concentration of prolactin and aldosterone in plasma may be distorted. Side effects in most cases, they develop within 36 hours after using the drug and disappear without additional treatment within 24 hours after its withdrawal.
Therapy, if possible, should be short-term. It is not recommended to drink alcohol while using Metoclopramide. During the period of treatment, care should be taken when working with potentially dangerous mechanisms that require increased concentration of attention and rapid psychomotor reactions, as well as when driving vehicles.
Drug interactions
Cholinesterase inhibitors weaken the effect of the medication. The risk of developing extrapyramidal disorders increases significantly with simultaneous therapy with antipsychotics.
Metoclopramide is able to increase the activity of histamine H2 receptor blockers, enhance the sedative effect of hypnotics, and aggravate the effect of ethanol on the nervous system. The drug enhances absorption:
- Acetylsalicylic acid.
- Diazepam.
- ethanol.
- Levodopa.
- Tetracycline (including tetracycline antibiotics).
Slows down the process of absorption of Cimetidine and Digoxin.
Analogues of the drug Metoclopramide
By structure, analogs are determined:
- Apo Metoclops.
- Ceruglan.
- Cerucalus.
- Perinorm.
- Metoclopramide Vial (Acri, Darnitsa, Promed, Eskom).
- Raglan.
- Metamol.
- Metoclopramide hydrochloride.
Antiemetics include analogues:
- Perinorm.
- Bonin.
- Trifluoperazine Apo.
- Eteperazine.
- Avomit.
- Ciel.
- Granisetron.
- Navoban.
- Ceruglan.
- Damelium.
- Emetron.
- Emeset.
- Motigect.
- Onicite.
- Lazaran.
- Ondantor.
- Passages.
- Ondansetron.
- Metamol.
- Vero Ondansetron.
- Rondacet.
- Setronon.
- Kinedril.
- Avioplant.
- Domstal.
- Bimaral.
- Motorinorm.
- Aviomarin.
- Notyrol.
- Zofran.
- Motilium.
- Cerucalus.
- Raglan.
- Domperidone.
- Validol.
- Domegan.
- Doom.
- Sturgeon.
- Motonium.
- Emend.
- Torekan.
- Apo Metoclops.
- Metoclopramide.
- Triftazin.
- Ondasol.
- Tropindol.
- Kitril.
- Latran.
Vacation conditions and price
The average cost of Metoclopramide (10 mg tablets No. 50) in Moscow is 29 rubles. The price of injections is 67 rubles for 10 ampoules. Dispensed by prescription.
Store should be protected from light, dry, out of reach of children at temperatures up to 25 C. Shelf life:
- Tablets - 2 years.
- Injection solution - 4 years.
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