metoclopramide, Reglan, Metozolv ODT, (Reglan ODT, Octamide, and Maxolon

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is metoclopramide, and how does it work (mechanism of action)?

Metoclopramide is a "prokinetic" drug that stimulates the muscles of the gastrointestinal tract including the muscles of the lower esophageal sphincter, stomach, and small intestine by interacting with receptors for acetylcholine and dopamine on gastrointestinal muscles and nerves.

The lower esophageal sphincter, located between the esophagus and the stomach, normally prevents reflux of acid and other contents in the stomach from backing up into the esophagus. In patients with gastroesophageal reflux disease (GERD), a weakened lower esophageal sphincter allows reflux of stomach acid into the esophagus, causing heartburn and damage to the esophagus (esophagitis). Metoclopramide decreases the reflux of stomach acid by strengthening the muscle of the lower esophageal sphincter. Metoclopramide also stimulates the muscles of the stomach and thereby hastens emptying of solid and liquid meals from the stomach and into the intestines.

In some patients, particularly those with diabetes, damage to nerves in the stomach can interfere with function of the muscles and cause delayed emptying of the stomach, resulting in nausea, vomiting, a sense of abdominal fullness and distention, and heartburn (diabetic gastroparesis). Metoclopramide can be effective in relieving the symptoms related to diabetic gastroparesis by stimulating more rapid emptying of the stomach as well as decreasing the reflux of stomach acid into the esophagus. Dopamine receptors on nerves in the brain are important in producing nausea. Metoclopramide interacts with the dopamine receptors in the brain and can be effective in treating nausea. The FDA approved metoclopramide in June 1985.

What brand names are available for metoclopramide?

Reglan, Metozolv ODT, (Reglan ODT, Octamide, and Maxolon are discontinued)

Is metoclopramide available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for metoclopramide?

Yes

What are the side effects of metoclopramide?

Metoclopramide is generally well-tolerated when used in low doses for brief periods. Neurological side effects increase with higher doses and longer periods of treatment. Common side effects of metoclopramide are:

Other important side effects of metoclopramide include serious neurological symptoms that mimic Parkinson's disease such as:

  • involuntary muscle movements,
  • facial grimacing, and
  • dystonic reactions resembling tetanus.

Fortunately, these more serious side effects are infrequent and usually - though not always - disappear when metoclopramide is discontinued. Patients with Parkinson's disease can experience worsening of symptoms with metoclopramide. Metoclopramide may impair the mental and/or physical abilities to drive or operate machinery.

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