- What is metoclopramide, and how does it work (mechanism of action)?
- What brand names are available for metoclopramide?
- Is metoclopramide available as a generic drug?
- Do I need a prescription for metoclopramide?
- What are the side effects of metoclopramide?
- What is the dosage for metoclopramide?
- Which drugs or supplements interact with metoclopramide?
- Is metoclopramide safe to take if I'm pregnant or breastfeeding?
- What else should I know about metoclopramide?
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)
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.
Quick GuideHeartburn: Causes, Symptoms, Remedies, Treatments
What is the dosage for metoclopramide?
The usual dose of metoclopramide for treating GERD is 10-15 mg four times daily, 30 minutes before each meal.
Gastroparesis is treated with 10 mg administered orally four times daily, 30 minutes before each meal and at bedtime.
Which drugs or supplements interact with metoclopramide?
Since metoclopramide accelerates emptying of the stomach, it can increase or decrease absorption and effects of other drugs that are absorbed in the small intestine. For example, the effects of alcohol, diazepam (Valium) and cyclosporine can be accelerated when used together with metoclopramide. Conversely, metoclopramide may decrease the concentrations in blood of digoxin (Lanoxin) and cimetidine (Tagamet). Metoclopramide should not be used in patients taking MAO inhibitors for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane), because of the risk of serious adverse effects due to excess release of neurotransmitters. Concurrent administration of anticholinergic drugs can decrease the effectiveness of metoclopramide.
Is metoclopramide safe to take if I'm pregnant or breastfeeding?
The safety of metoclopramide in pregnancy has not been established.
Metoclopramide is excreted in human breast milk. Nursing mothers should avoid metoclopramide during pregnancy.
What else should I know about metoclopramide?
What preparations of metoclopramide are available?
- Tablets: 5 and 10 mg.
- Syrup: 5 mg/5 ml.
- Injection: 5 mg/ml
How should I keep metoclopramide stored?
Tablets and syrup should be stored between 15 C - 30 C (59 F - 86 F). Injectable metoclopramide should be stored at room temperature 20 C - 25 C (68 F - 77 F).
Reference: FDA Prescribing Information
Quick GuideHeartburn: Causes, Symptoms, Remedies, Treatments
Metoclopramide, Reglan, Reglan ODT, Metozolv ODT, Octamide, (Maxolon discontinued) is a drug prescribed for the treatment of heartburn and esophagitis due to GERD in patients with gastroparesis. Metoclopramide is also prescribed for the treatment of impaired function of muscles of the small intestine and the nausea due to surgery or cancer chemotherapy. Side effects, drug interactions, dosing information, and pregnancy safety should be reviewed prior to taking any medication.
Multimedia: Slideshows, Images & Quizzes
What's Causing Your Abdominal Pain?
Get the facts on the most common causes of abdominal pain. Learn the difference between a stomachache and more serious causes of...
GERD Quiz: Test Your Digestive Diseases IQ
Who is at risk for developing GERD? Are you? Take this quiz to learn what GERD is, if you're at risk, and what you can do about...
Picture of Gastroesophageal Reflux (GERD)
The stomach contents regurgitate and back up (reflux) into the esophagus The food in the stomach is partially digested by...
Abdominal Pain: Common Causes of Stomach Pain in Children
Abdominal pain in children can be more than just a tummy ache. What are the common causes of abdominal pain in children? Learn...
Related Disease Conditions
Hiccups are a sudden, involuntary contraction of the diaphragm muscle. In general hiccups are just a temporary condition. Some of...
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are...
Intestinal Gas (Belching, Bloating, Flatulence)
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch....
Migraine headaches are severe headaches that are sensitive to light, sounds, and smells. Some people who suffer from...
Irritable Bowel Syndrome (IBS) Symptoms, Diet, Treatment, and Test
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms of: Abdominal...
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast...
GERD (Acid Reflux, Heartburn)
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the...
Gastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle...
Indigestion (Dyspepsia, Upset Stomach)
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some...
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD...
Fabry Disease (Symptoms and Life Expectancy)
Fabry disease (Fabry's disease, alpha-galactosidase-A) is a genetic disorder with symptoms such as burning sensations in...
Prolactinoma (Pituitary Tumor)
Prolactinoma is an adenoma (benign tumor) of the pituitary gland. Causes of many prolactinomas are unknown. Symptoms in women...
Breastfeeding (and Formula Feeding)
It's important to know whether you will breastfeed or bottle-feed your baby prior to delivery, as the breasts' ability to produce...
Migraine vs. Headache: Differences and Similarities
Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are...
GERD and GER (Acid Reflux) in Infants and Children
GERD (gastroesophageal reflux disease) is the upward movement of stomach content, including acid, into the esophagus and...
Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name...
Treatment & Diagnosis
- GERD Gastroesophageal Reflux Disease FAQs
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Generic Drugs, Are They as Good as Brand-Names?
- Drugs: Buying Prescription Drugs Online Safely
- Medication Disposal - What to Do with Old or Unusable Medication
- Dangers of Mixing Medications
- Drugs: The Most Common Medication Errors
Medications & Supplements
Prevention & Wellness
Daily Health News
Subscribe to MedicineNet's General Health Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top metoclopramide Related ArticlesComplete List
Abdominal Pain PicturesGet the facts on the most common causes of abdominal pain. Learn the difference between a stomachache and more serious causes of abdominal pain. Diagnosis of abdominal pain is based on symptoms and the location of pain, like sharp pain in the lower abdomen.
Antro-duodenal Motility StudyAn antro-duodenal motility study is used to diagnose motility disorders of the stomach or small intestine. Symptoms of a motility disorder include nausea, vomiting, and intestinal distention. One common cause of a stomach or intestinal motility disorder is diabetes mellitus.
ChemotherapyChemotherapy is the treatment of cancer with drugs that can destroy cancer cells. These drugs often are called "anticancer" drugs. Chemotherapy is often used with other treatments. Coping with side effects (fatigue, nausea, vomiting, pain, hair loss, infection, diarrhea, constipation, fluid retention, mouth and throat problems) are important to understand when undergoing chemotherapy treatment. It is important to eat well during chemotherapy, and get the support you need both during and after treatment.
Children's Abdominal PainAbdominal pain in children can be more than just a tummy ache. What are the common causes of abdominal pain in children? Learn about pediatric abdominal pain symptoms like rash, vomiting, diarrhea, and fever. What is the best treatment for stomach pain in children?
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast infection of the esophagus as well as herpes. Signs and symptoms of esophagitis include:
- Mouth sores
- Chest pain
- Bad breath
- Sore throat
- Difficulty swallowing
Treatment of esophagitis includes diet, lifestyle changes, and medication depending upon the cause.
GERD PictureThe stomach contents regurgitate and back up (reflux) into the esophagus The food in the stomach is partially digested by stomach acid and enzymes. See a picture of Gastroesophageal Reflux (GERD) and learn more about the health topic.
Gastroesophageal Reflux Disease (GERD)GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are:
- regurgitation, and
GastroparesisGastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
Take the GERD QuizWho is at risk for developing GERD? Are you? Take this quiz to learn what GERD is, if you're at risk, and what you can do about it.
Hiccups are a sudden, involuntary contraction of the diaphragm muscle. In general hiccups are just a temporary condition. Some of the causes of hiccups include
- certain medications,
- eating or drinking too much,
- spicy foods,
- diseases or conditions that irritate the nerves controlling the diaphragm,
- brain tumors,
- liver failure, and
- noxious fumes.
There are a variety of home remedies and treatments that can be used to get rid of hiccups.
Intestinal Gas (Belching, Bloating, Flatulence)
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.
Causes of belching or burping include drinking too rapidly, anxiety, carbonated drinks, habit, and swallowing air.
Causes of bloating or distension include tumors, ascites, fluid within the gastrointestinal (GI) tract, and obesity.
Causes of gas or flatulence are diseases such as sugary foods and drinks, fruits and vegetables, starches (wheat, oats, corn, and potatoes), lactose intolerance, untreated celiac disease, and SIBO.
Treatment for excessive intestinal gas depends on the cause. If anal itching persists, a doctor examination may be needed to identify an underlying cause.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms of:
- Abdominal pain
- Increased gas (flatulence)
- Abdominal cramping
- Food intolerance
Two new tests are now available that may help diagnose irritable bowel syndrome with diarrhea and constipation (IBS-M) and irritable bowel syndrome with diarrhea (IBS-D). Treatment for IBS includes diet changes, medications, and other lifestyle changes to manage symptoms.
Migraine headaches are severe headaches that are sensitive to light, sounds, and smells. Some people who suffer from migraines also have severe head pain. People also have symptoms of nausea and vomiting. Common migraine triggers may include:
- Certain foods
- Changes in barometric pressure
- Other phenomenon
They are diagnosed by a doctor if the headache pattern fits established migraine headache criteria. Over-the-counter (OTC) and prescription medications are sometime used to treat acute migraines. To prevent or reduce the frequency and severity of them doctors recommend supplements and prescription medications, for example:
- Blood pressure drugs
- Anti-seizure drugs
Lifestyle modification helps in migraine management. Many people who suffer from migraines get relief from their condition by keeping a headache diary, identifying and avoiding triggers, and taking appropriate medication.