- 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.
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).
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 (Causes, Cures, Remedies, and Medicine)
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...
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast...
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms that include abdominal pain, bloating,...
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 headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on...
Indigestion (Dyspepsia, Upset Stomach Pain) Symptoms, Relief Remedies, Medicine
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some...
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...
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...
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...
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD...
Reflux Laryngitis (Diet, Home Remedies, Medicine)
Reflux laryngitis is caused by acid refluxing back up through the esophagus and voice box. Reflux laryngitis causes irritation...
Prolactinoma (Pituitary Tumor)
Prolactinoma is an adenoma (benign tumor) of the pituitary gland. Causes of many prolactinomas are unknown. Symptoms in women...
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...
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...
Treatment & Diagnosis
- GERD Gastroesophageal Reflux Disease FAQs
- Medication Disposal
- Dangers of Mixing Medications
- Drugs: Buying Prescription Drugs Online Safely
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: The Most Common Medication Errors
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Prevention & Wellness
Health Solutions From Our Sponsors
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.