Metoclopramide (Oral)

Generic name: Metoclopramide

Usage of Metoclopramide (Oral)

Metoclopramide is used to treat the symptoms of slow stomach emptying (gastroparesis) in patients with diabetes. It works by increasing the movements or contractions of the stomach and intestines. It relieves symptoms such as nausea, vomiting, heartburn, a feeling of fullness after meals, and loss of appetite. Metoclopramide is also used to treat heartburn for patients with gastroesophageal reflux disease (GERD). GERD is esophageal irritation from the backward flow of gastric acid into the esophagus.

This medicine is available only with your doctor's prescription.

Metoclopramide (Oral) side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Chills

clay colored stools

dark urine

difficulty with breathing

difficulty with speaking or swallowing

dizziness or fainting

fast or irregular heartbeat

fever

general feeling of tiredness or weakness

headache (severe or continuing)

inability to move the eyes

increase in blood pressure

increased sweating

itching, skin rash

lip smacking or puckering

loss of appetite

loss of balance control

loss of bladder control

mask-like face

muscle spasms of the face, neck, and back

nausea

puffing of the cheeks

rapid or worm-like movements of the tongue

seizures

shuffling walk

sore throat

stiffness of the arms or legs

stomach pain or tenderness

swelling of the feet or lower legs

tic-like or twitching movements

trembling and shaking of the hands and fingers

twisting movements of the body

uncontrolled chewing movements

uncontrolled movements of the arms and legs

unusually pale skin

vomiting

weakness of the arms and legs

yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Confusion

drowsiness (severe)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

drowsiness

loss of strength or energy

muscle pain or weakness

restlessness

unusual weak feeling

Incidence not known

Breast tenderness and swelling

changes in menstruation

constipation

decreased interest in sexual intercourse

inability to have or keep an erection

increased flow of breast milk

increased need to urinate

loss in sexual ability, desire, drive, or performance

mental depression

passing urine more often

skin rash

trouble sleeping

unusual dryness of the mouth

unusual irritability

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Metoclopramide (Oral)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of metoclopramide in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of metoclopramide in the elderly. However, elderly patients are more likely to have side effects such as tardive dyskinesia, confusion, or drowsiness, and age-related kidney problems, which may require an adjustment in the dose for patients receiving metoclopramide.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Amineptine

Amitriptyline

Amitriptylinoxide

Amoxapine

Aripiprazole

Aripiprazole Lauroxil

Asenapine

Brexpiprazole

Cariprazine

Chlorpromazine

Chlorprothixene

Citalopram

Clomipramine

Clozapine

Desipramine

Dibenzepin

Doxepin

Escitalopram

Fluphenazine

Fluvoxamine

Haloperidol

Iloperidone

Imipramine

Loxapine

Lurasidone

Melitracen

Mesoridazine

Methotrimeprazine

Molindone

Nortriptyline

Olanzapine

Opipramol

Paliperidone

Periciazine

Perphenazine

Pimavanserin

Pimozide

Prochlorperazine

Promazine

Protriptyline

Quetiapine

Risperidone

Sertindole

Sertraline

Sulpiride

Thioridazine

Thiothixene

Tianeptine

Trifluoperazine

Triflupromazine

Trimipramine

Vilazodone

Vortioxetine

Ziprasidone

Zuclopenthixol

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acepromazine

Alfentanil

Alprazolam

Amantadine

Amobarbital

Anileridine

Apomorphine

Baclofen

Benperidol

Benzhydrocodone

Benztropine

Biperiden

Bromazepam

Butorphanol

Calcium Oxybate

Carphenazine

Chloral Hydrate

Chlordiazepoxide

Chlorzoxazone

Clobazam

Clonazepam

Clorazepate

Codeine

Cyclobenzaprine

Cyclosporine

Dexmedetomidine

Diacetylmorphine

Diazepam

Dichloralphenazone

Difenoxin

Digoxin

Dihydrocodeine

Diphenhydramine

Diphenoxylate

Doxylamine

Droperidol

Enflurane

Entacapone

Estazolam

Eszopiclone

Ethchlorvynol

Ethopropazine

Ethylmorphine

Fentanyl

Flibanserin

Fluoxetine

Flurazepam

Fluspirilene

Fospropofol

Furazolidone

Halazepam

Halothane

Hexobarbital

Hydrocodone

Hydromorphone

Hydroxyzine

Insulin

Insulin Aspart, Recombinant

Insulin Bovine

Insulin Degludec

Insulin Detemir

Insulin Glargine, Recombinant

Insulin Glulisine

Insulin Lispro, Recombinant

Iproniazid

Isocarboxazid

Isoflurane

Ketamine

Ketazolam

Ketobemidone

Levodopa

Levorphanol

Linezolid

Lorazepam

Magnesium Oxybate

Meclizine

Melperone

Mephobarbital

Meprobamate

Meptazinol

Metaxalone

Methadone

Methdilazine

Methocarbamol

Methohexital

Methylene Blue

Midazolam

Moclobemide

Moricizine

Morphine

Morphine Sulfate Liposome

Nalbuphine

Nialamide

Nicomorphine

Nitrazepam

Nitrous Oxide

Opicapone

Opium

Opium Alkaloids

Orphenadrine

Oxazepam

Oxycodone

Oxymorphone

Papaveretum

Paregoric

Paroxetine

Pentazocine

Pentobarbital

Perampanel

Perazine

Pergolide

Phenelzine

Phenobarbital

Piperacetazine

Pipotiazine

Piritramide

Potassium Oxybate

Pramipexole

Prazepam

Primidone

Procarbazine

Procyclidine

Promethazine

Propofol

Quazepam

Quinidine

Ramelteon

Rasagiline

Remifentanil

Remoxipride

Rivastigmine

Ropinirole

Rotigotine

Safinamide

Secobarbital

Selegiline

Sirolimus

Sodium Oxybate

Sufentanil

Suvorexant

Tacrolimus

Tapentadol

Temazepam

Terbinafine

Thiethylperazine

Thiopental

Thiopropazate

Tizanidine

Tolonium Chloride

Topiramate

Tramadol

Tranylcypromine

Triazolam

Trifluperidol

Trihexyphenidyl

Trimeprazine

Zaleplon

Zolpidem

Zopiclone

Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Didanosine

Mivacurium

Succinylcholine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol

How to use Metoclopramide (Oral)

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have questions.

Take this medicine on an empty stomach, at least 30 minutes before meals and at bedtime.

If you are using the disintegrating tablet, make sure your hands are dry before you handle it. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet on your tongue. It should melt quickly. If the tablet breaks or crumbles before you take it, throw it away and get a new tablet from the blister pack.

Do not use this medicine for longer than 12 weeks.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (solution or tablets):

For diabetic gastroparesis:

Adults—At first, 10 milligrams (mg) four times a day, taken 30 minutes before each meal and at bedtime for 2 to 8 weeks. Your doctor may adjust your dose as needed. However, the dose is usually not more than 40 mg.

Children—Use and dose must be determined by your doctor.

For gastroesophageal reflux disease (GERD):

Adults—At first, 10 to 15 milligrams (mg) four times a day, taken 30 minutes before symptoms are likely to begin or before each meal and at bedtime, for 4 to 12 weeks. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.

Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Warnings

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of these medicines while you are using metoclopramide.

This medicine may make you dizzy, drowsy, or have trouble with thinking or controlling body movements. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while taking this medicine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs. The risk of tardive dyskinesia is higher if you take this medicine for longer than 12 weeks. Treatment for longer than 12 weeks should be avoided in all but rare cases.

Tell your doctor right away if you have the following symptoms while you are using this medicine: inability to move the eyes, increased blinking or spasms of the eyelid, trouble with breathing, speaking, or swallowing, uncontrolled tongue movements, uncontrolled twisting movements of the neck, trunk, arms, or legs, unusual facial expressions, or weakness of the arms and legs.

Check with your doctor right away if you have any of the following symptoms while using this medicine: convulsions (seizures), difficulty with breathing, fast heartbeat, high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

Metoclopramide may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.

Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.

This medicine may increase prolactin blood levels if used for a long time. Check with your doctor if you have breast swelling or soreness, unusual breast milk production, absent, missed, or irregular menstrual periods, stopping of menstrual bleeding, loss in sexual ability, desire, drive, or performance, decreased interest in sexual intercourse, or an inability to have or keep an erection.

You may also have dizziness, headaches, or nervousness when you stop taking this medicine. These side effects should go away. Check with your doctor if any of the side effects continue or if you have any questions about them.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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