Metoclopramide (Reglan): Uses, Warnings, and More

What is metoclopramide?

Metoclopramide is a medicine used to treat nausea and vomiting. The active ingredient may appear as metoclopramide hydrochloride or metoclopramide hydrochloride monohydrate.

In the United States, brand names mentioned for this ingredient include Reglan, Maxolon, and Metozolv ODT.

How metoclopramide works

Metoclopramide acts as a dopamine D2 receptor antagonist. It also has activity related to 5-HT3 and 5-HT4 receptors. These actions are associated with its anti-nausea and anti-vomiting effects.

What metoclopramide is used for

According to the source content, metoclopramide is used in the following situations:

• Adults: prevention of postoperative nausea and vomiting.
• Adults: prevention of radiotherapy-induced nausea and vomiting.
• Adults: prevention of delayed chemotherapy-induced nausea and vomiting.
• Adults: symptomatic treatment of nausea and vomiting, including nausea and vomiting associated with acute migraine.
• Children and adolescents aged 1 to 18 years: second-line prevention of delayed chemotherapy-induced nausea and vomiting.
• Children and adolescents aged 1 to 18 years: treatment of postoperative nausea and vomiting, only via intravenous use.

How it is given

The source content states that metoclopramide is administered before meals. The exact form, route, and schedule depend on the product and the clinical situation.

Posology mentioned in the source

The original content includes the following general dosing information:

• Adults: 10 mg up to 3 times per day.
• Children: 0.1 to 0.15 mg/kg body weight up to 3 times per day.
• Maximum treatment duration: 5 days.
• Maximum dose: 0.5 mg/kg/day.
• Renal or hepatic impairment: dose reduction may be needed.

Always verify the exact dose and duration in the official leaflet or with a healthcare professional, because recommendations can vary by age, formulation, and indication.

Contraindications listed in the source

• Hypersensitivity to metoclopramide.
• Gastrointestinal bleeding, mechanical obstruction, or gastrointestinal perforation.
• History of tardive dyskinesia due to neuroleptics or metoclopramide.
• Pheochromocytoma.
• Epilepsy.
• Parkinson’s disease.
• Use with levodopa or dopaminergic agonists.
• History of methemoglobinemia with metoclopramide or deficiency in NADH cytochrome b5 reductase.
• Children under 1 year of age.

Warnings and precautions

The source content highlights several precautions to review with a clinician or pharmacist:

• Kidney or liver impairment: dose reduction may be needed.
• Extrapyramidal reactions: risk may be higher in children and adolescents.
• Dosing intervals: the source notes a minimum interval of 6 hours, even if vomiting occurs.
• Neuroleptic malignant syndrome: treatment should be stopped if this is suspected.
• Tardive dyskinesia risk: the source advises limiting treatment duration.
• Intravenous use: slow injection is noted in the source content.
• Cardiovascular risk with IV use: caution is advised in older adults, people with cardiac problems, electrolyte imbalance, bradycardia, or when taking QT-prolonging medicines.
• Neurological disease or CNS medicines: extra caution is advised.

Kidney and liver impairment

The source content says to use caution and reduce the dose in both kidney failure and liver failure. A clinician should confirm the appropriate regimen.

Drug interactions mentioned in the source

Because interaction details can vary by product and patient factors, it is important to check the official leaflet and ask a pharmacist or prescriber about all medicines, including over-the-counter products.

Pregnancy and breastfeeding

The source content says that use in pregnancy should be assessed if necessary.

For breastfeeding, the source notes that metoclopramide is excreted in breast milk at a low level, but adverse reactions in the infant cannot be excluded. It states that use is not recommended during lactation and that stopping the drug in breastfeeding women should be considered.

Effects on driving and using machines

Metoclopramide can cause drowsiness, dizziness, dyskinesia, and dystonia. These effects may affect vision and the ability to drive or use machines safely.

Possible adverse reactions

The source content lists the following side effects:

• Drowsiness
• Diarrhea
• Asthenia
• Extrapyramidal disorders, especially with doses above the recommended range
• Parkinsonism
• Akathisia
• Depression
• Hypotension
• Transient increase in blood pressure

What to verify in the official leaflet

If you are reviewing metoclopramide for yourself or someone else, check the official leaflet or ask a healthcare professional to confirm:

• The exact indication for the specific product.
• The correct dose and duration.
• Whether kidney or liver problems require adjustment.
• Whether any current medicines may interact.
• Whether the medicine is appropriate during pregnancy or breastfeeding.

Safety reminder

FAQs about metoclopramide

References and source links

The following resources were included in the original content and may help readers verify ingredient information:

• UNII: L4YEB44I46
• ChemIDplus
• DrugPortal
• PubChem CID: 4168
• NCI Thesaurus: C62046
• FDA Medication Guides