Home Drug Guide Metoclopramide Hydrochloride

Drug Guide

Generic Name

Metoclopramide Hydrochloride

Brand Names Reglan, Reglan Odt, Metozolv Odt, Maxolon, Clopra, Clopra-"yellow", Metoclopramide Hcl, Metoclopramide Intensol, Metoclopramide, Gimoti

Classification

Therapeutic: Antiemetic, Gastroprokinetic agent

Pharmacological: Dopamine D2 receptor antagonist

FDA Approved Indications

  • Gastroesophageal reflux disease (GERD) with delayed gastric emptying
  • Postoperative nausea and vomiting
  • Chemotherapy-induced nausea and vomiting

Mechanism of Action

Metoclopramide enhances gastrointestinal motility by blocking dopamine D2 receptors in the chemoreceptor trigger zone and gut, thereby acting as an antiemetic and prokinetic agent.

Dosage and Administration

Adult: Typically 10 mg orally 30 minutes before meals and at bedtime; intravenous doses vary based on indication.

Pediatric: Dosing is weight-based; typically 0.1-0.2 mg/kg/dose 3-4 times daily, not to exceed adult doses.

Geriatric: Start at lower doses due to increased sensitivity and risk of side effects.

Renal Impairment: Dose adjustment may be necessary; consult guidelines.

Hepatic Impairment: Use with caution; monitor closely.

Pharmacokinetics

Absorption: Well absorbed orally, with variable bioavailability.

Distribution: Widely distributed, crosses the blood-brain barrier and placenta.

Metabolism: Metabolized in the liver, partly by conjugation.

Excretion: Excreted mainly in urine.

Half Life: Approximately 5-6 hours.

Contraindications

  • Gastrointestinal hemorrhage
  • Mechanical bowel obstruction
  • Perforation
  • History of tardive dyskinesia

Precautions

  • Use with caution in Parkinson's disease, depression, and history of neuropsychiatric disorders.
  • Pregnancy category B; caution during lactation.

Adverse Reactions - Common

  • Fatigue (Frequent)
  • Drowsiness (Frequent)
  • Restlessness, somnolence (Common)

Adverse Reactions - Serious

  • Tardive dyskinesia (Uncommon but serious with long-term use)
  • Extrapyramidal symptoms (Uncommon)
  • Neuroleptic malignant syndrome (Rare)

Drug-Drug Interactions

  • CNS depressants (enhanced sedation)
  • Drugs lowering seizure threshold

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for extrapyramidal symptoms, tardive dyskinesia, and neuropsychiatric effects.

Diagnoses:

  • Risk for neurological adverse effects
  • Impaired GI motility

Implementation: Administer as prescribed; monitor for side effects; assess symptom relief.

Evaluation: Effectiveness in controlling nausea/vomiting and improving gastric emptying.

Patient/Family Teaching

  • Do not exceed prescribed dose.
  • Report any involuntary movements or abnormal muscle movements.
  • Caution when operating machinery or driving.
  • Avoid alcohol and CNS depressants.

Special Considerations

Black Box Warnings:

  • Tardive dyskinesia, which can be irreversible, especially with long-term or high-dose use.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Drowsiness, sedation, disorientation, extrapyramidal symptoms.

Treatment: Supportive care; administer activated charcoal if ingestion was recent; monitor and manage symptoms; use of diphenhydramine or benzodiazepines for extrapyramidal reactions, as indicated.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable when stored properly; consult product label for expiration.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.