Metoclopramide hydrochloride is indicated for the relief of
symptoms associated with acute and recurrent diabetic gastric
In general, the incidence of adverse reactions correlates with the
dose and duration of metoclopramide administration. The following
reactions have been reported, although in most instances, data do
not permit an estimate of frequency
The effects of metoclopramide on gastrointestinal motility are
antagonized by anticholinergic drugs and narcotic analgesics.
Additive sedative effects can occur when metoclopramide is given
with alcohol, sedatives, hypnotics, narcotics, or tranquilizers.
The finding that metoclopramide releases catecholamines in patients
with essential hypertension suggests that it should be used
cautiously, if at all, in patients receiving monoamine oxidase
Absorption of drugs from the stomach may be diminished (e.g.,
digoxin) by metoclopramide, whereas the rate and/or extent of
absorption of drugs from the small bowel may be increased (e.g.,
acetaminophen, tetracycline, levodopa, ethanol, cyclosporine).
Gastroparesis (gastric stasis) may be responsible for poor diabetic
control in some patients. Exogenously administered insulin may
begin to act before food has left the stomach and lead to
hypoglycemia. Because the action of metoclopramide will influence
the delivery of food to the intestines and thus the rate of
absorption, insulin dosage or timing of dosage may require
Precautions & Warning
In one study in hypertensive patients, intravenously administered
metoclopramide was shown to release catecholamines; hence, caution
should be exercised when metoclopramide is used in patients with
Intravenous injections of undiluted metoclopramide should be made
slowly allowing 1 to 2 minutes for 10 mg since a transient but
intense feeling of anxiety and restlessness, followed by
drowsiness, may occur with rapid administration.
Because metoclopramide produces a transient increase in plasma
aldosterone, certain patients, especially those with cirrhosis or
congestive heart failure, may be at risk of developing fluid
retention and volume overload. If these side effects occur at any
time during metoclopramide therapy, the drug should be
Intravenous administration of REGLAN Injection (metoclopramide
injection) diluted in a parenteral solution should be made slowly
over a period of not less than 15 minutes.
Giving a promotility drug such as metoclopramide theoretically
could put increased pressure on suture lines following a gut
anastomosis or closure. This possibility should be considered and
weighed when deciding whether to use metoclopramide or nasogastric
suction in the prevention of postoperative nausea and vomiting
Use in Pregnancy and Nursing Mothers:
Pregnancy Category B
Reproduction studies performed in rats, mice and rabbits by the IM,
IV, subcutaneous (SC), and oral routes at maximum levels ranging
from 12 to 250 times the human dose have demonstrated no impairment
of fertility or significant harm to the fetus due to
metoclopramide. There are, however, no adequate and well-controlled
studies in pregnant women. Because animal reproduction studies are
not always predictive of human response, this drug should be used
during pregnancy only if clearly needed.
Metoclopramide is excreted in human milk. Caution should be
exercised when metoclopramide is administered to a nursing mother.
Metoclopramide should not be used whenever stimulation of
gastrointestinal motility might be dangerous, e.g., in the presence
of gastrointestinal hemorrhage, mechanical obstruction, or
Metoclopramide is contraindicated in patients with pheochromocytoma
because the drug may cause a hypertensive crisis, probably due to
release of catecholamines from the tumor. Such hypertensive crises
may be controlled by phentolamine.
Metoclopramide is contraindicated in patients with known
sensitivity or intolerance to the drug.
Metoclopramide should not be used in epileptics or patients
receiving other drugs which are likely to cause extrapyramidal
reactions, since the frequency and severity of seizures or
extrapyramidal reactions may be increased.
Store below 25℃. Protect from moisture. Keep out of reach of