Metoclopramide

This page follows the US label for metoclopramide tablets (5 mg and 10 mg), taken by mouth.

The label lists treatment for 4 to 12 weeks of symptomatic gastroesophageal reflux in adults who do not respond to usual treatment.

It also lists relief of symptoms in adults with acute and recurrent diabetic gastroparesis.

The label does not recommend use in children.

• Gastroesophageal reflux in adults not helped by usual treatment (4 to 12 weeks)
• Diabetic gastroparesis in adults

The label says metoclopramide stimulates movement of the upper gut without increasing stomach, bile or pancreatic secretions.

It raises stomach muscle contractions, relaxes the pylorus, increases the tone of the lower oesophageal sphincter and speeds stomach emptying.

The exact way it works in reflux and gastroparesis is not fully established.

The US label for adults gives different schedules by condition.

For reflux, the label lists 10 to 15 mg up to four times daily, 30 minutes before meals and at bedtime, with a maximum of 60 mg a day for 4 to 12 weeks. Single doses up to 20 mg are allowed before a provoking situation.

For diabetic gastroparesis, it lists 10 mg 30 minutes before each meal and at bedtime, with a maximum of 40 mg a day.

The label says to use the shortest duration, with 12 weeks the maximum for reflux, and to lower doses in older adults, in some liver or kidney impairment, and in CYP2D6 poor metabolisers.

Indian pack labels may differ from the US label. Your prescriber's instruction always comes first. Do not change the dose yourself.

Boxed warning: metoclopramide can cause tardive dyskinesia, a potentially irreversible movement disorder. Risk rises with longer treatment and higher total dose.

The label contraindicates it with a history of TD or dystonic reaction, gut bleeding, obstruction or perforation, pheochromocytoma, epilepsy, and hypersensitivity.

Older adults, especially older women, and people with diabetes have a higher TD risk. The label says to lower the dose in older adults.

The label advises avoiding it in Parkinson's disease and in people with depression.

Pregnancy: published studies do not show increased risk, but it crosses the placenta and may cause movement signs and methemoglobinemia in newborns.

Breastfeeding: it is present in breast milk in variable amounts. Infants have had gut effects, so weigh benefit and risk with your doctor.

Children: the label says it is not recommended because of TD and methemoglobinemia risks in neonates.

Driving: the label notes effects on the ability to drive and operate machinery.

Alcohol: the label lists alcohol among CNS depressants whose effects add up. Ask your doctor about alcohol.

• History of TD or dystonia, epilepsy, pheochromocytoma, gut obstruction or bleeding: contraindicated
• Parkinson's disease and depression: avoid
• Older adults: lower dose, higher TD risk
• Not recommended in children
• Avoid driving until you know how it affects you

• Antipsychotics
• Alcohol, sedatives, opiates and anxiolytics
• Fluoxetine, paroxetine, bupropion, quinidine
• MAO inhibitors
• Medicines that impair gut movement
• Antipsychotics: effects add up and raise the risk of tardive dyskinesia and other movement symptoms.
• The label advises avoiding the combination.
• CNS depressants such as alcohol, sedatives, sleeping medicines, opiates and anxiolytics add to drowsiness.
• Strong CYP2D6 inhibitors such as quinidine, bupropion, fluoxetine and paroxetine raise metoclopramide levels, so the label advises a lower dose.
• MAO inhibitors raise the risk of high blood pressure, and the label advises avoiding them together.
• The label also says medicines that impair gut movement can reduce how much metoclopramide is absorbed.

No match in this label text. Ask your pharmacist about any medicine you take.

The label says overdose can cause drowsiness, disorientation, movement disorders, methemoglobinemia and sometimes death.

Neuroleptic malignant syndrome has been reported with overdose and other related medicines.

There is no specific antidote. Dialysis does not remove significant amounts. Get emergency care at once.

The label says to store tablets at controlled room temperature between 20 and 25 degrees C.

They should be kept in a tight, light-resistant container.

In the Drugs Rules 1945 schedules we checked, Metoclopramide appears as Schedule H, serial 317 (rules 65 and 97).

The National List of Essential Medicines 2022 lists these forms: Tablet 10 mg; Injection 5 mg/mL; Tablet 4 mg.

The National Pharmaceutical Pricing Authority (NPPA) lists ceiling prices for the formulations in the table below. A seller cannot charge more than the ceiling per unit.

The banned-combination list we checked mentions Metoclopramide in 1 entries. Fixed-dose combinations differ, so check your exact product.

The ceiling price is the most a seller may charge per unit for a scheduled formulation. Actual brand prices are usually at or below it. Check the pack and seller for the real price.

Jan Aushadhi (PMBJP) product rows we found for Metoclopramide are listed next.

Metoclopramide Tablets IP 10 mg, pack 10's.

Metoclopramide Injection IP 5mg per ml, pack 2ml Ampoule.

Metoclopramide Hydrochloride Syrup IP 5mg per 5ml, pack 60ml.

We do not show a brand price here. Prices change, so confirm with the seller.