Metoclopramide

Details About Generic Salt ::  Metoclopramide 

Main Medicine Class:: Gastrointestinal System   Sub Medicine Class ::  Prokinetics

7A. GERD, ULCER/ANTACIDS in 7. GASTROINTESTINAL SYSTEM
METOCLOPRAMIDE
DOPAMINE ANTAGONIST | PROKINETIC
also comes under 7F. Prokinetics in 7. Gastrointestinal System,  
PK: A: Rapid D: 3.5 L/kg (Vd) E: Urine

Indications & Dose: DIABETIC GASTRIC STASIS PO Adult 10mg QID given 30min before meals & at HS for 2-8 wk | IV/IM Adult 10mg over 1-2min 10 days of IV therapy may be necessary before symptoms are controlled to allow transition to oral administration for severe symptoms | GASTROESOPHAGEAL REFLUX DISEASE PO Adult 10-15mg QID 30min before food & at HS up to 12 wk, 20mg single dose are given prior to provoking situations | INTUBATION OF SMALL INTESTINE IV Adult 10mg as single dose Child < 6 yr: 0.1mg/kg, 6-14 yr: 2.5-5mg as single dose | PREVENTION OF CHEMOTHERAPY-INDUCED EMESIS IV Adult Inf: 1-2mg/kg 30min before chemotherapy & repeated q2h for two doses, then q3h for three additional doses | PREVENTION OF POSTOPERATIVE NAUSEA & VOMITING IM Adult 10-20mg near the end of surgical procedure | RADIOGRAPHIC EXAMINATION OF UPPER GI TRACT IV Adult 10mg as single dose to stimulate gastric emptying & intestinal transit

Contra: Hypersensitivity, GI obstruction, perforation/hemorrhage, pheochromocytoma, history of seizures

Precautions: DM, history of depression, elderly, children

ADR: Serious: AV block, bradycardia, HF, supraventricular tachycardia, hypotension, HTN, tardive dyskinesia, extrapyramidal reactions, parkinsonian-like reactions, gynecomastia, Others: akathisia, dystonia, nausea, constipation, diarrhea, dry mouth, fluid retention, drowsiness, restlessness, anxiety, depression, irritability, fatigue

DDI: Serious Nitrofurantoin absorption decreases, Ketoprofen/Cimetidine bioavailability reduced, Fosfomycin bioavailability reduces, Bromocriptine effects/levels is reduced, Neuromuscular blockers efficacy increases & prolongs by drug, SSRIs leads to extrapyramidal symptoms, Digoxin/Atovaquone levels decreases, Quinidine levels increases and decreases its exposure, Cefprozil/Cefpodoxime pharmacokinetics are affected, Aspirin/Alcohol/Ciclosporin/Mefloquine/Mexiletine/Paracetamol/Zopiclone rate of absorption increases, Morphine rate of absorption increases & its rate of onset, sedative effects also increases

Diet: 30min before food

Monitor: Dystonic reactions, signs of hypoglycemia, agitation & confusion

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