Metoclopramide

Why is this medicine prescribed?

Metoclopramide is used to treat gastroesophageal reflux disease (GERD; condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus) and gastroparesis (slow stomach emptying) . Metoclopramide is in a class of medications called prokinetic agents. It works by speeding the movement of food through the stomach and intestines.

Are there other uses for this medicine?

Metoclopramide is also sometimes used to treat the symptoms of slowed stomach emptying in people who are recovering from certain types of surgery, and to prevent nausea and vomiting in people who are being treated with chemotherapy for cancer. Ask your doctor about the risks of using this medication to treat your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Metoclopramide comes as a tablet an orally disintegrating (dissolving) tablet, and a solution (liquid) to take by mouth. Take 4 times a day on an empty stomach, 30 minutes before each meal and at bedtime. When metoclopramide is used to treat symptoms of GERD, it may be taken less frequently, Follow the directions on your prescription label carefully.

Take metoclopramide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are taking the orally disintegrating tablet, use dry hands to remove the tablet from the package just before you take your dose. If the tablet breaks or crumbles, dispose of it and remove a new tablet from the package. Gently remove the tablet and immediately place it on the top of your tongue. The tablet will usually dissolve in about one minute and can be swallowed with saliva.

If you are taking metoclopramide to treat the symptoms of slow stomach emptying caused by diabetes, you should know that your symptoms will not improve all at once. You may notice that your nausea improves early in your treatment and continues to improve over the next 3 weeks. Your vomiting and loss of appetite may also improve early in your treatment, but it may take longer for your feeling of fullness to go away.

Continue to take metoclopramide even if you feel well. Do not stop taking metoclopramide without talking to your doctor. You may experience withdrawal symptoms such as dizziness, nervousness, and headaches when you stop taking metoclopramide.

What special precautions should I follow?

Before taking metoclopramide,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• you should know that some medications should not be taken with metoclopramide. Make sure you have discussed any medications you are currently taking or plan to take before starting metoclopramide with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking metoclopramide please get the advice of your doctor or pharmacist.
• tell your doctor if you have or have ever had blockage, bleeding, or a tear in your stomach or intestines; pheochromocytoma (tumor on a small gland near the kidneys); or seizures. Your doctor will probably tell you not to take metoclopramide.
• tell your doctor if you have or have ever had Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance) or other conditions that affect muscle control and movement; high blood pressure; depression; breast cancer; asthma; glucose-6-phosphate dehydrogenase (G-6PD) deficiency (an inherited blood disorder); NADH cytochrome B5 reductase deficiency (an inherited blood disorder); or heart, liver, or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking metoclopramide, call your doctor.
• you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• talk to your doctor about the risks and benefits of taking metoclopramide if you are 65 years of age or older. Older adults should not usually take metoclopramide because it is not as safe or effective as other medications that can be used to treat those conditions.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking metoclopramide.
• ask your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects of metoclopramide worse.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your regular diet.

What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• drowsiness
• confusion
• seizures
• unusual, uncontrollable movements
• bluish coloring of the skin

What side effects can this medicine cause?

Metoclopramide may cause side effects. Tell your doctor if any of these symptoms or those in the SPECIAL PRECAUTIONS section are severe or do not go away:

• excessive tiredness, weakness
• breast enlargement or discharge
• decreased sexual ability
• frequent urination, inability to control urination

Some side effects can be serious. If you experience any of the following symptoms, or those mentioned in the IMPORTANT WARNING section, call your doctor immediately:

• tightening of the muscles, especially in the jaw or neck
• speech problems
• depression, thinking about harming or killing yourself
• fever, muscle stiffness, confusion,sweating, or changes in heartbeat
• restlessness, agitation, nervousness or jitteriness, pacing, foot tapping
• difficulty falling asleep or staying asleep
• slow or stiff movements
• blank facial expression
• uncontrollable shaking of a part of the body
• difficulty keeping your balance
• rash, hives, or swelling of the eyes, face, lips, tongue, mouth, throat, arms, hands, feet, ankles, or lower legs
• sudden weight gain
• difficulty breathing or swallowing
• high-pitched sounds while breathing
• vision problems

Metoclopramide may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone ( 1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.