Metoclopramide

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Half-life
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2,3–8,3 h

Pharmacodynamics (Effect)
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Excitation of muscarinic choline receptors by release of acetylcholine; dopamine antagonist.

Indication
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Nausea, vomiting, prophylaxis of cytostatic-induced nausea.

Limited indication
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Pregnancy (1st trimenon), lactation, depression, children < 14 years, breast cancer in the history, renal insufficiency.

Dosage and method of use
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2 mg/kg bw i.v. as a short infusion 30 minutes before administration of the cytostatic drug and 1.5/3.5/5.5 and 8.5 hours after administration of the cytostatic drug. Alternatively, 0.5-1 mg/kg bw/hour i.v. starting 2 hours before administration of cytostatics over 24 hours as continuous infusion.

Undesirable effects
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Malignant neuroleptic syndrome (extrapyramidal symptoms, subfebrile temperatures, polypnoea, tachycardia, salivation, sweating, loss of consciousness), CNS disorders, galactorrhea, gynecomastia, hyperprolactinemia, menstrual disorders.

Interactions
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See Table 1.

Contraindication
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Prolactinoma, intestinal obstruction, epilepsy, extrapyramidal symptoms, children < 2 years, gastrointestinal bleeding, MAO-inhibitor intake, pheochromocytoma.

Preparations
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Gastrosil; Paspertine; MCP

Tables
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Essential interactions of metoclopramide

Alimemazine

extrapyramidal symptoms ↑

Anticholinergics

mutual effect ↓

Antidepressants, tricyclic

extrapyramidal symptoms ↑, fatigue ↑

Atovaquon

Atovaquone effect ↓

Barbiturates

Tiredness ↑

Ciclosporin A

Ciclosporin levels ↑

Cimetidine

Cimetidine level ↓, intake 2 hours apart

Digoxin

Digoxin level ↓

Ipatropium bromide

mutual effect ↓

Lisurid

Lisuride effect ↓

Neuroleptics

extrapyramidal symptoms ↑

Sleeping pills

Tiredness ↑

Scopolamine

mutual effect ↓

Sympathomimetics

Avoid combination

Tranquillizer

extrapyramidal symptoms ↑, fatigue ↑

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Last updated on: 29.10.2020