Metoclopramide
2 medicines
Metoclopramide relieves nausea, vomiting and slow stomach emptying by speeding up gut movement and blocking the dopamine signal that triggers vomiting. Using it for more than about 12 weeks raises the risk of tardive dyskinesia, an often irreversible movement disorder, so treatment is normally limited to short courses.
Key facts
- Metoclopramide speeds up stomach emptying and blocks the dopamine signal in the brain that triggers nausea and vomiting.
- It's usually taken 3 or 4 times a day, about 30 minutes before meals and at bedtime.
- Do not use metoclopramide for longer than about 12 weeks. Longer use raises the risk of tardive dyskinesia, a movement disorder causing uncontrollable facial and body movements that can be permanent.
- Seek urgent care for uncontrollable muscle spasms, a stiff neck or jaw, eyes rolling upward, or high fever with muscle rigidity.
What metoclopramide treats
Metoclopramide treats nausea and vomiting from chemotherapy, migraine and surgery, and it relieves the symptoms of gastroparesis, a condition where the stomach empties too slowly, common in diabetes. It's also used short-term to help gastric emptying before certain medical procedures and to ease reflux symptoms linked to delayed stomach emptying. It is not intended for everyday or long-term nausea.
How metoclopramide works
Metoclopramide blocks dopamine receptors in the brain's vomiting center and in the gut, which removes a brake on stomach and intestinal muscle contractions. This makes the stomach empty faster and reduces the signal that triggers nausea and vomiting.
Before you take it
- Do not use metoclopramide if you have a bowel obstruction, perforation or active gastrointestinal bleeding, since stronger gut contractions could worsen these conditions.
- Avoid it if you have Parkinson's disease or a seizure disorder; it can worsen movement symptoms and lower the seizure threshold.
- Tell your prescriber about depression or a past history of tardive dyskinesia or other movement disorders.
- Other dopamine-blocking medicines, such as antipsychotics, raise the risk of movement side effects when combined with metoclopramide.
Side effects
Common effects include drowsiness, restlessness, fatigue and diarrhea.
Stop and seek urgent medical care for:
- Uncontrollable movements of the face, tongue or limbs, or muscle stiffness.
- High fever, rigid muscles, confusion or an irregular heartbeat, which can signal neuroleptic malignant syndrome.
- New or worsening depression, agitation, or thoughts of self-harm.
Safety essentials
- Limit treatment to the shortest effective course, generally no more than 12 weeks, because the risk of tardive dyskinesia rises with cumulative dose and duration.
- Tell your doctor right away about any new abnormal movements; stopping the drug promptly can prevent the symptoms becoming permanent.
- Older adults and people on higher doses face the greatest risk of movement side effects, so regular review is important.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.