METOCLOPRAMIDE

What is metoclopramide?

Metoclopramide increases muscle contractions in the upper digestive tract. This speeds up the rate at which the stomach empties into the intestines.

Metoclopramide is used short-term to treat heartburn caused by gastroesophageal reflux in people who have used other medications without relief of symptoms.

Metoclopramide is also used to treat slow gastric emptying in people with diabetes (also called diabetic gastroparesis), which can cause nausea, vomiting, heartburn, loss of appetite, and a feeling of fullness after meals.

Metoclopramide may also be used for other purposes not listed in this medication guide.

Important information about metoclopramide

You should not take this medication if you are allergic to metoclopramide, or if you have bleeding or blockage in your stomach or intestines, epilepsy or other seizure disorder, or an adrenal gland tumor (pheochromocytoma).

Before taking metoclopramide, tell your doctor if you have kidney or liver disease, congestive heart failure, diabetes, or a history of depression.

Avoid drinking alcohol. It can increase some of the side effects of metoclopramide. There are many other medicines that can interact with metoclopramide.

Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Do not take it in larger amounts than recommended, or for longer than 3 months. High doses or long-term use of metoclopramide may cause tremors or other uncontrollable muscle movements, especially in older women.

Stop using metoclopramide and call your doctor at once if you have tremors or uncontrolled muscle movements, fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing, depressed mood, thoughts of suicide or hurting yourself, hallucinations, anxiety, agitation, seizure, or jaundice (yellowing of your skin or eyes).

After you stop taking metoclopramide, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Before taking metoclopramide

You should not take this medication if you are allergic to metoclopramide, or if you have:

·         bleeding or blockage in your stomach or intestines;

·         a perforation (hole) in your stomach or intestines;

·         epilepsy or other seizure disorder; or

·         an adrenal gland tumor (pheochromocytoma).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take metoclopramide:

• kidney disease;
• liver disease (especially cirrhosis);

·         congestive heart failure;

·         high blood pressure;

·         Parkinson's disease;

·         diabetes (your insulin dose may need adjusting); or

·         a history of depression.

FDA pregnancy category B. metoclopramide is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Metoclopramide can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take metoclopramide?

Take metoclopramide exactly as prescribed by your doctor. Do not take metoclopramide in larger amounts than recommended, or for longer than 3 months. High doses or long-term use of metoclopramide may cause tremors or other uncontrollable muscle movements, especially in older women. Follow the directions on your prescription label.

Take metoclopramide on an empty stomach, at least 30 minutes before eating. Metoclopramide is usually taken before meals and at bedtime. Your doctor may want you to take the medication as needed only with meals that usually cause heartburn. Follow your doctor's instructions.

Measure the liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

To take metoclopramide orally disintegrating tablet (Metozolv):

·         Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. If the tablet breaks, throw it away and take out a new one.

·         Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

·         Swallow several times as the tablet dissolves. You do not need to drink liquid to help the tablet dissolve.

Store metoclopramide at room temperature away from moisture and heat.

After you stop taking metoclopramide, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include drowsiness, confusion, tremors or uncontrolled muscle movements in face or neck, or seizure (convulsions).

What should I avoid while taking metoclopramide?

Avoid drinking alcohol. It can increase some of the side effects of metoclopramide. Metoclopramide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Metoclopramide side effects

Get emergency medical help if you have any of these signs of an allergic reaction to metoclopramide: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using metoclopramide and call your doctor at once if you have any of these serious side effects:

·         tremors, or restless muscle movements in your eyes, tongue, jaw, or neck;

·         mask-like appearance of the face;

·         very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;

·         depressed mood, thoughts of suicide or hurting yourself;

·         hallucinations, anxiety, agitation, jittery feeling, trouble staying still;

·         swelling, fluid retention;

·         jaundice (yellowing of your skin or eyes); or

·         seizure (convulsions).

Less serious metoclopramide side effects may include:

·         feeling restless, drowsy, tired, or dizzy;

·         headache, sleep problems (insomnia);

·         nausea, vomiting, diarrhea;

·         breast tenderness or swelling;

·         changes in your menstrual periods; or

·         urinating more than usual.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect metoclopramide?

Before taking metoclopramide, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by metoclopramide.

Tell your doctor about all other medications you use, especially:

·         acetaminophen (Tylenol);

·         cyclosporine (Gengraf, Neoral, Sandimmune);

·         digoxin (digitalis, Lanoxin);

·         glycopyrrolate (Robinul);

·         levodopa (Larodopa, Atamet, Parcopa, Sinemet);

·         mepenzolate (Cantil);

·         tetracycline (Brodspec, Panmycin, Robitet, Sumycin, Tetracap, and others);

·         atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

·         bladder or urinary medications such as darifenacin (Enablex), tolterodine (Detrol), or solifenacin (Vesicare);

·         bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);

·         irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), or propantheline (Pro-Banthine);

·         an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate); or

·         medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa, Symbyax), prochlorperazine (Compazine), risperidone (Risperdal), thiothixene (Navane), and others.

This list is not complete and there may be other drugs that can interact with metoclopramide. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about metoclopramide.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use metoclopramide only for the indication prescribed.
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