metoclopramide (Reglan, Metozolv ODT)

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Introduction

Tradename: Reglan.

Indications

Contraindications

(relative)

pregnancy category = b

pregnancy category = +

safety in lactation = +

Dosage

10 mg IV/IM every 2-3 hours PRN 10-30 mg PO QID, 30 min before meals & QHS.

Tabs: 5 & 10 mg. Elixir 5 mg/5 mL (480 mL).

Injection: 5 mg/mL ( 2 mL, 10 mL)

Oral disintegrating tablet Metozolv ODT

Pharmacokinetics

  • onset of action
    • IV: 1-3 minutes
    • IM: 10-15 minutes
    • PO: 30-60 minutes
  • duration of action: 1-2 hours
  • 13-30% in plasma is bound to protein, mostly albumin
  • excreted in the urine & feces
  • elimination is biphasic:
    • t1/2 alpha: 5 minutes
    • t1/2 beta: 2.5-6 hours
  • dose adjustment necessary with renal insufficiency

elimination via kidney

1/2life = 2.5-6 hours

Adverse effects

* If adverse CNS effects occur, discontinue metoclopramide. Do not attempt to simply lower the dose as the is unlikely to resolve CNS symptoms[10]

Drug interactions

Mechanism of action

More general terms

Component of

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. AHFS 96 Drug Information, GK McEnvoy et al (ed), American Society of Health-System Pharmacists, Bethesda, MD 1996, pg 2160
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  5. Jump up to: 5.0 5.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  6. Jump up to: 6.0 6.1 Braude D, Soliz T, Crandall C, Hendey G, Andrews J, Weichenthal L. Antiemetics in the ED: a randomized controlled trial comparing 3 common agents. Am J Emerg Med. 2006 Mar;24(2):177-82. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16490647
  7. Jump up to: 7.0 7.1 FDA MedWatch http://www.fda.gov/medwatch/safety/2009/safety09.htm#Metoclopramide
  8. Jump up to: 8.0 8.1 Matok I et al, The Safety of Metoclopramide Use in the First Trimester of Pregnancy PMID: https://www.ncbi.nlm.nih.gov/pubmed/19516033 N Engl J Med 2009 (June 11) 360:2528-2535
  9. Jump up to: 9.0 9.1 Pasternak B et al Metoclopramide in Pregnancy and Risk of Major Congenital Malformations and Fetal Death. JAMA. 2013;310(15):1601-1611 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24129464 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1752754
  10. Jump up to: 10.0 10.1 10.2 Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018
  11. Jump up to: 11.0 11.1 Benard-Laribiere A et al. Risk of first ischaemic stroke and use of antidopaminergic antiemetics: Nationwide case-time-control study. BMJ 2022 Mar 23; 376:e066192 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35321876 Free article https://www.bmj.com/content/376/bmj-2021-066192
  12. Jump up to: 12.0 12.1 NEJM Knowledge+

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