Metoclopramide Injection
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Metoclopramide Injection Overview
Metoclopramide Injection is a prescription medication used for symptoms caused by slow stomach emptying related to diabetes. It is also used to prevent nausea and vomiting associated with cancer chemotherapy and surgery. This medication may also be used to empty the intestines during certain medical procedures. Metoclopramide Injection belongs to a group of drugs called prokinetic agents, which speed the movement of food through the digestive system.
This medication comes in an injectable form to be given directly into a muscle (IM) or a vein (IV).
Common side effects of Metoclopramide Injection include restlessness, headache, and confusion. Metoclopramide Injection can cause dizziness and drowsiness. Do not drive or operate machinery until you know how this medication will affect you.
Uses of Metoclopramide Injection
Metoclopramide injection is a prescription medicine used to:
- relieve symptoms of slow stomach emptying in people with diabetes
- prevent nausea and vomiting that can happen with cancer chemotherapy
- prevent nausea and vomiting that may happen after surgery, if your doctor decides that you should not be treated with a stomach tube and suction
- help make it easier to insert a tube into the small intestine in both adults and children, if the tube does not pass into the stomach normally
- to help empty stomach contents or to help barium move through your intestine, when you get an X-ray examination of the stomach or small intestine. It is not known if metoclopramide injection is safe and works in children except when used to help insert a tube into the small intestine.
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Side Effects of Metoclopramide Injection
Metoclopramide injection can cause serious side effects, including:
- Abnormal muscle movements. See the section “Drug Precautions” section.
- Uncontrolled spasms of your face and neck muscles, or muscles of your body, arms, and legs (dystonia). These muscle spasms can cause abnormal movements and body positions. These spasms usually start within the first 2 days of treatment. These spasms happen more often in children and adults under age 30.
- Depression, thoughts about suicide, and suicide. Some people who take metoclopramide injection become depressed. You may have thoughts about hurting or killing yourself. Some people who take metoclopramide injection have ended their own lives (suicide).
- Neuroleptic Malignant Syndrome (NMS). NMS is a very rare but very serious condition that can happen with metoclopramide injection. NMS can cause death and must be treated in a hospital. Symptoms of NMS include: high fever, stiff muscles, problems thinking, very fast or uneven heartbeat, and increased sweating.
- Parkinsonism. Symptoms include slight shaking, body stiffness, trouble moving or keeping your balance. If you already have Parkinson’s disease, your symptoms may become worse while you are receiving metoclopramide injection.
Call your doctor and get medical help right away if you:
- feel depressed or have thoughts about hurting or killing yourself
- have high fever, stiff muscles, problems thinking, very fast or uneven heartbeat, and increased sweating
- have muscle movements you can not stop or control
- have muscle movements that are new or unusual
Common side effects of metoclopramide injection include:
- feeling restless, sleepy, tired, dizzy, or exhausted
- headache
- confusion
- trouble sleeping
Infusion related side effects can happen if metoclopramide injection is given too fast. You may feel very anxious and restless for a short time, and then become sleepy while you are receiving a dose of metoclopramide injection. Tell your doctor or nurse right away if this happens.
You may have more side effects the longer you take metoclopramide injection and the more metoclopramide injection you take.
Tell your doctor about any side effects that bother you or do not go away. These are not all the possible side effects of metoclopramide injection.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Metoclopramide Injection Interactions
Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Metoclopramide injection and some other medicines can affect each other and may not work as well, or cause possible side effects. Do not start any new medicines while receiving metoclopramide injection until you talk with your doctor.
Especially tell your doctor if you take:
- another medicine that contains metoclopramide, such as REGLAN Injection, REGLAN tablets, REGLAN ODT tablets, or metoclopramide oral syrup
- a blood pressure medicine
- a medicine for depression, especially a Monoamine Oxidase Inhibitor (MAOI)
- insulin
- a medicine that can make you sleepy, such as anti-anxiety medicine, sleep medicines, and narcotics
This is not a complete list of metoclopramide injection drug interactions. Ask your doctor or pharmacist for more information.
Metoclopramide Injection Precautions
Metoclopramide injection can cause serious side effects, including:
Abnormal muscle movements called tardive dyskinesia (TD). These movements happen mostly in the face muscles. You can not control these movements. They may not go away even after stopping metoclopramide injection. There is no treatment for TD, but symptoms may lessen or go away over time after you stop taking metoclopramide injection.
Your chances for getting TD go up:
- the longer you take metoclopramide injection and the more metoclopramide injection you take. You should not take metoclopramide injection for more than 12 weeks.
- if you are older, especially if you are a woman
- if you have diabetes
It is not possible for your doctor to know if you will get TD if you take metoclopramide injection.
Call your doctor right away if you get movements you can not stop or control, such as:
- lip smacking, chewing, or puckering up your mouth
- frowning or scowling
- sticking out your tongue
- blinking and moving your eyes
- shaking of your arms and legs
Do not receive metoclopramide injection if you:
- have stomach or intestine problems that could get worse with metoclopramide injection, such as bleeding, blockage or a tear in your stomach or bowel wall
- have an adrenal gland tumor called pheochromocytoma
- are allergic to metoclopramide injection or anything in it. See the end of this Medication Guide for a list of ingredients in metoclopramide injection.
- take medicines that can cause uncontrolled movements, such as medicines for mental illness
- have seizures
What to avoid while receiving metoclopramide injection:
- Do not drink alcohol while receiving metoclopramide injection. Alcohol may make some side effects of metoclopramide injection worse, such as feeling sleepy.
- Do not drive, work with machines, or do dangerous tasks until you know how metoclopramide injection affects you. Metoclopramide injection may cause sleepiness.
Metoclopramide Injection Food Interactions
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of metoclopramide injection there are no specific foods that you must exclude from your diet when receiving metoclopramide injection.
Inform MD
Tell your doctor about all of your medical conditions, including if you have:
- depression
- Parkinson’s disease
- high blood pressure
- kidney problems. Your doctor may start with a lower dose.
- liver problems or heart failure. Metoclopramide injection may cause your body to hold fluids.
- diabetes. Your dose of insulin may need to be changed.
- breast cancer
- you are pregnant or breastfeeding
Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Metoclopramide injection and some other medicines can affect each other and may not work as well, or cause possible side effects. Do not start any new medicines while receiving metoclopramide injection until you talk with your doctor.
Metoclopramide Injection and Pregnancy
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if metoclopramide injection will harm your unborn child.
Metoclopramide Injection and Lactation
Tell your doctor if you are breastfeeding. Metoclopramide injection is passed into human milk and may harm your baby. Talk with your doctor about the best way to feed your baby if you take metoclopramide injection.
Metoclopramide Injection Usage
- Metoclopramide injection will be given to you by intravenous (IV) infusion into your vein or by intramuscular (IM) injection into a large muscle. Where and how you receive your metoclopramide injection (IV or IM) will depend on why you are receiving it.
- Certain side effects can happen if metoclopramide injection is given too fast. See the section “Side Effects" section.
- You should not take or receive metoclopramide injection for more than 12 weeks.
Metoclopramide Injection Dosage
Diabetic Gastroparesis (slow stomach emptying due to diabetes)
- If you have severe symptoms of diabetic gastroparesis, your doctor may start you metoclopramide injections for up to 10 days, until symptoms subside, and then switch you to oral metoclopramide.
- Doses of 10 mg may be given directly into a vein (IV)) over a 1 to 2 minute period.
Prevention of Nausea and Vomiting Associated with Cancer Chemotherapy
- The first two doses should be 1 to 2 mg/kg given directly into a vein (IV) over a period of 15 minutes, 30 minutes before beginning cancer chemotherapy and every 2 hours for two doses, then every 3 hours for three doses.
Prevention of Nausea and Vomiting After Surgery
- The usual dose is 10 mg; however, doses of 20 mg may be used.
- The dose is given directly into a muscle (IM) near the end of surgery.
To Facilitate Small Bowel Intubation (to help make it easier to insert a tube into the small intestine, if the tube does not pass into the stomach normally)
- A single dose may be given directly into a vein (IV) over a 1 to 2 minute period.
- The recommended dose for patients above 14 years of age is 10 mg metoclopramide base.
- The recommended dose for patients 6 to 14 years of age is 2.5 to 5 mg metoclopramide base.
- For children under 6 years of age, the recommended dose is based on weight - 0.1 mg/kg metoclopramide base.
To Aid in Radiological Examinations (to help empty stomach contents or to help barium move through your intestine, when you get an X-ray examination of the stomach or small intestine)
- In patients where delayed gastric emptying interferes with radiological examination of the stomach and/or small intestine, a single dose may be given directly into a vein (IV) over a 1 to 2 minute period.
- The recommended dose for patients above 14 years of age is 10 mg metoclopramide base.
- The recommended dose for patients 6 to 14 years of age is 2.5 to 5 mg metoclopramide base.
- For children under 6 years of age, the recommended dose is based on weight - 0.1 mg/kg metoclopramide base.
Metoclopramide Injection Overdose
If you take too much metoclopramide injection, call your local Poison Control Center or seek emergency medical attention right away.
Forms of Metoclopramide Injection
Active ingredient: metoclopramide
Inactive ingredients: may vary by manufacturer
Metoclopramide Injection FDA Warning
WARNING: TARDIVE DYSKINESIA
Treatment with metoclopramide can cause tardive dyskinesia, a serious movement disorder that is often irreversible. The risk of developing tardive dyskinesia increases with duration of treatment and total cumulative dose.
Metoclopramide therapy should be discontinued in patients who develop signs or symptoms of tardive dyskinesia. There is no known treatment for tardive dyskinesia. In some patients symptoms may lessen or resolve after metoclopramide treatment is stopped.
Treatment with metoclopramide for longer than 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing tardive dyskinesia.