Metoclopramide (Reglan)

Indications


Pharmacology

Physiologic Effects

  • Antiemetic Effect
    • Mediated by antagonism at dopamine D2 receptors in the chemoreceptor trigger zone of the central nervous system
    • May alse be mediated by antagonism at the 5-HT3 receptor when used at higher doses
  • Gastroprokinetic Effect: may contribute to the antiemetic effect
    • Mediated by muscarinic activity, dopamine D2 receptor antagonist activity, and 5-HT4 receptor agonist activity
  • Increased Lower Esophageal Sphincter Tone

Metabolism

  • Renal: 85% of oral dose appears in the urine within 72 hrs (50% is present as free or conjugated metoclopramide)
  • Half-Life: 5-6 hrs

Administration

  • PO: 5-10 mg q6hrs
    • Onset: 30-60 min
    • Duration: 1-2 hrs
  • IV: 5-10 mg q6hrs
    • Onset: 1-3 min
    • Duration: 1-2 hrs

Dose Adjustment

  • Hepatic: none
  • Renal: decrease initial dose by 50% in patients with CrCl <40 mL/min

Use in Pregnancy (see Pregnancy, Pregnancy)

  • xxx

Drug Interactions


Adverse Effects

Cardiovascular Adverse Effects

Dermatologic Adverse Effects

Endocrine Adverse Effects

Gastrointestinal Adverse Effects

Hematologic Adverse Effects

Neurologic Adverse Effects

Renal Adverse Effects

Toxicologic Adverse Effects

Other Adverse Effects

  • xxx

References

  • xxx