Metoclopramide - instructions for use, analogs, reviews and release forms (10 mg tablets, injections in injections in solution) for the treatment of nausea, vomiting and flatulence in adults, children and pregnancy

In this article, you can read the instructions for using the drug Metoclopramide. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Metoclopramide in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of metoclopramide in the presence of existing structural analogs.Use for the treatment of nausea, vomiting and flatulence in adults, children, as well as during pregnancy and lactation.

Metoclopramide antiemetic. A specific blocker of dopamine (D2) and serotonin (5-HTZ) receptors, depresses the chemoreceptors of the trigger zone of the brainstem, weakens the sensitivity of the visceral nerves that transmit impulses from the pylorus to the vomiting center. Through the hypothalamus and the parasympathetic nervous system (innervation of the gastrointestinal tract) has a regulating and coordinating effect on the tone and motor activity of the upper gastrointestinal tract (including the tone of the lower sphincter of the esophagus). Increases the tone of the stomach and intestines, accelerates the emptying of the stomach, reduces hyperacid stasis, prevents duodenopiloric and gastroesophageal reflux, stimulates intestinal peristalsis. Normalizes the separation of bile, reduces the spasm of the sphincter of Oddi. Without changing its tone, it eliminates dyskinesia of the gallbladder according to the hypomotor type. Does not affect the tone of the blood vessels of the brain, blood pressure, respiratory function, as well as kidney and liver, on hematopoiesis, gastric and pancreatic secretion. Stimulates the secretion of prolactin.Increases the sensitivity of tissues to acetylcholine (the action does not depend on vagal innervation, but is eliminated by m-holinoblokatorami). Stimulating the secretion of aldosterone, enhances the retention of sodium ions and the excretion of potassium ions.

The onset of action on the gastrointestinal tract is noted 1-3 minutes after intravenous administration, 10-15 minutes after intramuscular injection and is manifested by the acceleration of evacuation of the stomach contents (approximately from 0.5 to 6 hours depending on the route of administration) and antiemetic effect (continues 12 h).

Composition

Metoclopramide hydrochloride + excipients.

Pharmacokinetics

The connection with plasma proteins is about 30%. It is metabolized in the liver. The half-life period is 4-6 hours, with renal dysfunction up to 14 hours.

Removal of the drug occurs mainly through the kidneys for 24-72 hours in unchanged form and in the form of conjugates. Passes through the placental and blood-brain barrier and penetrates into the mother's milk.

Indications

• vomiting, nausea, hiccough of different genesis (in some cases can be effective in vomiting caused by radiation therapy or the use of cytotoxic drugs);
• atony and hypotension of the stomach and intestines (in particular, postoperative);
• dyskinesia of bile ducts in hypomotor type;
• reflux esophagitis;
• flatulence;
• functional stenosis of the pylorus;
• in the complex therapy of exacerbations of peptic ulcer of the stomach and duodenum;
• It is used to enhance peristalsis during radiocontrast studies of the digestive tract;
• as a means to facilitate duodenal sounding (to accelerate the emptying of the stomach and promote food through the small intestine).

Forms of release

Tablets 10 mg.

Solution for intravenous and intramuscular injection (injections in ampoules for injection).

Instructions for use and dosage

Pills

Tablets are taken 30 minutes before meals, washed down with a small amount of water. Adults - 5-10 mg 3-4 times a day. The maximum single dose is 20 mg, the daily dose is 60 mg. Children older than 6 years - 5 mg 1-3 times a day.

Ampoules

Intravenous or intramuscular.

Adults in a dose of 10-20 mg 1-3 times a day (maximum daily dose - 60 mg). Children older than 6 years of 5 mg 1-3 times a day.

For the prevention and treatment of nausea and vomiting caused by the use of cytostatics or radiation therapy,the drug is administered intravenously at a dose of 2 mg / kg body weight 30 minutes before the use of cytostatics or irradiation; if necessary, the administration is repeated after 2-3 hours.

Before the X-ray study, adults are administered intravenously 10-20 mg for 5-15 minutes before the study.

Patients with clinically expressed hepatic and / or renal insufficiency are prescribed a dose twice as low as usual, the subsequent dose depends on the individual reaction of the patient to metoclopramide.

Side effect

• spasm of facial musculature;
• lockjaw;
• rhythmic protrusion of the tongue;
• bulbar type of speech;
• spasm of extraocular muscles (including oculogarous crisis);
• spasmodic torticollis;
• opisthotonus;
• muscular hypertonia;
• Parkinsonism (hyperkinesis, muscle rigidity - a manifestation of dopamine-blocking action, the risk of development in children and adolescents increases with exceeding the dose of 0.5 mg / kg per day);
• dyskinesia (in the elderly, with chronic renal failure);
• drowsiness;
• fatigue;
• anxiety;
• confusion;
• headache;
• noise in ears;
• depression;
• constipation or diarrhea;
• dry mouth;
• neutropenia, leukopenia, sulfgemoglobinaemia in adults;
• atrioventricular block;
• porphyria;
• hives;
• bronchospasm;
• angioedema;
• gynecomastia;
• galactorrhea;
• violation of the menstrual cycle;
• hyperemia of the nasal mucosa.

Contraindications

• bleeding from the gastrointestinal tract;
• stenosis of the pylorus of the stomach;
• mechanical intestinal obstruction;
• Perforation of the wall of the stomach or intestine;
• pheochromocytoma;
• epilepsy;
• glaucoma;
• extrapyramidal disorders;
• Parkinson's disease;
• prolactin-dependent tumors;
• vomiting during treatment or overdose with antipsychotics and in patients with breast cancer;
• bronchial asthma in patients with hypersensitivity to sulfites;
• pregnancy (1 trimester), lactation period;
• early childhood (for children under 2 years - the use of metoclopramide in the form of any dosage forms is contraindicated, parenteral administration is contraindicated for children under 6 years of age);
• hypersensitivity to metoclopramide or any of the components of the drug;
• after operations on the digestive tract (such as pyloroplasty or anastomosis of the intestine), because vigorous muscle contractions prevent healing.

Application in pregnancy and lactation

Metoclopramide is contraindicated for use in the first trimester of pregnancy.Application in the 2nd and 3rd trimesters of pregnancy is possible only for life indications.

If you need to use the drug during lactation, you should decide whether to stop breastfeeding.

Use in children

Contraindicated in early childhood (children under 2 years - metoclopramide in the form of any dosage forms is contraindicated, parenteral administration is contraindicated for children under 6 years old).

The use of the drug in children causes an increased risk of developing a dyskinetic syndrome.

special instructions

It is not effective for vomiting of vestibular genesis.

In connection with the sodium sulfite content, the injectable solution of metoclopramide should not be prescribed to patients with bronchial asthma, with increased sensitivity to sulfites. Against the background of the use of metoclopramide, there are possible distortions of these laboratory parameters of liver function and determination of the concentration of aldosterone and prolactin in plasma.

Most side effects occur within 36 hours of the start of treatment and take place within 24 hours after withdrawal. Treatment should be, if possible, short-term.

During the treatment with the drug, alcohol is not recommended.

Impact on the ability to drive vehicles and manage mechanisms

It is recommended to use caution when driving a vehicle or when working with potentially dangerous mechanisms that require increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

Strengthens the action of ethanol (alcohol) on the central nervous system, the sedative effect of hypnotics, increases the effectiveness of therapy with H2-histamine receptor blockers.

Increases the absorption of diazepam, tetracycline, ampicillin, paracetamol, acetylsalicylic acid, levodopa, ethanol (alcohol); slows the absorption of Digoxin and cimetidine.

With simultaneous use with neuroleptics, the risk of developing extrapyramidal symptoms increases.

The effects of metoclopramide may weaken cholinesterase inhibitors.

If you are taking other medications, you should consult your doctor.

Analogues of the medicinal product Metoclopramide

Structural analogs for the active substance:

• Apo Metoclop;
• Metamol;
• Metoclopramide Acry;
• Metoclopramide Vial;
• Metoclopramide Darnitsa;
• Metoclopramide Promed;
• Metoclopramide by Eskom;
• Metoclopramide hydrochloride;
• Perinorm;
• Raglan;
• Ceruglan;
• Cried.

Analogues on the therapeutic effect (antiemetics):

• Aviomarine;
• Avioplant;
• Avomit;
• Apo Metoclop;
• Bimaral;
• Bonin;
• Validol;
• Vero Ondansetron;
• Granisetron;
• Damelyum;
• Domegan;
• Domet;
• Domperidone;
• Domstal;
• Zofran;
• Kinedryl;
• Citril;
• Lazaran;
• Latran;
• Metamol;
• Metoclopramide;
• Motigect;
• Motilac;
• Motilium;
• The monotonous;
• Motion;
• Navoban;
• Notirol;
• Ondansetron;
• Ondantor;
• Ondasol;
• Onitsit;
• Sturgeon;
• Passion;
• Perinorm;
• Raglan;
• Rondaset;
• Stronon;
• Ciel;
• Torekan;
• Trifluoperazine Apo;
• Triftazine;
• Tropindol;
• Ceruglan;
• Cerucal;
• Emend;
• Emeset;
• Emetron;
• Etaperazine.

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