How does it work?

Metoclopramide hydrochloride works primarily by blocking dopamine receptors, that are found in an area of the brain known as the chemoreceptor trigger zone (CTZ). The CTZ is activated by nerve messages from the stomach when an irritant is present. It is also directly stimulated by agents circulating in the blood, for example anti-cancer medicines. When it is stimulated it sends messages to another area of the brain, known as the vomiting centre. This in turn sends messages to the gut, which cause vomiting. Metoclopramide, by blocking dopamine receptors in the CTZ, prevents messages from being sent to the vomiting centre. This reduces the sensation of nausea and prevents vomiting. Metoclopramide also acts in the upper gut, where it enhances the action of a chemical called acetylcholine. Increasing the action of acetylcholine results in the tightening of the muscles at the entry to the stomach, as well as relaxing the muscles at the exit of the stomach. It also increases the contraction of the muscles in the stomach itself. This speeds the passage of food through the stomach into the intestine, and physically helps to prevent vomiting. These actions make it useful in treating nausea and vomiting from many causes, including anti-cancer chemotherapy, following surgery, and in migraine. Due to its action on the gut, metoclopramide also has several other uses. It is useful in relieving nausea associated with migraine. During a migraine attack, stomach emptying is slowed. Metoclopramide is useful in this situation because it speeds up the passage of painkillers from the stomach to the intestine, where they are absorbed. For the same reason, it is often given before diagnostic proceedures such as a barium meal, to speed the passage of the meal through the gut. It is also used to restore normal muscle tone and function to the gut in some digestive disorders.

What is it used for?

Diagnostic proceedures (e.g. after a barium meal)

Digestive disorders (e.g reflux oesophagitis, peptic ulcer)

Nausea and vomiting

Post-operative conditions where there is loss of muscle tone in the stomach (gastric dystonia)

Relieving symptoms of migraine

Warning!

This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

The blood level and effect of alcohol may be increased by this medicine.

If vomiting persists, consult your doctor.

Use with caution in

Children or young adults under 20 years of age

Chronic kidney failure

Elderly people

Epilepsy

Following certain types of gut surgery (pyloroplasty or gut anastomosis)

Tumour of the adrenal gland (phaeochromocytoma)

Not to be used in

No known conditions

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used in pregnancy unless considered essential by your doctor. It should be avoided in the first trimester. Seek medical advice from your doctor.

This medicine passes into breast milk. Discuss its use during breastfeeding with your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Confusion

Dizziness

Rhythmical involuntary movement of the tongue, face, mouth and jaw, which may sometimes be accompanied by involuntary movements of the arms and legs (tardive dyskinesia)

Uncontrolled rolling of the eyes and neck (oculogyric crisis). Requires immediate treatment.

High temperature combined with falling levels of consciousness, paleness, sweating and a fast heart beat (neuroleptic malignant syndrome). Requires stopping the medicine and immediate medical treatment.

Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects)

High blood prolactin (milk producing hormone) level (hyperprolactinaemia). Sometimes this can lead to symptoms such as breast enlargement, production of milk and stopping of menstrual periods.

Diarrhoea

Drowsiness

Restlessness

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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