💊 Metoclopramide

Prokinetic & Antiemetic (Dopamine Antagonist)

Generic Name	Metoclopramide
Drug Class	Dopamine (D₂) Receptor Antagonist 5-HT₄ Agonist / 5-HT₃ Antagonist (weak)
Indications	Nausea and vomiting Gastroparesis (especially diabetic) Gastro-esophageal reflux disease (GERD) Migraine-associated nausea
Mechanism of Action	Blocks dopamine (D₂) receptors centrally and peripherally, enhances acetylcholine release in the gut, increases gastric emptying, and acts on the chemoreceptor trigger zone.
Available Forms & Strengths	• Tablet: 10 mg • Oral syrup • Injection: 5 mg/mL
Dosage	Adults: 10 mg up to 3 times daily (before meals) Children: 0.1–0.15 mg/kg per dose, max 10 mg
Route	Oral, IV, IM
Common Side Effects	Drowsiness Restlessness Fatigue Diarrhea
Serious Adverse Effects	Extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome (rare)
Contraindications	• Pheochromocytoma • Epilepsy • GI obstruction, perforation, or hemorrhage
Precautions	• Children and young adults (↑ EPS risk) • Parkinson’s disease • Renal impairment
Drug Interactions	• Antipsychotics (↑ EPS risk) • Levodopa (↓ effect) • CNS depressants
Pregnancy & Lactation	Pregnancy: Generally considered safe Lactation: Use with caution (may ↑ prolactin)
Storage	Store below 30°C, protect from light
References	BNF \| BNF for Children \| Nelson Textbook of Pediatrics

⚠️ Clinical note: Avoid long-term use due to risk of tardive dyskinesia; limit duration to the shortest effective period.