Klometol (Metoclopramide Hydrochloride Monohydrate)

• Metoclopramide acts on the central chemoreceptor trigger zone and enhances gastrointestinal motility, making it useful for several nausea‑related conditions.
• Nausea and vomiting: provides rapid relief of acute and chronic nausea and vomiting.
• Postoperative nausea and vomiting: prevents and treats nausea after surgical procedures.
• Gastroparesis: improves gastric emptying in patients with delayed gastric motility.
• Chemotherapy‑induced nausea: reduces nausea associated with cytotoxic therapy.

• Metoclopramide blocks dopamine D2 receptors in the chemoreceptor trigger zone, diminishing the vomiting reflex, and stimulates acetylcholine release in the gastrointestinal tract, which enhances coordinated smooth‑muscle contractions and accelerates gastric emptying.

Metoclopramide may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Drowsiness: mild sedation or fatigue.
• Restlessness: feeling of inner tension or agitation.
• Diarrhea: increased bowel movements.
• Dry mouth: reduced salivation.
• Headache: mild to moderate head pain.
• Dystonia: involuntary muscle contractions, especially in the neck or face.

Serious or Rare Side Effects

• Tardive dyskinesia: persistent involuntary movements after prolonged use.
• Neuroleptic malignant syndrome: life‑threatening hyperthermia and muscle rigidity.
• Extrapyramidal syndrome: severe motor disturbances requiring immediate medical attention.
• Seizures: rare convulsive episodes.
• Severe allergic reactions: rash, itching, swelling, or anaphylaxis.

• Before prescribing Klometol, clinicians should consider several safety aspects.
• Assess for extrapyramidal risk: monitor patients for signs of dystonia or tardive dyskinesia.
• Avoid in bowel obstruction: contraindicated in patients with mechanical gastrointestinal blockage.
• Use caution in elderly: increased susceptibility to sedation and motor disturbances.
• Renal/hepatic impairment: dose adjustment may be required in reduced clearance.
• Contraindicated in pheochromocytoma: may precipitate hypertensive crisis.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Metoclopramide can interact with several drug classes, altering efficacy or safety.

Major Interactions (Avoid)

• MAO inhibitors: risk of hypertensive crisis and serotonin syndrome.
• Anticholinergic agents: may reduce pro‑kinetic effect.
• CNS depressants: additive sedation and respiratory depression.

Moderate Interactions (Monitor Closely)

• Opioids: increased risk of constipation and reduced gastric motility.
• CYP2D6 inhibitors (e.g., fluoxetine): may raise metoclopramide plasma levels.
• QT‑prolonging drugs: potential additive effect on cardiac repolarization.