Maxolon (Metoclopramide Hydrochloride Monohydrate)

Metoclopramide is used to manage conditions involving nausea, vomiting and delayed gastric emptying.

• Nausea and vomiting: reduces frequency and severity of acute and chronic episodes in adult patients.
• Post‑operative nausea and vomiting: prevents and treats nausea after surgical procedures, improving patient comfort.
• Migraine‑associated nausea: alleviates nausea accompanying migraine attacks, supporting overall migraine management.
• Gastroparesis: enhances gastric motility and accelerates emptying, reducing symptoms such as early satiety and bloating.

• Metoclopramide acts as a dopamine D2‑receptor antagonist in the chemoreceptor trigger zone of the medulla, thereby suppressing the vomiting reflex. It also blocks peripheral D2 receptors in the gastrointestinal tract, increasing acetylcholine release, which enhances smooth‑muscle contractility and promotes coordinated gastric emptying. These actions result in rapid control of nausea and improvement of gastric motility in affected patients.

Metoclopramide may cause a range of adverse reactions, which are grouped by frequency and severity.

Common Side Effects

• Drowsiness: feeling of sleepiness or reduced alertness.
• Fatigue: general tiredness or lack of energy.
• Restlessness: uneasy feeling, often described as akathisia.
• Diarrhea: loose, watery stools.

Serious or Rare Side Effects

• Extrapyramidal symptoms: involuntary muscle movements, dystonia, or tremor.
• Tardive dyskinesia: persistent, potentially irreversible facial or tongue movements.
• Neuroleptic malignant syndrome: life‑threatening reaction with fever, muscle rigidity, and autonomic instability.

When using Metoclopramide, clinicians should observe several safety considerations to minimize risks.

• Assess renal and hepatic function: adjust use in patients with impairment.
• Use the lowest effective dose: limit exposure to reduce side‑effect risk.
• Monitor for extrapyramidal symptoms: watch for muscle rigidity, tremor or abnormal movements.
• Avoid in patients with known hypersensitivity: discontinue if allergic reaction occurs.
• Caution in pregnancy and lactation: category B1, benefits must outweigh potential risks.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Metoclopramide can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Antipsychotics (dopamine antagonists): additive risk of extrapyramidal effects.
• MAO inhibitors: may precipitate hypertensive crisis.
• CYP2D6 inhibitors (e.g., quinidine): increase metoclopramide plasma concentrations.

Moderate Interactions (Monitor Closely)

• CNS depressants (sedatives, antihistamines): enhanced drowsiness or sedation.
• Opioids: may potentiate gastrointestinal motility effects.
• SSRIs or SNRIs: increased risk of serotonin syndrome.