Maxolon Sr (Metoclopramide Hydrochloride)

Metoclopramide acts on dopamine pathways to control nausea, vomiting and gastrointestinal motility disorders.

• Nausea and vomiting: reduces episodes by blocking dopamine receptors in the chemoreceptor trigger zone.
• Gastroparesis: accelerates gastric emptying and improves stomach motility.
• Gastroesophageal reflux disease (GERD): enhances lower esophageal sphincter tone and reduces reflux episodes.
• Prevention of chemotherapy‑induced nausea: provides antiemetic protection during cytotoxic treatment.

• Metoclopramide competitively antagonizes central and peripheral dopamine D2 receptors, which increases acetylcholine release in the gastrointestinal tract, enhancing motility and accelerating gastric emptying. In the central nervous system, blockade of D2 receptors in the chemoreceptor trigger zone diminishes the vomiting reflex, providing antiemetic effects.

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

Common Side Effects

• Drowsiness: feeling of sleepiness or reduced alertness.
• Fatigue: general lack of energy.
• Restlessness: inner sense of agitation or inability to stay still.
• Diarrhea: loose or watery stools.
• Headache: mild to moderate head pain.
• Dry mouth: reduced salivation.

Serious or Rare Side Effects

• Tardive dyskinesia: involuntary, repetitive movements, especially of the face.
• Neuroleptic malignant syndrome: high fever, muscle rigidity, autonomic instability.
• Severe depression or suicidal thoughts.
• Seizures: convulsive episodes.
• Anaphylactic reactions: sudden, severe allergic response.
• Cardiac arrhythmias: irregular heart rhythms.

Before prescribing Metoclopramide, clinicians should consider several safety measures.

• Assess renal and hepatic function: adjust use in patients with impairment.
• Use the lowest effective dose: limit exposure to reduce risk of side effects.
• Monitor for extrapyramidal symptoms: watch for muscle rigidity or tremor.
• Avoid in patients with known hypersensitivity to metoclopramide or other dopamine antagonists.
• Caution in pregnancy: safety category is unknown; weigh benefits against potential risks.
• Store at ambient temperature: keep in the original pack, protect from moisture.

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

Major Interactions (Avoid)

• CNS depressants (e.g., opioids, benzodiazepines): may enhance sedation and respiratory depression.
• Anticholinergic agents: can reduce pro‑kinetic effect of metoclopramide.
• MAO inhibitors: increase risk of hypertensive crisis.
• CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): raise metoclopramide plasma levels.
• QT‑prolonging drugs: additive risk of cardiac arrhythmias.

Moderate Interactions (Monitor Closely)

• SSRIs and SNRIs: may increase risk of serotonin syndrome.
• Antihistamines: may blunt antiemetic effect.
• Diabetic agents: metoclopramide can affect glucose control.
• Warfarin: potential alteration of anticoagulant effect.
• Digoxin: may increase serum concentrations.