Metoclopramid Biofarm (Metoclopramide Hydrochloride Monohydrate)

Metoclopramide acts on dopaminergic pathways in the gastrointestinal tract and the chemoreceptor trigger zone to control nausea, vomiting and motility disorders.

• Nausea and vomiting: reduces frequency and severity of acute and chemotherapy‑induced episodes.
• Gastroparesis: accelerates gastric emptying and improves related symptoms such as early satiety.
• Gastro‑oesophageal reflux disease (GERD): enhances lower esophageal sphincter tone and promotes gastric clearance.
• Post‑operative nausea and vomiting: prevents and treats nausea after surgical procedures.

• Metoclopramide antagonizes peripheral and central dopamine D2 receptors, diminishing the stimulus for nausea in the chemoreceptor trigger zone. It also blocks serotonin 5‑HT3 receptors and exerts cholinergic agonist activity, increasing acetylcholine release. These actions collectively enhance gastrointestinal smooth‑muscle contractility, accelerate gastric emptying, and raise lower esophageal sphincter pressure, thereby reducing reflux and emesis.

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

Common Side Effects

• Drowsiness: feeling of sleepiness or reduced alertness.
• Fatigue: general tiredness.
• Restlessness or akathisia: inner sense of unease.
• Diarrhea: loose stools.
• Headache: mild to moderate head pain.
• Dry mouth: reduced salivation.

Serious or Rare Side Effects

• Tardive dyskinesia: involuntary, repetitive movements, potentially irreversible.
• Neuroleptic malignant syndrome: high fever, muscle rigidity, autonomic instability.
• Severe allergic reactions: rash, angioedema, anaphylaxis.
• Depression or suicidal thoughts: mood changes requiring immediate attention.

When prescribing Metoclopramide, clinicians should consider several safety precautions to minimize risks.

• Assess renal function: dose may need adjustment in renal impairment.
• Monitor for extrapyramidal symptoms: watch for tremor, rigidity, or involuntary movements.
• Use caution in patients with depression: drug may exacerbate mood disorders.
• Avoid in known hypersensitivity: discontinue if allergic reaction occurs.
• Adjust dose in elderly patients: increased sensitivity to central effects.
• Store at room temperature: keep in the original packaging, protect from moisture and light.

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

Major Interactions (Avoid)

• Monoamine oxidase inhibitors (MAOIs): risk of hypertensive crisis.
• CNS depressants (e.g., opioids, benzodiazepines): additive sedation and respiratory depression.
• Anticholinergic agents: may reduce prokinetic effect.
• CYP2D6 inhibitors (e.g., quinidine): increase metoclopramide plasma levels.

Moderate Interactions (Monitor Closely)

• Selective serotonin reuptake inhibitors (SSRIs): potential for serotonin syndrome.
• Antihistamines: may enhance drowsiness.
• Digoxin: possible increase in serum digoxin concentrations.
• Antidiabetic drugs: may affect glucose control.