Metoclopramide Crescent Pharma International (Metoclopramide Hydrochloride)

Metoclopramide acts on dopaminergic pathways that trigger nausea and on gastrointestinal motility, making it useful in several emetic and motility disorders.

• Nausea and vomiting of various origins: reduces the frequency and severity of symptoms.
• Post‑operative nausea and vomiting: helps prevent and treat nausea after surgery.
• Chemotherapy‑induced nausea and vomiting: improves patient tolerance to anticancer regimens.
• Gastroparesis: accelerates gastric emptying and relieves associated discomfort.
• Gastro‑oesophageal reflux disease (GERD) adjunct: used as an add‑on to improve reflux symptoms when standard therapy is insufficient.

• Metoclopramide competitively antagonises dopamine D2 receptors in the chemoreceptor trigger zone and throughout the gastrointestinal tract, diminishing emetic signalling. It also blocks peripheral 5‑HT3 receptors and enhances acetylcholine release, which together promote coordinated gastric contractions and accelerate gastric emptying, thereby reducing nausea and improving gastrointestinal motility.

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

Common Side Effects

• Drowsiness: feeling unusually sleepy or fatigued.
• Restlessness or akathisia: inner sense of agitation.
• Diarrhoea: loose or frequent stools.
• Dry mouth: reduced salivary flow.
• Headache: mild to moderate head pain.

Serious or Rare Side Effects

• Extrapyramidal symptoms: muscle rigidity, tremor, or dystonia.
• Tardive dyskinesia: involuntary, repetitive movements with long‑term use.
• Neuroleptic malignant syndrome: high fever, muscle rigidity, autonomic instability.
• Severe allergic reactions: rash, swelling, or difficulty breathing.

Before prescribing Metoclopramide, clinicians should consider several safety aspects.

• Renal or hepatic impairment: adjust use or monitor closely.
• History of movement disorders: avoid or use with extreme caution.
• Elderly patients: increased risk of CNS side effects; monitor closely.
• Concomitant CNS depressants: may enhance drowsiness or sedation.
• Pregnancy and breastfeeding: safety not established; weigh benefits against potential risks.
• Store at ambient temperature: keep below 25 °C, in the original container, protected from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Monoamine oxidase inhibitors (MAOIs): risk of hypertensive crisis.
• Antipsychotics that block dopamine: may reduce therapeutic effect.
• CNS depressants (e.g., benzodiazepines, opioids): additive sedation.

Moderate Interactions (Monitor Closely)

• CYP2D6 substrates (e.g., metoprolol, codeine): possible altered plasma levels.
• Anticholinergic agents: may diminish pro‑kinetic benefit.
• Antihistamines: could increase risk of extrapyramidal symptoms.