Metoclopramide Ennogen Ip (Metoclopramide Hydrochloride Anhydrous)

Metoclopramide acts on dopaminergic and serotonergic pathways to control emesis and improve gastric motility.

• Nausea and vomiting: reduces frequency and severity of acute and chemotherapy‑induced episodes.
• Gastroparesis: enhances gastric emptying and alleviates related symptoms.
• Migraine‑associated nausea: mitigates nausea accompanying migraine attacks.

• Metoclopramide blocks dopamine D2 receptors in the chemoreceptor trigger zone, diminishing the central vomiting stimulus. It also stimulates 5‑HT4 receptors in the gastrointestinal tract, promoting acetylcholine release and increasing smooth‑muscle contractility, which accelerates gastric emptying. The combined antagonism and agonism improve both anti‑emetic control and gastro‑prokinetic activity.

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

Common Side Effects

• Drowsiness: mild sedation or fatigue.
• Restlessness: feeling of inner tension or agitation.
• Diarrhea: loose stools.
• Headache: mild to moderate pain.
• Extrapyramidal symptoms: transient muscle stiffness or tremor.

Serious or Rare Side Effects

• Tardive dyskinesia: irreversible involuntary movements with prolonged use.
• Neuroleptic malignant syndrome: high fever, rigidity, autonomic instability.
• Seizures: rare convulsive episodes.
• Severe allergic reaction: rash, swelling, anaphylaxis.

When prescribing Metoclopramide, clinicians should consider several safety measures.

• Renal impairment: adjust dose or monitor closely in patients with reduced kidney function.
• History of movement disorders: avoid or use with caution in patients with Parkinson’s disease or dystonia.
• Elderly patients: increased risk of extrapyramidal effects; monitor closely.
• Concomitant CNS depressants: may enhance sedation; observe for additive effects.
• Store below 25°C: keep in the original container, protect from light and moisture.

Metoclopramide can alter the activity of other medicines, requiring attention to potential interactions.

Major Interactions (Avoid)

• Anticholinergic agents: may reduce pro‑kinetic effect; avoid concurrent use.
• CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): increase metoclopramide plasma levels; avoid.
• Other dopamine antagonists (e.g., haloperidol): additive risk of extrapyramidal symptoms; avoid.

Moderate Interactions (Monitor Closely)

• Opioids: may enhance nausea; monitor response.
• MAO inhibitors: risk of hypertensive crisis; use with caution.
• Antihistamines: may increase sedation; observe patient.