Metoclopramide Relonchem (Metoclopramide Hydrochloride Bp)

Metoclopramide is used to treat conditions affecting the gastrointestinal tract and the central emetic pathways.

• Nausea and vomiting: reduces the urge to vomit by blocking dopamine receptors in the chemoreceptor trigger zone.
• Gastroparesis: enhances gastric motility, facilitating stomach emptying in patients with delayed gastric emptying.
• Postoperative nausea and vomiting: prevents and treats nausea after surgical procedures.
• Migraine-associated nausea: alleviates nausea accompanying migraine attacks.

• Metoclopramide antagonizes dopamine D2 receptors in the chemoreceptor trigger zone of the brain, diminishing the emetic signal. By blocking these receptors it also disinhibits cholinergic neurons, leading to increased release of acetylcholine in the gastrointestinal tract, which stimulates smooth‑muscle contraction and accelerates gastric emptying. The combined central anti‑emetic and pro‑kinetic actions produce its therapeutic effect.

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

Common Side Effects

• Drowsiness: feeling of sleepiness or fatigue.
• Restlessness: mild agitation or inability to stay still.
• Diarrhea: loose, watery stools.
• Dry mouth: reduced salivation.
• Headache: mild to moderate head pain.

Serious or Rare Side Effects

• Extrapyramidal symptoms: involuntary muscle movements or tremors.
• Tardive dyskinesia: persistent, potentially irreversible facial or tongue movements.
• Neuroleptic malignant syndrome: rare life‑threatening reaction with fever and muscle rigidity.
• Severe allergic reaction: rash, itching, swelling, or difficulty breathing.

Before prescribing Metoclopramide, clinicians should consider several safety precautions.

• Assess for history of movement disorders: avoid use in patients with Parkinson’s disease or tardive dyskinesia.
• Monitor renal function: dose adjustment may be needed in severe renal impairment.
• Limit duration of therapy: use the lowest effective dose for the shortest possible time to reduce risk of extrapyramidal effects.
• Use caution in the elderly: increased susceptibility to side effects such as confusion and sedation.
• Pregnancy and lactation: safety data are limited; weigh potential benefits against risks.
• Store at ambient temperature below 25°C: keep in original packaging, protect from moisture and direct sunlight.

Metoclopramide can interact with other medicines, altering its efficacy or increasing adverse effects.

Major Interactions (Avoid)

• MAO inhibitors: concurrent use may cause hypertensive crises or serotonin syndrome.
• CNS depressants: additive sedation and respiratory depression risk.
• Anticholinergic agents: may reduce pro‑kinetic effect of metoclopramide.

Moderate Interactions (Monitor Closely)

• Opioid analgesics: increased risk of extrapyramidal symptoms.
• Selective serotonin reuptake inhibitors (SSRIs): potential for serotonin syndrome.
• Antihistamines: may enhance drowsiness.
• Digoxin: may increase serum levels.