Metoclopramide S.A.L.F. (Metoclopramide Hydrochloride Monohydrate)

Metoclopramide acts on the dopaminergic pathways that trigger nausea and impair gastric motility. It is indicated for several gastrointestinal and postoperative conditions.

• Nausea and vomiting: reduces the frequency and severity of acute episodes.
• Postoperative nausea and vomiting: prevents and treats nausea after surgery.
• Gastroparesis: enhances gastric emptying and alleviates related symptoms.

• Metoclopramide blocks dopamine D2 receptors in the chemoreceptor trigger zone, diminishing the central stimulus for nausea. It also antagonizes peripheral D2 receptors, increasing acetylcholine release, which stimulates smooth‑muscle contraction and accelerates gastrointestinal motility, thereby facilitating gastric emptying.

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

Common Side Effects

• Drowsiness: mild sedation or sleepiness.
• Fatigue: general feeling of tiredness.
• Restlessness: inner sense of unease or agitation.
• Diarrhea: loose stools or increased bowel movements.
• Headache: mild to moderate cranial pain.
• Dizziness: sensation of light‑headedness or imbalance.

Serious or Rare Side Effects

• Extrapyramidal symptoms: involuntary muscle movements or tremor.
• Tardive dyskinesia: persistent, potentially irreversible dyskinetic movements.
• Neuroleptic malignant syndrome: life‑threatening hyperthermia and rigidity.
• Severe allergic reactions: rash, swelling, or anaphylaxis.
• Cardiac arrhythmias: irregular heart rhythm.
• Seizures: sudden, uncontrolled electrical activity in the brain.

Before using Metoclopramide, clinicians should consider several safety measures.

• Renal and hepatic function: assess and adjust use in impairment.
• Dose minimization: employ the lowest effective dose for the shortest duration.
• Extrapyramidal monitoring: watch for signs of muscle rigidity or abnormal movements.
• Prolonged therapy avoidance: limit use to prevent tardive dyskinesia.
• Hypersensitivity: discontinue if allergic reaction occurs.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

• MAO inhibitors: risk of hypertensive crisis.
• CNS depressants (e.g., benzodiazepines, opioids): enhanced sedation.
• Anticholinergic agents: reduced pro‑kinetic effect.
• QT‑prolonging drugs: increased risk of cardiac arrhythmia.

Moderate Interactions (Monitor Closely)

• CYP2D6 inhibitors (e.g., fluoxetine): may raise metoclopramide levels.
• Antipsychotics: potential additive extrapyramidal effects.
• Alcohol: may intensify drowsiness.
• Antihistamines: possible increase in sedation.