Metoclopramidhydrochlorid Accord (Metoclopramide Hydrochloride Anhydrous)

• Metoclopramide acts on the central chemoreceptor trigger zone and enhances gastrointestinal motility, making it useful for several gastrointestinal and emetic conditions.
• Nausea and vomiting: reduces frequency and severity of episodes.
• Post‑operative nausea and vomiting: prevents onset after surgery.
• Gastroparesis: improves gastric emptying and symptom relief.
• Gastro‑oesophageal reflux disease (GERD): alleviates reflux‑related discomfort.

• Metoclopramide hydrochloride antagonizes dopamine D2 receptors in the chemoreceptor trigger zone, diminishing the vomiting reflex, while simultaneously increasing cholinergic tone in the gastrointestinal tract to promote coordinated peristalsis and accelerate gastric emptying.

Metoclopramide may cause a range of adverse reactions, from mild to severe, that should be monitored during therapy.

Common Side Effects

• Drowsiness
• Fatigue
• Restlessness or akathisia
• Diarrhea
• Headache
• Dizziness

Serious or Rare Side Effects

• Tardive dyskinesia (involuntary movements)
• Neuroleptic malignant syndrome
• Severe depression or suicidal thoughts
• Seizures
• Cardiac arrhythmias (QT prolongation)
• Anaphylactic or severe allergic reactions

• Before initiating therapy, clinicians should evaluate patient‑specific factors and monitor for potential complications.
• Assess renal and hepatic function: adjust use if impairment is present.
• Monitor for extrapyramidal symptoms: watch for muscle rigidity or abnormal movements.
• Use the lowest effective dose: limit duration to reduce risk of tardive dyskinesia.
• Avoid in patients with known hypersensitivity to metoclopramide.
• Exercise caution during pregnancy and lactation: weigh benefits against potential risks.
• Store at room temperature: keep in the original pack, protect from moisture and heat.

Metoclopramide can interact with several drug classes, requiring careful assessment to avoid adverse outcomes.

Major Interactions (Avoid)

• Anticholinergic agents: may reduce pro‑kinetic effect.
• MAO inhibitors: increase risk of hypertensive crisis.
• CNS depressants (e.g., opioids, benzodiazepines): enhance sedation and respiratory depression.
• QT‑prolonging drugs: additive risk of cardiac arrhythmias.
• Drugs that lower seizure threshold: may precipitate seizures.

Moderate Interactions (Monitor Closely)

• CYP2D6 substrates (e.g., codeine, tramadol): altered metabolism may increase side effects.
• SSRIs and tricyclic antidepressants: may increase risk of serotonin syndrome.
• Antihistamines: may potentiate drowsiness.