Metoclopramidum Polpharma (Metoclopramide Hydrochloride)

Metoclopramide acts on the gastrointestinal and central pathways that trigger nausea and delayed gastric emptying.

• Nausea and vomiting: reduces the frequency and severity of acute and chronic episodes.
• Post‑operative nausea and vomiting: helps prevent and treat nausea after surgery.
• Gastroparesis: enhances gastric motility and accelerates stomach emptying.
• Gastro‑esophageal reflux disease: alleviates reflux symptoms by promoting gastric clearance.

• Metoclopramide competitively blocks dopamine D2 receptors in the chemoreceptor trigger zone and throughout the gastrointestinal tract, which diminishes the emetic signal and increases the tone of the lower esophageal sphincter. It also exerts weak antagonism at 5‑HT3 receptors, further contributing to its anti‑emetic and pro‑kinetic actions.

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

Common Side Effects

• Drowsiness: feeling unusually sleepy or fatigued.
• Restlessness: inner sense of agitation or inability to stay still.
• Diarrhea: loose or watery stools.
• Headache: mild to moderate head pain.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Fatigue: reduced energy and increased tiredness.

Serious or Rare Side Effects

• Extrapyramidal reactions: involuntary muscle movements or rigidity.
• Tardive dyskinesia: persistent, irreversible facial or tongue movements.
• Neuroleptic malignant syndrome: high fever, muscle rigidity, autonomic instability.
• Depression or suicidal thoughts: mood changes requiring immediate attention.
• Seizures: convulsive episodes.
• Cardiac arrhythmia: irregular heart rhythm.

Before initiating therapy, clinicians should evaluate patient‑specific factors and monitor for known risks.

• Assess renal and hepatic function: adjust use in impairment.
• Monitor for extrapyramidal symptoms: watch for muscle rigidity or tremor.
• Use the lowest effective dose: limit exposure to reduce side‑effects.
• Avoid in patients with known hypersensitivity to metoclopramide.
• Caution in pregnancy: weigh benefits against potential risks.
• Store at room temperature: keep in original container, protect from moisture and light.

Metoclopramide can alter the activity of several co‑administered medicines, requiring vigilance.

Major Interactions (Avoid)

• Antipsychotics (e.g., haloperidol): may increase risk of extrapyramidal symptoms.
• MAO inhibitors: can potentiate central nervous system effects.
• CNS depressants (e.g., benzodiazepines): may enhance sedation and respiratory depression.

Moderate Interactions (Monitor Closely)

• Opioids: may augment nausea control but increase sedation.
• SSRIs and SNRIs: potential for serotonin syndrome, especially with high doses.
• Tricyclic antidepressants: may increase anticholinergic burden.
• Anticholinergic agents: can reduce pro‑kinetic efficacy of metoclopramide.