Antimet

Indications

Metoclopramide is used in adults for the short-term prevention and treatment of nausea and vomiting, including:

• nausea and vomiting after an operation;
• delayed nausea and vomiting after radiotherapy or cancer treatment;
• nausea during a migraine attack (it also helps pain tablets work faster).

Specialists sometimes use it for slow stomach emptying (gastroparesis), for example in people with diabetes. In children it is used only when other treatments have not worked, and only as prescribed.

How It Works

Metoclopramide blocks dopamine, a chemical messenger, in the part of the brain that triggers vomiting. It also makes the stomach and upper gut move food along faster, which reduces bloating and the urge to vomit.

Dosage and Administration

Adults: 10 mg up to three times a day, about 30 minutes before meals. The usual maximum is 30 mg in a day. It is normally taken for no longer than 5 days unless a doctor advises otherwise.

Older people and people with kidney or liver problems: the doctor may give a lower dose.

Children: only as prescribed by a doctor, based on body weight. It must not be given to babies under 1 year.

Injections and suppositories: injections are given by a doctor or nurse; suppositories and nasal spray are used only as prescribed.

Leave at least 6 hours between doses, even if you vomit after a dose.

Interactions

• Levodopa and other medicines for Parkinson's disease: the two work against each other.
• Antipsychotic medicines: higher risk of abnormal movements.
• Alcohol, sleeping tablets and other sedating medicines: more drowsiness.
• Opioid painkillers and Hyoscine Butyl Bromide: can reduce its effect on the gut.
• Some antidepressants (such as Fluoxetine or Sertraline): rare risk of serotonin syndrome.

Tell your doctor or pharmacist about all medicines you take.

Contraindications

• Blockage, bleeding or a tear in the stomach or bowel, or within 3 to 4 days of gut surgery
• Parkinson's disease
• Past abnormal movements (tardive dyskinesia) caused by this or similar medicines
• Epilepsy
• Phaeochromocytoma (a rare adrenal gland tumour)
• Babies under 1 year
• Allergy to Metoclopramide

Side Effects

Common: drowsiness, tiredness, restlessness, diarrhoea, low blood pressure and low mood.

It can cause sudden muscle spasms of the face, eyes, jaw or neck, especially in children and young adults. With long or high-dose use it can cause slow, uncontrolled movements of the face and tongue (tardive dyskinesia), which may not go away.

Get medical help at once for uncontrollable movements of the face, tongue, eyes or neck; high fever with stiff muscles and confusion; a very slow or irregular heartbeat; fainting; or swelling of the face and trouble breathing.

Pregnancy and Lactation

Metoclopramide may be used in pregnancy when a doctor considers it necessary, for the shortest time. Use near the end of pregnancy can rarely cause movement problems in the newborn. Small amounts pass into breast milk; breastfeeding mothers should use it only on a doctor's advice.

Precautions and Warnings

• Do not take it for more than 5 days without a doctor's advice.
• Take extra care in older people and in kidney or liver disease.
• Tell your doctor if you have heart rhythm problems, low potassium or depression.
• It can cause drowsiness; do not drive or use machines if affected.

Overdose

Too much can cause drowsiness, confusion, irritability and abnormal movements of the face and body. Go to hospital straight away; the movements can be treated.

Therapeutic Class

Antiemetic and prokinetic (dopamine antagonist).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze the syrup or drops.