Metoclopramide Hydrochloride: Brands, Price & Uses in Bangladesh

Gastroesophageal Reflux Disease (GERD)

Metoclopramide Hydrochloride is an established short-term (up to 12 weeks) treatment for symptomatic GERD in adults who have not responded adequately to other therapy, used to relieve heartburn and related symptoms by increasing gastric emptying and lower esophageal sphincter tone.

Diabetic Gastroparesis

Metoclopramide Hydrochloride is FDA-approved for the relief of symptoms associated with acute and recurrent diabetic gastroparesis, including nausea, vomiting, early satiety, bloating, and abdominal pain related to delayed gastric emptying. Because of the risk of tardive dyskinesia, treatment with Metoclopramide Hydrochloride for this indication is generally limited to 12 weeks or less.

Nausea and Vomiting

Metoclopramide Hydrochloride is an established antiemetic used to prevent and treat nausea and vomiting associated with chemotherapy (often as part of a combination antiemetic regimen for highly or moderately emetogenic chemotherapy), postoperative nausea and vomiting, and other causes of nausea and vomiting when other measures are inadequate.

Facilitation of Small Bowel Intubation and Radiologic Examination

Metoclopramide Hydrochloride is used, as a single intravenous dose, to stimulate gastric and small bowel motility to facilitate intubation of the small bowel when the tube does not pass the pylorus with conventional maneuvers, and to accelerate gastric emptying and small bowel transit when a barium examination of the stomach or small intestine is delayed.

Off-Label Use

Metoclopramide Hydrochloride is used off-label by some clinicians to support lactation (as a galactagogue) in mothers with low milk supply; this use is not FDA-approved, is supported only by limited evidence, and carries the same tardive dyskinesia and other risks as approved uses, so it should only be considered under close medical supervision.

The dose of Metoclopramide Hydrochloride depends on the indication being treated, the route of administration, and patient-specific factors such as age, renal function, and body weight, and must be individualized by a qualified healthcare professional. Because of the risk of tardive dyskinesia, treatment with Metoclopramide Hydrochloride should be limited to the lowest effective dose and, for chronic indications such as GERD and diabetic gastroparesis, generally should not exceed 12 weeks unless the treating physician judges that therapeutic benefit clearly outweighs the risk.

Common Side Effects

• Drowsiness and fatigue
• Restlessness or nervousness
• Headache
• Diarrhea or bowel changes
• Nausea

Serious Side Effects (Seek Medical Attention)

• Acute dystonic reactions (involuntary muscle spasms of the face, neck, tongue, or eyes), akathisia (severe restlessness), and parkinsonian symptoms (tremor, rigidity) — these extrapyramidal symptoms occur more often in children, young adults, and with higher doses; see Precautions and Warnings.
• Tardive dyskinesia — involuntary, repetitive movements of the face, tongue, or limbs, which may be irreversible and is associated with prolonged use or higher cumulative doses of Metoclopramide Hydrochloride; see Precautions and Warnings for details.
• Symptoms of hyperprolactinemia, such as breast tenderness or enlargement, unexpected milk production (galactorrhea), or menstrual irregularities.
• Signs of neuroleptic malignant syndrome (high fever, severe muscle rigidity, altered consciousness, unstable blood pressure) — a rare but life-threatening reaction.
• Signs of an allergic reaction, such as rash, swelling of the face or throat, or difficulty breathing.
• Depression, suicidal ideation, or significant mood changes.
• Methemoglobinemia (unusual bluish discoloration of the skin, shortness of breath) — rare, reported particularly in neonates and infants given excessive doses.