What helps metoclopramide and how to take the drug?

Metoclopramide is an antiemetic drug.

Its effect is due to the inhibition of the vomiting center located in the medulla oblongata and thalamus. Positively affects the motility of the intestine and stomach, reducing the intensity and strength of the waves of reverse peristalsis.

Normalizes the tone of the esophageal sphincter, reduces the effect on it from the autonomic nervous system.

Clinical and pharmacological group

Antiemetic, helps to reduce nausea, hiccups; stimulates the peristalsis of the gastrointestinal tract.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does metoclopramide? The average price in pharmacies is at the level of35 rubles.

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Form of issue and composition

Tablets are white or almost white in color, with a bevel, marble is allowed.

• 1 tablet contains: active substance - metoclopramide hydrochloride - 10 mg;
• auxiliary substances - lactose monohydrate, potato starch, povidone, calcium stearate.

Pharmacological effect

The drug has antiemetic effect. It reduces manifestations of hiccups, nausea and vomiting, alleviating the condition of the patient. The drug stimulates the peristalsis of the gastrointestinal tract, reduces the reflux of the contents of the stomach into the esophagus by increasing the pressure of the sphincter.

Metoclopramide - an active active substance of the drug stimulates the production of prolactin and causes transient increase in the level of circulating aldosterone, which may be accompanied by a short-term delay liquid.

Indications for use

What helps? Metoclopramide is prescribed in the following cases:

1. Nausea, vomiting and hiccough of different genesis (in some cases, the drug is effective in vomiting caused by taking cytotoxic drugs or radiation therapy);
2. Flatulence;
3. Exacerbation of peptic ulcer of stomach and duodenum (as part of complex therapy);
4. Postoperative hypotension and atony of the intestine and stomach;
5. Reflux esophagitis;
6. Dyskinesia of bile ducts in hypomotor type;
7. Functional stenosis of the pylorus.

In addition, metoclopramide is used in radiocontrast studies of the gastrointestinal tract in order to enhance peristalsis, as well as during duodenal sounding to accelerate the emptying of the stomach and promote food through a thin gut.

Contraindications

The drug is contraindicated in the following diseases and conditions:

1. Extrapyramidal disorders;
2. Prolactin-dependent tumors;
3. Stenosis of the pylorus of the stomach;
4. Perforation of the wall of the intestine or stomach;
5. Bleeding from the gastrointestinal tract;
6. Mechanical intestinal obstruction;
7. Glaucoma;
8. Pheochromocytoma;
9. Epilepsy;
10. Parkinson's disease;
11. Bronchial asthma in patients with hypersensitivity to sulfites;
12. Vomiting during treatment or overdose with antipsychotics, as well as in patients with breast cancer;
13. Early childhood (the drug is contraindicated for children under 2 years old, and in children under 6 years of age, metoclopramide is not used parenterally);
14. The first trimester of pregnancy and the period of breastfeeding;
15. Hypersensitivity to the main or auxiliary components of the drug.

Metoclopramide should not be given after surgery on the gastrointestinal tract (anastomosis of the intestine or pyloroplasty), since vigorous muscle contractions inhibit healing.

The drug is used with caution in patients with arterial hypertension, bronchial asthma, hepatic and / or renal insufficiency, in the elderly (over 65 years) and childhood.

Use in pregnancy and lactation

Contraindicated in pregnancy.

When used during lactation (breastfeeding), it should be borne in mind that metoclopramide penetrates into breast milk.

In experimental studies, no adverse effect of metoclopramide on the fetus has been established.

Dosage and route of administration

In the instructions for use indicated that the tablets Metoclopramide I appoint adults inside - 5-10 mg 3-4 times / day. When vomiting, severe nausea, metoclopramide is given in / m or IV in a dose of 10 mg. Intranasal - 10-20 mg in each nostril 2-3 times / day.

• Maximum doses: one-time with oral administration - 20 mg; daily - 60 mg (for all modes of administration).

The average single dose for children over 6 years is 5 mg 1-3 times / day inward or parenterally. For children under 6 years of age, the daily dose for parenteral administration is 0.5-1 mg / kg, the frequency of reception is 1-3 times / day.

Side effects

Taking tablets Metoclopramide can lead to the development of unwanted reactions from various organs and systems, which include:

• Allergic reactions - in rare cases, a skin rash develops.
• Digestive system - at the beginning of the drug application, development of constipation or diarrhea, less dryness in the mouth, is possible.
• Blood and red bone marrow - at the beginning of treatment with the drug, the development of agranulocytosis (disappearance of granulocytes from peripheral blood, including neutrophils, eosinophils and basophils) is possible.
• Endocrine system - gynecomastia (enlargement of mammary glands in men due to increased prolactin in blood), menstrual disorders in women, galactorrhea (the appearance of excretion of breast milk beyond the period lactation).
• Nervous system - the appearance of a feeling of fatigue (especially at the beginning of the drug), drowsiness, headache, depression (prolonged decline in mood), dizziness, akathisia (a feeling of inner motor anxiety). Children and young people may develop extrapyramidal movement disorders, which are characterized by hyperkinesis (involuntary movements of striated skeletal muscle), spasm of facial musculature, spastic torticollis. With prolonged use of the drug may develop manifestations of Parkinsonism.

With the development of side effects, the use of Metoclopramide tablets is not advisable.

Overdose

The main symptoms of an overdose of metoclopramide are extrapyramidal disorders, stopping breathing and heart, drowsiness, hallucinations, clouded consciousness, fainting and fainting state.

If the patient is diagnosed with extrapyramidal symptoms, provoked by an overdose, or other cause, it is recommended the appointment of symptomatic therapy (anticholinergic antiparkinsonian drugs in adults and / or benzodiazepines in children).

Depending on the clinical condition of the patient, symptomatic treatment and regular monitoring of respiratory and cardiac functions are required.

special instructions

Before you start using the drug, read the special instructions:

1. When used in elderly patients, it should be borne in mind that with prolonged use of metoclopramide in high or medium doses, the most common side effect are extrapyramidal disorders, especially parkinsonism and late dyskinesia.
2. With extreme caution should be used in children, especially the early age, t. they have a significantly higher risk of dyskinetic syndrome. Metoclopramide in some cases can be effective in vomiting caused by the use of cytotoxic drugs.
3. With caution apply in patients with bronchial asthma, arterial hypertension, impaired liver and / or kidney function, with Parkinson's disease.
4. Against the background of the use of metoclopramide, there may be distortions in the laboratory parameters of liver function and the determination of the concentration of aldosterone and prolactin in the blood plasma.

Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

1. With simultaneous use with anticholinergic agents, mutual weakening of effects is possible.
2. With simultaneous use, absorption of acetylsalicylic acid, paracetamol, ethanol is enhanced.
3. Metoclopramide with IV introduction increases the rate of absorption of diazepam and increases its maximum concentration in the blood plasma.
4. With simultaneous application with zopiclone, zopiclone absorption is accelerated; with cabergoline - possibly reducing the effectiveness of cabergoline; with ketoprofen - the bioavailability of ketoprofen decreases.
5. When used simultaneously with morphine, the absorption of morphine is accelerated when ingested and its sedative effect is enhanced.
6. At simultaneous application with nitrofurantoin absorption of nitrofurantoin decreases.
7. When metoclopramide is used immediately before administration of propofol or thiopental, their induction doses may need to be reduced.
8. In patients receiving metoclopramide, the effects of suxamethonium chloride are enhanced and prolonged.
9. With simultaneous application with mexiletine, the absorption of mexiletine is accelerated; with mefloquine - increased the rate of absorption of mefloquine and its concentration in the blood plasma, while it is possible to reduce its by-products effects.
10. When used simultaneously with neuroleptics (especially the phenothiazine series and butyrofenone derivatives), the risk of extrapyramidal reactions increases.
11. When used simultaneously with a slowly dissolving dosage form of digoxin, it is possible to reduce the digoxin concentration in serum by 1/3. With simultaneous use with digoxin in liquid dosage form or in the form of a rapidly dissolving drug, no interaction was observed.
12. Due to antagonism with respect to dopamine receptors, metoclopramide can reduce the antiparkinsonian action levodopa, it is possible to increase the bioavailability of levodopa due to the acceleration of its evacuation from the stomach under the influence of metoclopramide. The results of the interaction are ambiguous.
13. With simultaneous application with tolterodine, the effectiveness of metoclopramide decreases; with fluvoxamine - the case of development of extrapyramidal disorders has been described; from fluoxetine - there is a risk of developing extrapyramidal disorders; with cyclosporine - increases the absorption of cyclosporine and increases its concentration in the plasma blood.

Reviews

We picked up some reviews of people taking the drug Metoclopramide:

1. Lily. Metoclopramide was prescribed for poisoning with vomiting. I took metoclopramide for 24 hours, vomiting and nausea passed after taking the second pill. This drug can be taken and animals with poisoning, my dog ​​was assigned to quarters a day.
2. Olga. Well helped by the medicine when vomiting from my husband. At first we tried to get by some means from the abdomen like furazolidone, levomycetin, since thought that he was vomiting because of indigestion, but it turned out to be much more terrible and the diagnosis was put by a terrible one - oncology. Now everything is fine and the husband is on the mend.. but then it was scary and plus the vomiting that metoclopramide stopped.
3. Catherine. Previously, always from the nausea took cerulek. Have advised metoclopramide. The drug is a new generation, much cheaper cerulekala. My child is four years old, a viral illness that is accompanied by vomiting. You can certainly and without pills, but if vomiting becomes frequent, then there are no options. And the very problem with digestion. The drug worked fine, in 30 minutes! No side effects were observed. Now always in our medicine cabinet!

Analogues

Structural analogs for the active substance:

• Apo Metoclop;
• Metamol;
• Metoclopramide Acry;
• Metoclopramide Vial;
• Metoclopramide Darnitsa;
• Metoclopramide Promed;
• Metoclopramide by Eskom;
• Metoclopramide hydrochloride;
• Perinorm;
• Raglan;
• Ceruglan;
• Cried.

Before using analogues, consult your doctor.

"Tserukal" as an analogue of "Metoclopramide"

"Cerucal" is the direct and most common substitute for "Metoclopramide." It removes nausea, hiccough and vomiting of various genesis. It is used for radiation therapy and cytotoxic therapy. The medicine has contraindications and can cause a number of negative symptoms. Passes through the blood-brain barrier and breast milk. The greatest concentration of active substance is observed after half an hour after the application of the drug.

The cost of the medicine fluctuates around 200-300 rubles. Produce the drug in Germany and Croatia.

The reviews say that he not only relieves nausea and vomiting, but also effectively removes pain in the stomach with gastritis. Another means saves some people from a hangover.

Storage conditions and shelf life

Store at a temperature of no more than 25 ° C, in a place protected from light. Keep away from children.

Shelf life - 4 years.

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