section name header

Indications

BEERS REMS


Unlabeled Use:
  • Treatment of hiccups.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: bradycardia, hypertension, hypotension, supraventricular tachycardia

Endo: gynecomastia, hyperprolactinemia

GI: constipation, diarrhea, dry mouth, nausea

Hemat: agranulocytosis, leukopenia, methemoglobinemia, neutropenia

Neuro: drowsiness, dysgeusia (intranasal), extrapyramidal reactions, restlessness, anxiety, bradykinesia, cog-wheel rigidity, depression, irritability, NEUROLEPTIC MALIGNANT SYNDROME, tardive dyskinesia, tremor

Interactions

Drug-drug:

Availability

(Generic available)

Route/Dosage

Prevention of Chemotherapy-Induced Nausea and Vomiting

Facilitation of Small Bowel Intubation

Diabetic Gastroparesis

Renal Impairment

Hepatic Impairment

Gastroesophageal Reflux

Renal Impairment

Hepatic Impairment

Prevention of Postoperative Nausea and Vomiting

Treatment of Hiccups

US Brand Names

Gimoti, Reglan

Action

  • Blocks dopamine receptors in chemoreceptor trigger zone of the CNS.
  • Stimulates motility of the upper GI tract and accelerates gastric emptying.
Therapeutic effects:
  • Decreased nausea and vomiting.
  • Decreased symptoms of gastric stasis.
  • Easier passage of nasogastric tube into small bowel.

Classifications

Therapeutic Classification: antiemetics

Pharmacokinetics

Absorption: Well absorbed from the GI tract, from rectal mucosa, and from IM sites. 47% absorbed following intranasal administration. IV administration results in complete bioavailability.

Distribution: Widely distributed into body tissues and fluids. Crosses blood-brain barrier.

Metabolism/Excretion: Partially metabolized by the liver via the CYP2D6 isoenzyme; the CYP2D6 isoenzyme exhibits genetic polymorphism (7% of population may be poor metabolizers and may have significantly metoclopramide concentrations and an risk of adverse effects). 25% eliminated unchanged in the urine.

Half-Life: 2.5–6 hr.

Canadian Brand Names

Metonia

Time/Action Profile

(effects on peristalsis)

ROUTEONSETPEAKDURATION
PO30–60 minunknown1–2 hr
IM10–15 minunknown1–2 hr
Intranasalunknownunknownunknown
IV1–3 minimmediate1–2 hr



Patient/Family Teaching

Pronunciation

met-oh-KLOE-pra-mide