Experiences with

Metoclopramide

Metoclopramide is an anti-sickness medicine (known as an antiemetic). It's used to help stop you feeling or being sick (nausea or vomiting) including:

• after radiotherapy or chemotherapy (treatment for cancer)
• sickness you may get with a migraine
• if you've had an operation
• at the end of life (palliative care)

Metoclopramide comes as tablets or a liquid that you swallow. It can also be given as an injection, but this is usually given in hospital or by a member of a care team visiting you at home.

It's only available on prescription.

For migraines, you can also get metoclopramide combined with the painkillers aspirin (brand name Migramax) or paracetamol (brand name Paramax). These are both prescription only.

Who can take metoclopramide

Most adults and children aged 1 year old and over can take metoclopramide.

Who may not be able to take metoclopramide

Metoclopramide is not suitable for some people. To make sure it's safe for you, tell your doctor or pharmacist if you:

• have ever had an allergic reaction to metoclopramide or any other medicine
• have ever had bleeding from your stomach or intestines
• have kidney or liver problems
• have a slow heartbeat (bradycardia)
• have a tumour on your adrenal gland
• have a rare inherited blood disorder such as porphyria, methaemoglobinemia, or NADH cytochrome-b5 deficiency
• have ever had involuntary muscle spasms when taking medicines such as metoclopramide or antipsychotics
• have Parkinson's disease, or epilepsy, or a history of fits or seizures

Dosage

Metoclopramide comes as tablets or a liquid that you swallow.

Doses can vary, depending on why you need metoclopramide.

The usual adult dose is 10mg, taken up to 3 times a day.

Doses are lower for adults who weigh less than 60kg, and for people with a liver or kidney problem.

If your child is prescribed metoclopramide, the doctor will use your child's age and weight to work out the right dose.

How to take it

You can take metoclopramide with or without food.

Swallow the tablets whole, with a drink of water.

If you're taking metoclopramide liquid, use the plastic syringe or medicine spoon that comes with your medicine to measure out the right dose. If you do not have one, ask your pharmacist. Do not use a kitchen teaspoon as it will not measure the right amount.

Try to spread your doses evenly over 24 hours. If you take it 3 times a day, then take a dose every 8 hours.

Wait at least 6 hours between each dose, even if you're sick (vomit). This is to avoid a possible overdose.

How long to take it for

How long you take metoclopramide for depends on why you're taking it. It's usually only prescribed short-term, for up to 5 days.

If you're taking it for migraine, you'll only take it when you have symptoms. You will not need to take it every day.

For nausea and vomiting caused by chemotherapy or radiotherapy, take it for as long as your doctor tells you to.

Talk to your doctor or pharmacist if you're unsure how long you need to take metoclopramide for.

If you forget to take it

If you forget to take your dose of metoclopramide, skip the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you forget doses often, it might help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

If you take 1 extra dose of metoclopramide, it's unlikely to be harmful, however, taking more than this can be dangerous.

Call a doctor or contact 111 if:

• you take 2 or more extra doses of metoclopramide, even if you feel well
• you get symptoms such as muscle spasms, shaking, tremor, drowsiness, confusion or hallucinations (seeing things that are not there).

• you have a seizure or fit

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the metoclopramide packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of metoclopramide happen in more than 1 in 100 people. They're usually mild and go away by themselves. There are things you can do to help cope with them:

Keep taking the medicine, but talk to your doctor or pharmacist if the advice on how to cope does not help and these side effects bother you or do not go away.

Serious side effects

Some people may have serious side effects when taking metoclopramide, but these are rare.

Stop taking metoclopramide and call your doctor or call 111 now if:

• your muscles or eyes start moving in an unusual or uncontrolled way

• you've had a seizure or fit

In rare cases, metoclopramide may cause a serious allergic reaction (anaphylaxis).

These are not all the side effects of metoclopramide. For a full list, see the leaflet inside your medicine packet.

Metoclopramide and pregnancy

Metoclopramide can be taken in pregnancy as there is no evidence that it will harm your baby. However, there are other anti-sickness medicines that have fewer side effects and may be more suitable. Talk to your doctor or pharmacist about which medicine would be best for you.

Metoclopramide and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take metoclopramide while breastfeeding but it's best to only use it for a short time. Other medicines may be more suitable while you're breastfeeding but your doctor will help you decide.

Metoclopramide passes into breast milk in small amounts. It rarely affects babies, but it can occasionally cause mild side effects such as trapped wind.

Metoclopramide can also be used to help increase your breast milk supply. Although it is not made for this purpose, it may be offered on specialist advice.

If you notice your baby is not feeding as well as usual, seems unusually sleepy, has trapped wind or diarrhoea, or you have any other concerns about your baby, talk to a midwife, health visitor, pharmacist, or doctor as soon as possible.

Metoclopramide and fertility

There's no evidence that metoclopramide affects fertility.

Cautions with other medicines

Some medicines and metoclopramide can affect each other. This can increase your chance of having side effects.

Speak to your doctor or pharmacist before starting to take metoclopramide if you take any of these medicines:

• medicines for Parkinson's disease, such as levodopa
• medicines that make you sleepy (drowsy) including diazepam or amitriptyline
• any other anti-sickness medicines (antiemetics)

Mixing metoclopramide with herbal remedies and supplements

There's not enough information to say that complementary medicines, herbal remedies and supplements are safe to take with metoclopramide. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Some herbal remedies can make your side effects worse.

Related links

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