METOCLOPRAMIDE

Brand & Generic Names

Apo-Metoclop	Octamide
Clopra	Octamide PFS
Emex	Reclomide
Maxeran	Reglan

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antiemetic, dopaminergic blocker

Uses

• Relieves nausea and vomiting caused by chemotherapy and drug- related postoperative factors.
• Relieves symptoms of esophagitis and stomach swelling in people with diabetes.

Dosage & Usage Information

How to take:
Tablet or syrup--Swallow with liquid or food to lessen stomach irritation.

When to take:
30 minutes before symptoms expected, up to 4 times a day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Prevents smooth muscle in stomach from relaxing.
Affects vomiting center in brain.

Time lapse before drug works:
30 to 60 minutes.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Severe drowsiness, muscle spasms, mental confusion, trembling, seizure, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, give mouth-to- mouth breathing. If there is no heartbeat, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Drowsiness, restlessness.

Frequent:

Rash.

Infrequent:

• Wheezing, shortness of breath.
• Dizziness; headache; insomnia; tender, swollen breasts; increased milk flow, menstrual changes, decreased sex drive.

Rare:

• Abnormal, involuntary movements of jaw, lips and tongue; depression; Parkinson* syndrome.
• Constipation, nausea, diarrhea, dry mouth.

Warnings & Precautions

Don't take if:
You are allergic to procaine, procainamide or metoclopramide.

Before you start, consult your doctor:

• If you have Parkinson's disease.
• If you have liver or kidney disease.
• If you have epilepsy.
• If you have bleeding from gastrointestinal tract or intestinal obstruction.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
No proven harm to unborn child. Avoid if possible. Consult doctor.

Breast-feeding:
Unknown effect. Consult doctor.

Infants & children:
Adverse reactions more likely to occur than in adults.

Prolonged use:
Adverse reactions including muscle spasms and trembling hands more likely to occur.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
May be unnecessary to finish medicine. Follow doctor's instructions.

Others:
No problems expected.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Acetaminophen	Increased absorption of
	acetaminophen.
Anticholinergics*	Decreased metoclopramide effect.
Aspirin	Increased absorption of aspirin.
Bromocriptine	Decreased bromocriptine effect.
Butyophenone	Increased chance of muscle spasm
	and trembling.
Central nervous system	Excess sedation.
(CNS) depressants*
Clozapine	Toxic effect on the central nervous
	system.
Digitalis	Decreased absorption of digitalis.
Ethinamate	Dangerous increased effects of
	ethinamate. Avoid combining.
Fluoxetine	Increased depressant effects of
	both drugs.
Guanfacine	May increase depressant effects of
	either drug.
Insulin	Unpredictable changes in blood
	glucose. Dosages may require
	adjustment.
Leucovorin	High alcohol content of leucovorin
	may cause adverse effects.
Levodopa	Increased absorption of levodopa.
Lithium	Increased absorption of lithium.
Loxapine	May increase toxic effects of both
	drugs.
Methyprylon	Increased sedative effect, perhaps
	to dangerous level. Avoid.
Nabilone	Greater depression of central
	nervous system.
Narcotics*	Decreased metoclopramide effect.
Nizatidine	Decreased nizatidine absorption.
Pergolide	Decreased pergolide effect.
Phenothiazines*	Increased chance of muscle spasm
	and trembling.
Sertraline	Increased depressive effects of
	both drugs.
Tetracyclines*	Slow stomach emptying.
Thiothixines*	Increased chance of muscle spasm
	and trembling.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Excess sedation. Avoid.
Coffee.	Decreased metoclopramide effect.
Cocaine:	Decreased metoclopramide effect.
Foods:	No problems expected.
Marijuana:	Decreased metoclopramide effect.
Tobacco:	Decreased metoclopramide effect.