Metoclopramide

What it is used for

• As a prokinetic for adjunctive treatment of esophagitis
• General use
• General use
• To increase bladder contractility
• To induce milk let-down for secondary agalactia
• To stimulate the gastrointestinal tract
• For reflux esophagitis
• General therapeutics (Rabbits)
• To assist in removing gastric hairballs (Rabbits)
• Pro-motile drug for ileus (Rabbits)
• General therapeutics (Mice, Rats, Gerbils, Hamsters, Guinea pigs, Chinchillas)
• As an antiemetic
• As an antiemetic
• To treat vomiting associated with pancreatitis
• For vomiting disorders, gastroesophageal reflux, delayed gastric emptying, ileus, intestinal pseudo-obstruction
• For adjunctive treatment of esophagitis
• For post-operative ileus
• As an antiemetic/prokinetic
• To induce milk let-down for secondary agalactia
• To increase bladder contractility

How it is given

Possible side effects

• Dogs: Changes in mentation and behavior (motor restlessness, involuntary spasms, aggression, hyperactivity to drowsiness/depression), constipation
• Cats: Frenzied behavior, disorientation, constipation
• Horses: Severe CNS effects (IV use), alternating sedation and excitement, behavioral changes, abdominal pain
• Extrapyramidal effects (tremors, rigid posture)
• Nausea and diarrhea
• Transient hypertension
• Elevated prolactin levels
• Extrapyramidal signs (tremors, twitching, hyperactivity, restlessness)
• Sedation
• Constipation or diarrhea
• Changes in mentation or behavior

Cautions & contraindications

• GI hemorrhage
• GI obstruction or perforation
• Hypersensitivity to metoclopramide
• Seizure disorders (relatively contraindicated, lowers seizure threshold)
• Head trauma
• Pheochromocytoma (may induce hypertensive crisis)
• Concurrent phenothiazine therapy
• Dogs with pseudopregnancy (stimulates prolactin release)
• Gastrointestinal obstruction
• Gastrointestinal perforation
• Gastrointestinal hemorrhage
• Seizure disorders (epilepsy)
• Pheochromocytoma
• > **Absolute Contraindication**: Do not use in patients with suspected or confirmed GI obstruction, perforation, or hemorrhage. * Use with extreme caution in patients with a history of seizures, as metoclopramide can lower the seizure threshold. * Dosage adjustment (reduce CRI by 25-50%) may be required in patients with renal failure. * Avoid use in dogs experiencing pseudopregnancy due to its prolactin-stimulating effects. * Monitor closely for extrapyramidal signs (involuntary muscle spasms, rigidity, tremors), which can be reversed with anticholinergic agents like diphenhydramine.

Drug interactions

• Aspirin, Acetaminophen, Alcohol: Metoclopramide may enhance the absorption of these agents.
• Anesthetics: Acute hypotension has been reported if metoclopramide is used concurrently IV.
• Atropine (and anticholinergics): May antagonize the GI motility effects of metoclopramide.
• Cephalexin: Oral metoclopramide increases cephalexin peak plasma concentrations and AUC in dogs.
• Cholinergic Drugs (e.g., bethanechol): May enhance metoclopramide's GI effects.
• CNS Depressants: Metoclopramide may enhance CNS depressant effects.
• Cyclosporine: Metoclopramide increases the rate and extent of GI absorption.
• Opiate Analgesics: May antagonize the GI motility effects and enhance metoclopramide's CNS effects.
• MAO Inhibitors (e.g., amitraz, selegiline): Could cause hypertension.
• Phenothiazines and Butyrophenones: May potentiate the extrapyramidal effects of metoclopramide.
• Propofol: Reduces induction requirements of propofol by 20-25%.
• SSRI Antidepressants: Potential for enhanced extrapyramidal effects.
• Tetracyclines: Metoclopramide increases the rate and extent of GI absorption.
• Phenothiazines (e.g., Acepromazine): Increased risk of extrapyramidal effects and CNS depression
• Opioids: May antagonize the gastrointestinal prokinetic effects of metoclopramide
• Anticholinergics (e.g., Atropine): Antagonize the prokinetic effects on the gastrointestinal tract

Preguntas frecuentes