API

Metoclopramide (5mg/ml)

Drug classification

Dopamine antagonist; specific subclass: prokinetic and antiemetic agent.

Dosage form

Sterile solution for injection, administered intramuscularly or intravenously.

API strength per dosage

Dose

Perinorm Injection (metoclopramide 5 mg/ml) is typically dosed at 10 mg up to three times daily in adults. In children, dosing is weight-based. Dose reduction is recommended in renal or hepatic impairment. Use the lowest effective dose for the shortest duration. Maximum adult daily dose is generally 30 mg. Avoid prolonged use due to risk of tardive dyskinesia.

Mechanism of action

Metoclopramide is a dopamine D2 receptor antagonist and serotonin 5-HT3 receptor antagonist in the chemoreceptor trigger zone, and a 5-HT4 receptor agonist in the gastrointestinal tract. It enhances gastric motility and accelerates gastric emptying, while also exerting antiemetic effects by blocking central and peripheral dopamine and serotonin receptors.

Indications

Treatment of NauseaTreatment of VomitingTreatment of IndigestionTreatment of Heartburn

Side effects

Restlessness Fatigue Weakness

Pregnancy category

Metoclopramide should be used during pregnancy only if clearly needed; limited data suggest low risk, but potential benefits must outweigh possible fetal risks.

Precautions

Contraindicated in gastrointestinal obstruction, perforation, or hemorrhage, risk of tardive dyskinesia with prolonged use, monitor for extrapyramidal symptoms, caution in Parkinson’s disease, depression, renal or hepatic impairment, avoid in children unless essential, monitor for neuroleptic malignant syndrome, adjust dose in elderly, avoid with other dopamine antagonists.

Contraindications

Pheochromocytoma, gastrointestinal hemorrhage, mechanical bowel obstruction, perforation, epilepsy, history of tardive dyskinesia with neuroleptics or metoclopramide, Parkinson’s disease, known hypersensitivity to metoclopramide or excipients.