Metoclopramide is used for the symptomatic treatment of post-operative or chemotherapy-induced nausea and vomiting, gastroesophageal reflux disease and gastroparesis. Metoclopramide is generally started at a dose of 5–10 mg orally, 30 min before meals and at bedtime. The dose can be increased up to 20 mg four-times daily if necessary, but may be limited by side effects.
Metoclopramide is available in a liquid preparation for patients for whom there is concern that oral tablets may not be adequately emptied from the stomach to allow sufficient absorption of the medication. Recently, an orally disintegrating sublingual formulation of metoclopramide has been developed and is available for use. An intranasal formulation of metoclopramide is also available and may have advantages including rapid-onset of delivery and circumvention of first-pass elimination compared with oral formulations. Bioavailability was recently demonstrated to be increased with the intranasal compared with the oral formulation of metoclopramide (54.61 vs 40.67%).
Subcutaneous injections of metoclopramide are also available and have been demonstrated to improve symptoms in patients with more refractory symptoms. Finally, intravenous metoclopramide is often used for patients who are hospitalized with exacerbations of gastroparesis.
Expert Rev Endocrinol Metab. 2010;5(5):653-662. © 2010 Expert Reviews Ltd.
Cite this: Metoclopramide in the Treatment of Diabetic Gastroparesis - Medscape - Sep 01, 2010.