NAME OF DRUG
metoclopramide HCl

Upper GIT motility modifier

ALTERNATE NAMES

  MAXERAN, REGLAN

• management of delayed gastric emptying, gastroesophageal reflux
• adjunct to facilitate small bowel intubation, radiological examination
• prevention and treatment of nausea and vomiting due to chemotherapy

• stable at room temperature
• protect from light
• solution should be colourless

• compatible with D5W, NS, D5 1/2S, RS, LR
• compatible via Y-site with acyclovir, aminophylline, calcium gluconate, ciprofloxacin, clindamycin, dexamethasone, dimenhydrinate, diphenhydramine, fluconazole, heparin, hydrocortisone, insulin regular, levofloxacin, lidocaine, magnesium sulphate, meperidine, methylprednisolone, morphine, MVI, ondansetron, piperacillin-tazobactam, potassium chloride, potassium phosphate, prochlorperazine, ranitidine, vitamin K
• incompatible with sodium bicarbonate
• see Appendix X for syringe compatibilities
• see Appendix II for subcutaneous administration compatibilities

• SC injection
• SC infusion: see Policy for Administration of Subcutaneous Infusions
• IM
• IV direct - slowly over 1-2 minutes
• IV intermittent - doses greater than 10 mg should be diluted in 50 mL of a compatible IV solution and administered over 15 minutes

E - Direct IV route can be administered by nurses on general nursing units provided a venous access has been established and according to policies and recommendations stated in this manual.

Adults: 

• General use:
  • usual dose - 0.5 mg/kg/24 hours or 10 mg IM, IV or SC
  • may repeat 2 to 4 times/day
• Small bowel intubation:
  • 10 mg IV 15 minutes prior to intubation or, preferably, when tip of tube reaches pyloric region
• Prevention of emesis due to chemotherapy (mild to moderate emetogenic agents):
  • 10-60 mg IV, 15-30 minutes prior to chemotherapy and repeated every 4 hours as required
• Prevention of emesis due to highly emetogenic agents:
  • 1-2 mg/kg 30 min prior to and every 4 hours after chemotherapy administration (maximum = 10mg/kg/day)
  • if vomiting is controlled, subsequent doses may be reduced to 1 mg/kg/dose
• Chronic nausea:
  • 60-240 mg/24 hours continuous SC infusion

Children:

• For small bowel intubation, radiological examinations: 
  • < 6 yr:   0.1 mg/kg IV
  • 6-14 yr:   2.5-5 mg IV
• Total daily dose in children should not exceed 0.5 mg/kg  

Reduce dosage in renal impairment:

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

• parkinsonism and/or other extrapyramidal effects with high doses and/or in renal impairment
• sedation, diarrhea; anxiety, agitation with rapid IV administration

• may accelerate the absorption of drugs from the small bowel (e.g. diazepam, levodopa, lithium)
• may decrease the absorption of drugs from the stomach (e.g. digoxin)
• may enhance sedative effects of concurrently administered sedatives, hypnotics, or tranquillizers
• may increase seizure frequency in epileptics
• may increase release of catecholamines; use with caution in patients with pheochromocytoma or receiving MAO inhibitors