MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Critical Care

Generic Name: Metoclopramide
Trade Name: Reglan
Indications: Diabetic gastrostasis
Post surgical gastrostasis
Gastro esophageal reflux
Chemotherapy induced nausea and vomiting
Actions: Dopamine receptor antagonist
Accelerates gastric emptying time
Administration Guidelines:
Usual Dose and Route Primary gut dysfunction: 10 mg IV every 6 to 8 hours

Chemotherapy induced n/v: 2 mg/kg 30 minutes prior to chemotherapy and 1 mg/kg at 2 - 3 hour intervals post chemotherapy

Standard Concentration:

10mg / 10ml

40mg/40ml

300mg / 60ml

Suggested Maximum Dose: 5 mg / kg
Special Considerations: - Dosage adjustments may be required in:

* geriatric patients

* renal failure

* hepatic failure

- Cumulative effect may be observed, dosage adjustment may be required

- Moderate to high doses of metoclopramide may be combined with diphenhydramine to avoid dystonic and extrapyramidal side effects

Precautions and Side Effects: - Extrapyramidal symptoms such as hyperreflexia, parkinson-like symptoms, motor restlessness

- Insomnia, agitation, depression, confusion, drowsiness, lethargy

- Hypotension

- Tachycardia, angina

- Respiratory depression

- Malignant neuroleptic syndrome

 

revised 09/03