A drug Metoclopramidit is a peristaltic stimulator (missing).
Metoklopramide is a central dopamine antagonist, which also shows peripheral cholinergic activity.
Celebrate two main effects drug: anti-ansit and effect of acceleration of gastric emptying and passing through the delicate intestine.
The antieme effect is caused by the action on the central point of the stem part of the brain (chemoreceptors - the activating zone of the vomit center) is probably due to the braking of dopaminergic neurons.
Peristaltic enhancement is also partially controlled by the highest centers, but the mechanism of peripheral action can also be partially involved together with the activation of postganglyonary cholinergic receptors and, possibly, inhibition of dopaminergic gastric receptors and thin gut. Through hypothalamus and parasympathetic nervous system Adjusts and coordinates the motor activity of the upper gastrointestinal tract: increases the tone of the stomach and intestines, accelerates the emptying of the stomach, reduces the gastrostaz, prevents the pyloric and esophageal reflux, stimulates the intestinal peristalsis. Normalizes the selection of bile, reduces the sphincter spum appa, without changing its tone, eliminates the dyskinesia of the gallbladder.
Side effects propagate mainly on extrapyramidal symptoms, which are based on the mechanism of dopamine-receptor-blocking action to the central nervous system.
Long-term treatment by metoclopramide may cause a concentration of prolactin in serum due to the lack of dopaminergic braking of prolctin secretion. Women describe cases of galactoree and violations menstrual cycle, men - gynecomastia. However, these symptoms disappeared after the cessation of treatment.

Pharmacokinetics

.
Start action on gastrointestinal marks 1-3 minutes after intravenous administration And 10-15 minutes after the introduction. Anti-emission action is saved for 12:00. 13-30% of the drug are associated with blood plasma proteins. Distribution volume - 3.5 l / kg. Penetrates the hematosphalic and placental barriers, stand out in breast milk. Metabolized in the liver. The half-life period is 4-6 hours. Part of the dose (approximately 20%) is excreted in the initial form, and the remaining (about 80%) after metabolic transformations of the liver is removed by the kidneys in compounds with glucurous or sulfuric acid.
In patients with severe renal failure Creatinine clearance decreases to 70%, and the half-life of blood rises (approximately 10:00 at QC 10-50 ml / min and 15 hours at QC<10 мл / мин).
In patients with liver cirrhosis, metoclopramid was observed, which was accompanied by a decrease in blood clearance by 50%.

Indications for use

Metoclopramidfor adults: prevent postoperative nausea and vomiting; nausea and vomiting caused by radiation; Symptomatic treatment of nausea and vomiting, including those related to acute migraine.
Metoclopramidfor children: as a dosage agent of the second line for the prevention of delayed nausea and vomiting caused by chemotherapy; Treatment of postoperative nausea and vomiting.

Mode of application

Injection Metoclopramidapply intramuscularly or intravenously in the form of a slow bolus injection for at least 3 minutes.
As a solvent, an 0.9% sodium solution of chloride, 5% glucose solution is used.
Adults.
The drug is prescribed at a dose of 10 mg to 3 times a day. The maximum daily dose is 30 mg or 0.5 mg / kg body weight.
The use of injection forms should occur for a short period of time as possible with as soon as possible by the transition to the use of oral or rectal forms of methoclopramide.
Children.
When used to prevent postoperative nausea and vomiting, metoclopramide should be used after the end of the operation.
The recommended dose of metoclopramid is 0.1-0.15 mg / kg of body weight up to 3 times a day. The maximum daily dose is 0.5 mg / kg body weight. If you need to continue the use of the drug, no less than 6-hour intervals should be observed.
Dosing scheme:

The maximum duration of the use of metoclopramid for the treatment of installed postoperative nausea and vomiting is 48 hours.
The maximum duration of the use of metoclopramid to prevent delayed nausea and vomiting caused by chemotherapy is 5 days.
Patients with impaired kidney function
In patients with a terminal stage of impairment of kidney function (creatinine clearance ≤ 15 ml / min), the dose of metoclopramid must be reduced by 75%.
In patients with moderate and severe impairment of kidney function (creatinine clearance 15-60 ml / min), the dose of metoclopramid must be reduced by 50%.
Patients with liver failure due to an increase in the half-life to apply a half-dose.
Elderly patients.
It should be given to a reduction in dose in elderly patients due to reducing the function of the kidneys and liver due to age.
Duration of treatment.
In order to minimize the risks of adverse reactions from the nervous system and other adverse reactions, the drug should be applied only for short-term treatment (up to 5 days).
Children. Metoklopramide is contraindicated in children under the age of 1 year.

Side effects

From the gastrointestinal tract: nausea, dyspepsia, dry mouth, constipation. When using methoclopramid in doses exceeding the daily, diarrhea may occur in patients.
On the part of the nervous system: extrapyramidal reactions, as a rule, dystonia (including very rarely diskinetic syndrome cases), especially in children and patients under the age of 30 years, the risk of which increase when the daily dose of 0.5 mg / kg of body weight is exceeded: Spasm muscles, trismism, rhythmic protraza language, bulbar type speech, spasm extraocular muscles, including oculo-boiled crisis, involuntary spasmodic movements, in particular in the head, neck and shoulders, tonic blofarpasm, unnatural positions of head and shoulders, opistotonus, muscular hypertonus; Parkinsonism (tremor, muscle twitching, bradykinosis, muscle rigidity, akinesia, mask face) after a long-term treatment of metoclopramide in some elderly patients, as well as with renal failure late dyskinesia, which may be irreversible, can occur with long-term therapy by metoclopramid, mainly Elderly patients (especially women), in patients with diabetes mellitus and is usually evolving after the discharge of the drug. Manifests by involuntary movements of language, face, mouth, jaws, sometimes involuntary movements of the body and / or limbs;
neuroleptic malignant syndrome, including hypertension, altered consciousness, muscle rigidity, violation of the functions of the autonomic nervous system and an increased level of KFK in serum. This syndrome is potentially lethal, if it occurs, it is necessary to immediately stop the reception of metoclopramid and urgently begin treatment (Dentrenolen, Bromocriptine); Heat, headache, dizziness, drowsiness, feeling of fatigue, feeling of fear, confusion, asthenia, increased fatigue, depressed level of consciousness, noise in ears, acatia.
There is also a risk of sharp (short-term) neurological disorders, higher in children.
From the psyche: depression, hallucinations, confusion of consciousness, anxiety, anxiety.
From the side of the cardiovascular system: bradycardia, especially when intravenous, stop the heart for a short time after an injection, which can be a consequence of bradycardia, AV blockade, blockade of a sinus node, especially when intravenous, prolongation of the Qt interval, sugarytricular extrasystole, ventricular extrasystole , ventricular tachycardia type "Pirouette", arterial hypotension, shock, fainting with intravenous administration, acute arterial hypertension in patients with pheochromocytoma.
There are separate reports on the possibility of developing severe cardiovascular reactions due to the use of metoclopramid, especially when intravenous administration.
From the blood and lymphatic system: methemoglobinemia, which may be associated with a deficiency of NAP-cytochrome-B5 reductase, especially in infants, sulfgemoglobinemia, which is mainly related to the concomitant use of high doses of drugs, release sulfur.
From the immune system: hypersensitivity reactions including anaphylactic reactions, including swelling, anaphylactic shock. Due to the sodium sodium content of sulfite, individual cases of hypersensitivity reactions may be observed, especially in patients with bronchial asthma, in the form of nausea, vomiting, whistling breathing, acute attack of asthma, violation of consciousness or shock. These reactions may have an individual move.
From the side of the skin and subcutaneous fiber: the reaction of hypersensitivity, in particular: skin rashes, hyperemia and itching of the skin, urticaria.
On the part of the reproductive system and the functions of the mammary glands: after longer therapy with the drug, due to the stimulation of the prolctin secretion, hyperprolactinemia, gynecomastia, a galactorerium or a menstrual cycle, amenorrhea, can occur during the development of these phenomena.
Laboratory indicators: Enhance the level of liver enzymes.
In adolescents, I patients with severe impairment of kidney function (renal failure), as a result of which the withdrawal of methoclopramid weakens, should be particularly closely monitoring the development of side effects. In the case of their occurrence of the drug, immediately stop.
The risk of developing adverse reactions on the part of the nervous system increases with the use of drugs in high doses and long-term use.

Contraindications

Contraindications for the use of the drug Metoclopramidare: increased sensitivity to methoclopramide or to any other component of the drug; gastrointestinal bleeding; mechanical intestinal obstruction; gastrointestinal perforation; The ohromocytoma is confirmed or suspected (due to the risk of severe attacks of arterial hypertension); late dyskinesia caused by neuroleptics or metoclopramide, a history; epilepsy (increasing frequency and intensity of attacks); Parkinson's disease; simultaneous use with levodopa or dopaminergic agonists; Installed ?? Methmoglobinemia when using methoclopramid or deficiency of NAP-cytochrome-B5 reductase in history; prolactinzing tumor; increased convulsive readiness (extrapyramidny motor disorders); The age of the patient is up to 1 year (due to the risk of developing extrapyramidal disorders).
Due to the content of sodium sulfite, the drug can not be prescribed to a pain of bronchial asthma with increased sensitivity to sulfite.

Pregnancy

A large amount of data for pregnant women (more than 1000 drug use) indicates the absence of toxicity, which leads to malformations or fetotoxicity.

Metoclopramidit can be used during pregnancy, if there is a clinical need. Through pharmacological properties (as in other neuroleptics), in the case of the use of metoclopramid at the final period of pregnancy, the appearance of extrapyramine syndrome in a newborn can not be excluded. It is necessary to avoid the use of metoclopramid at the final period of pregnancy. When using metoclopramid, you need to observe the newborn.
Metoklopramide in minor quantities penetrates breast milk. Therefore, it is not recommended to use metoclopramide during breastfeeding. It is necessary to consider the abolition of metoclopramide in women, nursing breasts.

Interaction with other medicines

Combinations are contraindicated.
Legodopa or dopaminergic agonists and metoclopramide are characterized by mutual antagonism.
Combinations to avoid.
Alcohol enhances the sedative effect of metoclopramid.
Combinations to pay attention to.
With simultaneous use with oral drugs, such as paracetamol, methoclopramide can affect their absorption due to the influence of the stomach motor.
Anticholinergic agents and morphine derivatives: Anticholinergic agents and morphine derivatives are characterized by mutual antagonism with methoclopramide regarding the influence on the motor activity of the digestive tract.
Inhibitors of the central nervous system (morphine derivatives, neuroleptics, sedative antihistamine-blockers receptor H 1, sedative antidepressants, barbiturates, clonidine and related preparations): the effect of metoclopramid.
Neuroleptics: In the case of the use of methoclopramid in combination with other neuroleptics, the cumulative effect and the appearance of extrapyramidal disorders may occur.
Serotoninergic preparations: The use of methoclopramid in combination with serotonergic preparations, for example, selective inhibitors of serotonin (SSRS) re-seizure inhibitors can increase the risk of serotonin syndrome.
Digoxin: Metoklopramide can reduce the bioavailability of digoxin. It is necessary to conduct careful monitoring of the concentration of digoxin in the blood plasma.
Cyclosporin: Metoklopramide increases the bioavailability of cyclosporin (C Max by 46% and influence by 22%). It is necessary to carry out careful monitoring of the concentration of cyclosporine in the blood plasma. The clinical consequences of this phenomenon are finally defined.
Mivacure and Suksamethonium: The injection of metoclopramid can extend the duration of the neuromuscular block (inhibition of blood plasma cholinesterase).
Powerful CYP2D6 inhibitors: The level of exposure of metoclopramid increases while its use with strong CYP2D6 inhibitors, such as fluoxetine and paroxetine. Although the clinical significance of this is exactly unknown, patients need to be observed for adverse reactions.
Metoklopramide can extend the action of succinylcholine.
Due to the content in the injection solution of sodium sulfite, thiamine (vitamin 1), adopted simultaneously with metoclopramide, can quickly split in the body.

Overdose

Symptoms overdose Metoclopramid: drowsiness, reduction in the level of consciousness, confusion of consciousness, irritability, anxiety and its strengthening, convulsions, extrapyramidal-motor disorders, violations of the function of the cardiovascular system with bradycardia and an increase in or decrease in blood pressure, hallucinations, stopping respiratory and cardiac activity, dystonic reactions. Single cases of methemoglobinemia have been reported.
Treatment: Extrapyramidal disorders eliminate the slow administration of biperiden antidote. In the case of the use of large doses of methoclopramid, it must be removed from the gastrointestinal tract by washing the stomach or take activated coal and sodium sulfate. For the vital functions of the body to observe until the symptoms of poisoning are completely disappeared.

Storage conditions

Store in an unavailable place in the original packaging at a temperature not higher than 25 ° C. Do not freeze.

Form release

Metoklopramide - solution for injections.
Packaging: 2 ml in ampoule; 5 ampoules in the contour cellular packaging, 1 or 2 contour packages in a pack.

Structure

1 ml of methoclopramide of hydrochloride 5 mg.
Auxiliary substances: sodium chloride, sodium edestate, sodium sulphite anhydrous (E 221), propylene glycol, hydrochloric diluted acid, water for injection.

Additionally

The drug should not be used to treat chronic diseases, such as gastroparesis, dyspepsia and gastroesophageal reflux disease or as an additional means when conducting surgical or radiological procedures.
Patients under the age of 30 have a greater tendency to the emergence of dystonic-discnetic disorders in the treatment of metoclopramide.
With caution to prescribe the drug to the elderly patients due to the frequent occurrence of Parkinsonism.
Neurological disorders.
Extrapyramidal disorders may be observed, especially in children, and / or when applying high doses. These reactions are usually observed at the beginning of treatment and may occur after one-time application. In the event of the development of extrapyramidal symptoms, metoclopramide must be canceled immediately. In general, these effects after discontinuation of treatment are completely disappearing, but may require symptomatic treatment (benzodiazepines in children and / or antiholinergic anti-chain drugs in adults).
Between each administration of metoclopramid, even in the case of vomiting and rejection of the dose to avoid an overdose, it is necessary to observe at least a 6-hour interval.
Long-term treatment with metoclopramide can lead to late dyskinesia, potentially irreversible, especially in elderly people. Treatment should not last more than 3 months due to the risk of late Discinesia. Treatment must be discontinued if clinical signs of Late Discinesia appear.
When using methoclopramid in combination with neuroleptics, as well as at monotherapy, metoclopramid reported the development of malignant neuroleptic syndrome. In the event of symptoms of malignant neuroleptic syndrome, the use of metoclopramid must be immediately discontinued and start appropriate treatment.
In patients with concomitant neurological diseases and in patients receiving treatment with other drugs acting on the central nervous system, it is necessary to be particularly careful.
When using methoclopramide, the symptoms of Parkinson's disease can also increase.
Methemoglobinemia.
The cases of methemoglobinemia, which may be related to the NADH-cytochrome-B5-reductase deficiency are reported. In such cases, it is necessary to immediately terminate the reception of methoclopramid and take appropriate measures (for example, treatment with methylene blue).
Cardiac disorders.
Heavy adverse reactions from the cardiovascular system, including cases of acute vascular failure, severe bradycardia, heart stop and elongation of the Qt interval, which were observed after receiving metoclopramide in the form of injections, especially after administration.
An intravenously drug should be administered by slow bolus injection (minimum for 3 minutes) to reduce the risk of adverse reactions (for example, hypotension, acatius).
Violation of the kidney and liver function.
Patients with impaired kidney function or severe liver disorders are recommended to reduce dose.
It is necessary to use the drug in patients of risk groups, namely, in elderly patients with cardiac conduction disorders, with an uncorrected electrolyte imbalance or bradycardia, and patients taking other drugs lengthening the Qt interval. The drug should not be used to treat chronic diseases, such as gastroparesis, dyspepsia and gastroesophageal reflux disease or as an additional means when conducting surgical or radiological procedures.
The ampoules can be taken from the packaging can not be left in the sun for a long time.

Main settings

Name:	Metoclopramid
ATH code:	A03Fa01. -

This article allows you to familiarize yourself with the instructions for the use of the drug. Metoclopramid. Reviews of site visitors - consumers of this medicine, as well as the opinions of medical professionals in the use of metoclopramid in their practice. A big request to more actively add your reviews about the preparation: helped or did not help the medicine to get rid of the disease, which complications were observed and side effects, possibly not stated by the manufacturer in annotations. Analogs of metoclopramid in the presence of available structural analogues. Use for treating nausea, vomiting and meteorism in adults, children, as well as during pregnancy and breastfeeding.

Metoclopramid - anti-ansulistic agent. The specific blockator of dupamic (D2) and serotonin (5-NTZ) receptors, inhibits chemoreceptors of the trigger zone of the brain trunk, weakens the sensitivity of visceral nerves transmitting pulses from the gastric gatellchka and duodenum to the patent center. Through the hypothalamus and parasympathetic nervous system (innervation of the gastrointestinal tract), he has an adjusting and coordinating effect on the tone and motor activity of the upper gastrointestinal tract (including the tone of the lower esophageal sphincter). Increases the tone of the stomach and intestines, accelerates the emptying of the stomach, reduces the hyperacid stasis, prevents the duodenopyllic and gastroesophageal reflux, stimulates the intestinal peristalsis. Normalizes the bile separation, reduces sphincter spam appa. Without changing its tone, eliminates the dyskinesia of the gallbladder on the hypomotor type. Does not affect the tone of blood vessels of the brain, blood pressure, the function of breathing, as well as the kidneys and the liver, to the blood formation, secretion of the stomach and pancreas. Stimulates the secretion of prolactin. Increases tissue sensitivity to acetylcholine (the action does not depend on the vagus innervation, but is eliminated by M-cholinoblocators). Stimulating the secretion of aldosterone, enhances the delay in sodium ions and the elimination of potassium ions.

The beginning of the action to the gastrointestinal tract is observed in 1-3 minutes after intravenous administration, 10-15 minutes - after intramuscular administration and is manifested by accelerating the evacuation of the contents of the stomach (from about 0.5-6 hours, depending on the path of administration) and the antiwhel effect (12 h).

Structure

Metoklopramid hydrochloride + excipients.

Pharmacokinetics

Communication with plasma proteins is about 30%. Subjected to metabolism in the liver. The half-life is 4-6 hours, with a violation of the kidney function - up to 14 hours.

The removal of the drug occurs mainly through the kidneys for 24-72 hours unchanged and in the form of conjugates. It passes through placental and blood-brazed barriers and penetrates the maternal milk.

Indications

• vomiting, nausea, IKota of various genes (in some cases can be effective in vomiting caused by radiation therapy or taking cytostatics);
• athony and hypotension of the stomach and intestines (in particular, postoperative);
• dyskinesia biliary tract on hypomotor type;
• reflux-esophagitis;
• flatulence;
• functional stenosis of the gatekeeper;
• as part of the complex therapy of exacerbations of the ulcer of the stomach and duodenum;
• it is used to enhance the peristaltics when conducting X-ray-sensitive studies of the tract;
• as a means that facilitates duodenal probing (to accelerate the emptying of the stomach and moving food on the small intestine).

Forms of release

Tablets 10 mg.

Solution for intravenous and intramuscular administration (injections in ampoules for injection).

Instructions for use and dosage

Pills

Tablets take 30 minutes before meals, drinking with a small amount of water. Adults - 5-10 mg 3-4 times a day. The maximum one-time dose is 20 mg, daily - 60 mg. Children over 6 years old - 5 mg 1-3 times a day.

Ampoules

Intravenously or intramuscularly.

Adults at a dose of 10-20 mg 1-3 times a day (maximum daily dose - 60 mg). Children over 6 years of 5 mg 1-3 times a day.

For the prevention and treatment of nausea and vomiting due to the reception of cytostatics or radiation therapy, the drug is administered intravenously at a dose of 2 mg / kg of body weight 30 minutes before the use of cytostatics or irradiation; If necessary, the introduction is repeated after 2-3 hours.

In front of the X-ray study, adults are administered intravenously 10-20 mg 5-15 minutes before the start of the study.

Patients with clinically pronounced hepatic and / or renal failure are prescribed a dose of two times alrigatory, the subsequent dose depends on the individual reaction of the patient on the metoclopramide.

Side effect

• spasm of facial muscles;
• lockjaw;
• rhythmic protrusion of the language;
• bulbarium type of speech;
• spasm extraocular muscles (including Okulogar crisis);
• spastic krivoshoy;
• opistotonus;
• muscular hypertonus;
• parkinsonism (hyperkinosis, muscular rigidity - manifestation of dopamic blocking action, the risk of development in children and adolescents increases with a dose of 0.5 mg / kg per day);
• discluences (in the elderly, in chronic renal failure);
• drowsiness;
• fatigue;
• anxiety;
• confusion;
• headache;
• noise in ears;
• depression;
• constipation or diarrhea;
• dry mouth;
• neutropenia, leukopenia, sulfgemoglobinemia in adults;
• atrioventricular blockade;
• porphyry;
• hives;
• bronchospasm;
• angioedema edema;
• gynecomastia;
• galactere;
• impairment of the menstrual cycle;
• hyperemia of the mucous membrane of the nose.

Contraindications

• bleeding from the gastrointestinal tract;
• stenosis of the gastric gatekeeper;
• mechanical intestinal obstruction;
• perforation of the wall of the stomach or intestines;
• feochromocytoma;
• epilepsy;
• glaucoma;
• extrapyramidal disorders;
• parkinson's disease;
• prolactically dependent tumors;
• vomiting against the background of treatment or overdose by neuroleptics and in patients with breast cancer;
• bronchial asthma in patients with increased sensitivity to sulfites;
• pregnancy (1 trimester), lactation period;
• early children's age (children under 2 years old - the use of methoclopramid in the form of any dosage forms, children under 6 years old is contraindicated with parenteral administration);
• hypersensitivity to metoclopramid or any of the components of the drug;
• after operations on the gastrointestinal tract (such as pyloroplasty or an anastomosis of the intestine), since the energetic muscle reductions prevent healing.

Application in pregnancy and breastfeeding

Metoklopramid is contraindicated to use in 1 trimester of pregnancy. Application of 2 and 3 trimesters of pregnancy is possible only on life indications.

If necessary, the use of the drug during the lactation period should be resolved about the cessation of breastfeeding.

Application in children

Contraindicated in early childhood (children under 2 years old are contraindicated to the use of methoclopramid in the form of any dosage forms, children under 6 years old - parenteral administration is contraindicated).

The use of the drug in children causes an increased risk of diskinetic syndrome.

special instructions

Not effective in vomiting vestibular genesis.

Most side effects occur within 36 hours from the start of treatment and passes within 24 hours after cancellation. The treatment must be, if possible, short-term.

Impact on the ability to driving vehicles and control mechanisms

Medicinal interaction

Enhances the effect of ethanol (alcohol) to the central nervous system, the sedative effect of the impact agents increases the effectiveness of therapy by the radial plates of H2-histamine receptors.

Increases the absorption of diazepam, tetracycline, ampicillin, paracetamol, acetylsalicylic acid, levodopa, ethanol (alcohol); Slows off the absorption of digoxin and cimetidine.

With simultaneous use with neuroleptics, the risk of extrapyramidal symptoms increases.

The effect of methoclopramid can weaken cholinesterase inhibitors.

If you are taking other drugs, you must consult with your doctor.

Analogs of the drug Metoklopramide

Structural analogues for the acting substance:

• APO Metoklop;
• Metamol;
• Metoclopramide acri;
• Metoklopramid Vial;
• Metoklopramid Darnitsa;
• Metoclopramide Pried;
• Metoklopramide Esk;
• Metoclopramid hydrochloride;
• Perinorm;
• Raglan;
• Graduate;
• Cerukal.

Analogues for the treatment effect (anti-aneft):

• Aviodarin;
• Air airplane;
• Avomit;
• APO Metoklop;
• Bimaral;
• Bonin;
• Validol;
• Faith Ondansetron;
• Riotheetron;
• Damelium;
• Domegean;
• Home;
• Domperidon;
• Domstal;
• Zofran;
• Kintedryl;
• Kitriel;
• Lazaran;
• Latran;
• Metamol;
• Metoclopramide;
• Motifek;
• Motike;
• Motilium;
• Motinorm;
• Motionium;
• NaVed;
• Noirol;
• Ondansetron;
• Ondanator;
• Ondasol;
• Oncite;
• Sturgeon;
• Passenger;
• Perinorm;
• Raglan;
• Rondase;
• Setronon;
• Siel;
• Takekan;
• Trifluopezine APO;
• Triftatazine;
• Tropindol;
• Graduate;
• Cerukal;
• Emement;
• Element;
• Emeter;
• Etperazin.

In the absence of analogues of drugs on the active substance, you can follow the links below on the disease, which helps the appropriate drug, and see the analogues on therapeutic effects.

Metoklopramide is a central action anti-ansite drug.

Reduces the manifestations of Icotes, nausea and vomiting, facilitating the patient's condition. Stimulates the peristaltics of the gastrointestinal tract, reduces the reflux of the contents of the stomach in the esophagus due to the increase in the pressure of the sphincter.

Normalizes the bile separation, reduces sphincter spam appa. Without changing its tone, eliminates the dyskinesia of the gallbladder on the hypomotor type. Does not affect the tone of blood vessels of the brain, blood pressure, the function of breathing, as well as the kidneys and the liver, to the blood formation, secretion of the stomach and pancreas.

Stimulates the production of prolactin and causes a transient increase in the level of circulating aldosterone, which may be accompanied by a short-term fluid delay.

The beginning of the action to the gastrointestinal tract is observed in 1-3 minutes after intravenous administration, 10-15 minutes - after intramuscular administration and is manifested by accelerating the evacuation of the contents of the stomach (from about 0.5-6 hours, depending on the path of administration) and the antiwhel effect (12 h).

Indications for use

What does metoclopramide help? According to the instructions, the drug is prescribed in the following cases:

• nausea, vomiting, hiking, having different etiology (in some cases, metoclopramide can be effective in the treatment of vomiting caused by the reception of cytostatics or carrying out radiation therapy);
• functional stenosis of the gatekeeper;
• flatulence;
• hypotension and attic of the stomach and intestines, including postoperative;
• reflux-esophagitis;
• dyskinesia biliary tract on hypomotor type;
• the ulcer disease of the stomach and duodenal intestine (with exacerbation, simultaneously with other drugs).

Also prescribed during X-ray-contrast studies of the gastrointestinal tract (to enhance the peristaltics) and as a means of facilitating duodenal probing (in order to accelerate the emptying of the stomach and moving food by the small intestine).

Instructions for use of metoclopramide, dosage

Tablets are taken inside, 30 minutes before meals, drinking with a small amount of water.

• A single dose for adults is 1 tablet of methoclopramide 10 mg, maximum daily - 30 mg or 0.5 mg per 1 kg of body weight.
• Children from 14 years are prescribed 0.1-0.15 mg per 1 kg of body weight, maximum per day - 0.5 mg per 1 kg of body weight.

The maximum duration of therapy is 5 days. In renal failure, a dose correction is necessary.

Ampoules metoclopramide - instruction

The solution can be introduced intravenously or intramuscularly.

• Adult dosage is 10-20 mg \\ 2-3 times a day (no more than 60 mg per day).
• For children from 6 years, the recommended dose is 5 mg, which are introduced 1-3 times a day.
• Children from 2 to 6 years old shown the introduction of a solution of 0.5-1 mg per kilogram of weight per day.

In order to prevent and treat vomiting and nausea, which arises against the background of radiation therapy or taking cystostatics, intravenously introduced in a dosage of 2 mg per kilogram of weight in half an hour before taking a medication or conducting a procedure. In the case of acute necessity after 2-3 hours it is possible to re-introduce the drug.

Before conducting an x-ray study with a contrast, an intravenous introduction of a solution in the amount of 10-20 mg 15 minutes before the procedure began.

Side effects

The instruction warns the possibility of developing the following side effects when appointing metoclopramide:

• From the nervous system: Extrapyramidal disorders - spasm of face muscles, triumism, rhythmic protraza language, bulbar type of speech, spasm of extraocular muscles (incl. Okulogar crisis), spastic krivoshoye, opistonus, muscle hyperptonus; Parkinsonism (hyperkinosis, muscle rigidity - manifestation of dopamic blocking actions, the risk of development in children and adolescents increases with a dose of 0.5 mg / kg / day); Discluences (in the elderly, in chronic renal failure); Sleepiness, fatigue, anxiety, confusion, headache, noise in the ears, depression.
• From the digestive system: constipation or diarrhea, rarely dry mouth. From the side of the blood formation system: neutropenia, leukopenia, sulfgemoglobinemia in adults.
• From the side of the cardiovascular system: an atrioventricular blockade. From the metabolism: Porphyry.
• Allergic reactions: urticaria, bronchospasm, angioedema edema.
• From the endocrine system: rarely (with long-term reception in high doses) - gynecomastia, galathery, disruption of the menstrual cycle.
• Others: At the beginning of treatment, agranulocytosis is possible, rarely (when used in high doses) - hyperemia of the nasal mucosa.

Contraindications

Contraindicated to prescribe metoclopramide in the following cases:

• bleeding from the gastrointestinal tract;
• stenosis of the gastric gatekeeper;
• mechanical intestinal obstruction;
• perforation of the wall of the stomach or intestines;
• feochromocytoma;
• epilepsy;
• glaucoma;
• extrapyramidal disorders;
• parkinson's disease;
• prolactically dependent tumors;
• vomiting against the background of treatment or overdose by neuroleptics and in patients with breast cancer;
• bronchial asthma in patients with increased sensitivity to sulfites;
• pregnancy (I trimester), lactation period;
• early children's age (children under 2 years old are contraindicated to the use of metoclopramid in the form of any dosage forms, children under 6 years old-resonated parenteral administration);
• hypersensitivity to metoclopramid or any of the components of the drug;
• operations on the gastrointestinal tract.

With caution: Bronchial asthma, arterial hypertension, Parkinson's disease, renal and / or liver failure, elderly age (over 65 years old), children's age (increased risk of developing diskinetic syndrome).

Medicinal interaction

The drug causes an increase in suction of acetylsalicylic acid, ethanol, paracetamol, tetracycline, levodopa, ampicillin.

Unwanted simultaneous use of the drug with anticholinergic agents (possibly a mutual weakening of effects), fluouxamine and fluoxetine, as well as with neuroleptics, including with butyrofenone derivatives and a phenothiazine series, (due to the risk of extrapyramidal disorders), with digoxin (namely, its Slowly soluble dosage form).

Caution is used with mexylenetic, zopiclon, meflohin, nitrofurantoin, ketoprofen, tolterodine, morphine due to changes in the expected therapeutic effect.

Overdose

There are no data on overdose. It is possible to occur or strengthen side effects. If necessary, treatment with M-cholinoblocators and anti-parkinsonic means is carried out.

Analogs of metoclopramide, price in pharmacies

If necessary, we can replace the metoclopramide on an analogue of the active substance - these are drugs:

1. Metamol,
2. Faith-metoclopramide
3. Perinorm
4. Cerukal,
5. Raglan.

Choosing analogues It is important to understand that the instructions for use, the price and reviews for similarities of similar action do not apply. It is important to obtain a doctor's advice and not to produce an independent replacement of the drug.

Price in the pharmacies of Russia: Tablets metoclopramide 10 mg 50 pcs. - from 25 to 37 rubles, according to 582 pharmacies.

According to the reviews of doctors, this is a fairly effective means that is actively used in the composition of antiemetic therapy. Patients who undergo a course of treatment with cytostatics, as well as those who face radiation therapy report that metoclopramide successfully helps to cope with nausea and vomiting.

Metoklopramide refers to drugs with an antiwhel effect.

Pharmacological action of metoclopramid

According to the instructions, the metoclopramide soothes the iris, has a controversial action, in some cases removes nausea. In addition, it has a normalizing and regulating effect on the functions of the gastrointestinal tract, contributes to a decrease in the motor activity of the esophagus, accelerating the emptying of the stomach and the promotion of food in the small intestine. It does not observe the occurrence of diarrhea or significant strengthening of the peristalsis.

The drug refers to high-speed. After intravenous administration, the effect is marked after a few minutes, and with intramuscular administration it comes in ten and fifteen minutes. The duration of the antiwheat effect lasts up to twelve hours.

Forms of release and composition of metoclopramid

The drug is produced in the form of methoclopramide tablets and a solution for intramuscular and intravenous injections.

Flat, round, with beveled edges and risk tablets can be different shades: from almost white to white.

In one tablet of the drug contains: ten milligrams of the active substance - metoclopramid hydrochloride. Auxiliary substances: starch, lactose, magnesium stearate, talc, sodium starch glycolat, silicon colloid anhydrous.

Colorless, transparent injection mortar produced in ampoules two milliliters. In one millilitress of the drug, there are five milligrams of hydrochloride methoclopramide and auxiliary substances: sodium metabisulfate and sodium acetate, diodium salt EDTA, ice acetic acid, water for injection.

Indications for the use of metoclopramid

We use metoclopramide according to the testimony: Ikota, nausea or vomiting of various genes (with radiation therapy, toxemia, reception of drugs such as morphine, apomorphine, diet violation).

The drug is also used in dyskinesia of biliary tract, hypotension and intestinal and stomach atony, including postoperative, reflux-esophagitis and meteorism.

As one of the components of complex therapy, the metoclopramide according to the indications is used in the exacerbation of ulcerative disease of the duodenum and stomach. The drug is also used to accelerate the peristaltics with X-ray-contrast studies of the gastrointestinal tract.

Contraindications

According to the instructions, metoclopramide is contraindicated in the case of perforation of the intestine or stomach, bleeding from the gastrointestinal tract, glaucoma, feochromocytomes, epilepsy, extrapyramidal disorders, prolactinent tumors, mechanical intestinal obstruction.

The drug is not recommended to be taken simultaneously with anticholinergic preparations, as well as with increased sensitivity to the active or auxiliary components of metoclopramid. The drug is prohibited for the use of pregnant and nursing women.

Caution use metoclopramid with bronchial asthma, functional disorders in the kidneys and liver, arterial hypertension, Parkinson's disease.

Special care is prescribed metoclopramide to children, since there is a chance of the occurrence and development of diskinetic syndrome (especially in young children).

Method of application and dosage

In Tablets, metoclopramide is prescribed adults in a dose of five to ten milligrams three or four times a day. In vomiting and severe nausea, the drug is injected intramuscularly or intravenously at a dose of ten milligrams. In addition, metoclopramide is used intranasally, instant in each nasal move from ten to twenty milligrams several times a day. For all routes of administration, the one-time maximum dose should not exceed twenty milligrams, the daily - sixty milligrams.

Dose of Metoklopramid to children are prescribed depending on age. The recommended dose of metoclopramid in tablets for children is not older than six years old - from half to one milligram per kilogram of weight three times a day. Metoklopramid Children from six years old - five milligrams three times a day.

Dosage in drops of methoclopramid to children under the one-year-old age - five to ten drops, from one year to three years - on eight or twelve drops, from three to six - from ten to fifteen drops. The recommended multiplicity of reception is three times a day.

Metoklopramid is also prescribed when vomiting, provoked by the reception of cytostatics.

Medicinal interaction of metoclopramid

Due to the use of metoclopramide, the absorption of acetylsalicylic acid, ethanol, paracetamol, tetracycline, levodopa, ampicillin occurs.

Unwanted simultaneous use of the drug with anticholinergic agents (possibly a mutual weakening of effects), fluouxamine and fluoxetine, as well as with neuroleptics, including with butyrofenone derivatives and a phenothiazine series, (due to the risk of extrapyramidal disorders), with digoxin (namely, its Slowly soluble dosage form).

Caution use methoclopramid with mexylenetic, zopiclon, meflohin, cabergoline, nitrofurantoin, ketoprophne, tolterodyne, morphine due to changes in the expected therapeutic effect.

Side effects of metoclopramid

The instruction of the methoclopramid indicates the possibility of occurrence at the beginning of the treatment of constipation or diarrhea, sometimes dryness in the mouth, drowsiness, dizziness, feelings of fatigue, depression, headache, acogram, agranulocytosis.

With long-term use in high doses, in rare cases, the drug causes side effects in the form of gynecomastia, galactors, menstrual disorders, skin rash. Elderly people have dyskinesia and Parkinsonism.

Metoklopramide in children can provoke a spasm of hypercines and face muscles, as well as the emergence of extrapyramidal symptoms that are manifested as spastic Krivoshi.

The patient during the treatment of metoclopramid should be aware that the drug has a negative impact on the speed of psychomotor reactions and the concentration of attention, so such activities should be avoided as driving vehicles, work at height.

Conditions and shelf life

Metoklopramide is released only by the doctor's prescription. The term of storage of the drug is up to four years.

"Metoklopramid" is a medicine used by adults during vomiting caused by different reasons. Not everyone knows whether it is possible to give this drug to children, in what situations it is allowed and in which dosage.

Form release

The drug is represented in pharmacies with two forms:

• Tablets that are from 10 to 100 pieces in one pack. They have a white or yellowish white color, there may be a minor marrium.

• Ampoules for intramuscular or intravenous administration, packed by 5-20 pieces. Inside the ampoule is a slightly painted or colorless transparent liquid.

Structure

The effect of the drug is due to a substance, which is called the same as the drug - metoclopramide. It is represented by the form of hydrochloride and is contained in 1 tablet and 1 ampoule in a dosage of 10 mg (in 1 ml of injection medication in an amount of 5 mg).

Among the auxiliary components of the tablets, different manufacturers can be seen lactose, talc, talc, stearate ca and other substances. In ampoules there is sodium chloride, sterile water, sodium sulfite and other connections.

Operating principle

"Metoklopramid" affects serotonin and dopamine receptors in the brain, and also reduces the sensitivity of the nerves, which conduct pulses from the digestive tract to the dump center. This is manifested by oppression of a vomit reflex.

In addition, the drug has the ability by influencing the parasympathetic nervous system and hypothalamus to strengthen the motorcycle gastrointestinal tract, so that it helps get rid of and nausea.

After taking the drug, the stomach empties faster, but at the same time the gastric juice is highlighted in normal quantities. Although food as a result of the impact of the medication is advanced by the intestine accelerated, diarrhea uses "Metoklopramid" does not provoke.

The drug also normalizes the selection of bile, helping with a dyskinesia of the gallbladder. The medication note the ability to stimulate healing of ulcerative lesions of the gastrointestinal tract.

The action of "Metoklopramid" begins to appear quite quickly - after 1-3 minutes after administration to Vienna, about 10 minutes after intramuscular injection. Tablets begin to act 30-60 minutes. The duration of the antiwheat effect from such a means reaches 12 hours.

Indications

The main reason to appoint a child "Metoklopramid" is vomiting.

The cause of its occurrence is:

• reception of medicines - for example, antibacterial or cytostatic;
• liver pathology;
• card and brain injury;
• dysfunction;
• renal failure;
• radiation therapy.

In addition, the medicine is used:

• with reflux esophagitis;
• with meteorism;
• with ulcer of stomach and intestines;
• with dyskinesia of biliary tract;
• with a postoperative reduction in motorcycle gasts;
• with turret syndrome;
• in migraine;
• when preparing for sensing or X-ray examination of the gastrointestinal tract.

How old are allowed to take?

Children in the first two years of life none of the forms of "Metoklopramid" are not prescribed. Tableted medicine can be given from 2 years of age, but only with testimony and under the control of the doctor. Pricks are used in the treatment of children 6 years and older.

Contraindications

The medicine cannot be given to children:

• with increased sensitivity to any of the ingredients of the selected form of "metoclopramid";
• with epilepsy;
• with bleeding in the gastrointestinal tract;
• with glaucoma;
• with intestinal obstruction;
• with pheochromocyta;
• with renal failure;

• with high blood pressure;
• with extrapyramidal disorders;
• after operations on the busty bodies;
• with bronchial asthma;
• with pylorostenosis;
• with a prolactin-dependent tumor;
• with the velocity of the wall of the digestive tract;
• with liver failure.

The drug is not prescribed in vomiting that has been provoked by the brand, since it does not help eliminate vestibular disorders.

Side effects

In some small patients, the use of "metoclopramid" can provoke drowsiness, increased fatigue, dry mouth, dizziness, motor anxiety, change in blood pressure or heart rate, allergic rash, stool changes and other negative effects. When they occur, it should immediately show the child to the doctor.

Instructions for use and dosage

Need to consider the following:

• Tableted "Metoklopramid" is accepted 15-30 minutes before meals. The drug is not chewed, but swallow and drove with water.
• Injections are made both intramuscularly and in Vienna. The method of administration is determined individually.
• The dosage for children 2-6 years is calculated by weight - it is multiplied by 0.5-1 mg. The daily dose obtained by this counting is divided into three receptions. At this age, the medication is given only in tablets.
• A child over 6 years old, any of the forms of "Metoklopramild" is prescribed in a single dose of 5 mg (half a tablet or 1 ml of solution) - one or three times a day.

Overdose

A too large dose of an injecting or tableted drug affects the nervous system and can cause disorientation, drowsiness, cramps and other symptoms. In case of overdose, you should immediately contact the doctor.

Interaction with other drugs

Treatment of "Metoklopramid" affects the reception of many drugs (sleeping pills, tetracycline, Famotidine, digoxin, neuroleptics, paracetamol, and so on), which necessarily takes into account the doctor, assigning such a medication.

Terms of sale

To acquire any form of "Metoklopramid" you need to show a recipe from a pediatrician, a gastroenterologist or other specialist. The price of the drug also affects the manufacturer, and the form of medication. On average, 50 tablets cost about 30 rubles, and 10 ampoules - approximately 50-60 rubles.

Storage features