Side Effects of metoclopramide: A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Major Research Findings

Metoclopramide is a drug that has been used worldwide for over 30 years to treat nausea and vomiting. 7 It is effective in controlling vomiting caused by high doses of cisplatin, which is a common chemotherapy drug. 10 However, like many medications, metoclopramide can cause various side effects, and studies have investigated these potential adverse effects in different settings and patient populations.

Reasons for Side Effects

Metoclopramide works by blocking dopamine receptors and increasing serotonin levels in the brain. This action helps to reduce nausea and vomiting. However, the same mechanism can also lead to side effects in the nervous system, particularly extrapyramidal symptoms. Additionally, metoclopramide increases the speed of digestion, which can contribute to gastrointestinal side effects.

Common Side Effects

Neurological Side Effects

Metoclopramide is known to cause neurological side effects, particularly extrapyramidal symptoms like muscle spasms, tremors, and involuntary movements. 3 8 These symptoms can be concerning, especially in children, where they might be more pronounced. Other neurological side effects can include dizziness, drowsiness, anxiety, and restlessness. 4

Gastrointestinal Side Effects

Metoclopramide can also cause gastrointestinal side effects, such as abdominal pain, diarrhea, and constipation. 11 These effects are likely related to its action of speeding up digestion.

Other Side Effects

Some studies have reported other potential side effects of metoclopramide, including rashes, itching, and difficulty breathing. 9

Side Effects Management

Neurological Side Effects

If you experience neurological side effects, it is crucial to consult with your doctor. They may adjust your dosage, change the frequency of administration, or switch you to a different medication. Anticholinergic medications may also be prescribed to manage these symptoms.

Gastrointestinal Side Effects

If you experience gastrointestinal side effects, consulting with your doctor is essential. They may adjust your dosage, change the frequency of administration, or switch you to a different medication. Dietary modifications may also help manage these side effects.

Comparison Between Studies

Common Points of Research

A consistent finding across many studies is that metoclopramide is effective in treating nausea and vomiting. 11 However, it is also consistently found that it has the potential to cause neurological and gastrointestinal side effects. The severity and type of side effects can vary depending on factors like the dosage, method of administration, and the individual's health condition. 7

Differences in Research

The occurrence and types of side effects reported in different studies may vary due to a variety of factors, including the age, gender, overall health, dosage, and combination with other medications of the study participants.

Points to Note Regarding Application in Daily Life

While metoclopramide can be helpful for managing nausea and vomiting, it's important to be aware of its potential side effects. Always consult with your doctor before starting metoclopramide to discuss appropriate dosage, frequency of administration, and potential risks. Be alert for any unusual symptoms and report them to your doctor immediately.

Limitations of Current Research

Our understanding of metoclopramide's side effects is still evolving. More research is needed, particularly on the long-term effects of the drug and its impact on specific populations, like children and older adults. 5

Future Research Directions

To improve our understanding of metoclopramide's side effects, more research is necessary, especially focused on long-term effects, the impact on different age groups, and the development of alternative medications or strategies to minimize side effects.

Conclusion

Metoclopramide can be a valuable tool for treating nausea and vomiting, but it's essential to remember that it has the potential to cause side effects. Always consult with your doctor before taking metoclopramide to determine the best course of treatment and to be aware of potential risks. Ongoing research is important to further refine our understanding of metoclopramide's effects and improve its safety for patients.

Literature analysis of 11 papers
Positive Content
9
Neutral Content
1
Negative Content
1
Article Type
5
1
1
1
11
1.

Slow infusion metoclopramide does not affect the improvement rate of nausea while reducing akathisia and sedation incidence.

Author: TuraPinar, ErdurBulent, AydinBerrin, TurkcuerIbrahim, ParlakIsmet

Reduced akathisia
Reduced sedation

Slowing the rate of infusion of metoclopramide may reduce the incidence of akathisia and sedation in ED patients with nausea without affecting its therapeutic effect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Risk of extrapyramidal side effects comparing continuous vs. bolus intravenous metoclopramide administration: a systematic review and meta-analysis of randomised controlled trials.

Author: Cavero-RedondoIván, Álvarez-BuenoCelia, Pozuelo-CarrascosaDiana P, Díez-FernándezAna, Notario-PachecoBlanca

Continuous metoclopramide infusion
Reduced extrapyramidal side effects

Continuous intravenous infusion of metoclopramide was associated with fewer extrapyramidal side effects than bolus administration.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Intravenous administration of metoclopramide by 2 min bolus vs 15 min infusion: does it affect the improvement of headache while reducing the side effects?

Author: ParlakIsmet, ErdurBulent, ParlakMine, ErginAhmet, TurkcuerIbrahim, TomrukOnder, AyrikCuneyt, ErginNesrin

Headache treatment
Metoclopramide efficacy
Infusion rate
Side effects

This study compared the therapeutic effect and side effects of slow intravenous metoclopramide infusion (15 minutes) vs. bolus intravenous metoclopramide infusion (2 minutes) in patients with recent-onset vascular type headache. The study aimed to determine the optimal administration method for metoclopramide in this patient population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Probing for affective side effects of drugs used in geriatric practice: use of daily diaries to test for effects of metoclopramide and naproxen.

Author: KatzIra R, MoralesKnashawn, DattoCatherine, StreimJoel, OslinDavid, DiFilippoSuzanne, HaveThomas Ten

Affective toxicity

This study explored the use of daily diaries to assess the affective toxicity of metoclopramide and naproxen in elderly patients. Both drugs were found to influence the relationship between daily events and affect.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Comparison of the efficacy and side-effects of ondansetron and metoclopramide-diphenhydramine administered to control nausea and vomiting in children treated with antineoplastic chemotherapy: a prospective randomized study.

Author: KöseogluV, KürekçiA E, SariciU, AtayA A, OzcanO, SoriciU

Nausea and vomiting prevention
Side effects

Ondansetron was more effective than metoclopramide-diphenhydramine in preventing nausea and vomiting in children treated with antineoplastic chemotherapy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Pharmacokinetics, toxicity, side effects, receptor affinities and in vitro radiosensitizing effects of the novel metoclopramide formulations, sensamide and neu-sensamide.

Author: PeroR W, OlssonA, SimanaitisM, AmiriA, AndersenI

Improved bioavailability
Radio and chemosensitizing properties
Reduced side effects

Neutral metoclopramide, a new formulation of the antiemetic drug, was found to be more bioavailable and safer than acidic metoclopramide when administered intramuscularly to rats.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Extrapyramidal side effects of metoclopramide in outpatient surgery patients.

Author: HoleshaW, Dziura-MurauskiJ

Extrapyramidal side effects

Metoclopramide is an antiemetic that can cause extrapyramidal side effects. Nurses should be aware of the symptoms of these side effects and initiate appropriate treatment.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

The effect of food and metoclopramide on the pharmacokinetics and side effects of bromocriptine.

Author: KopitarZ, VrhovacB, PovsicL, PlavsićF, FrancetićI, UrbancicJ

Reduced side effects
Not specified

Food slightly reduced the peak plasma concentrations of bromocriptine, but did not significantly affect its bioavailability. Metoclopramide pretreatment significantly reduced the side effects of bromocriptine by about 83%.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Antiemetic control and prevention of side effects of anti-cancer therapy with lorazepam or diphenhydramine when used in combination with metoclopramide plus dexamethasone. A double-blind, randomized trial.

Author: KrisM G, GrallaR J, ClarkR A, TysonL B, GroshenS

Control of cisplatin-induced vomiting
Enuresis
Restlessness
Sedation

A combination of metoclopramide, dexamethasone, and either lorazepam or diphenhydramine was found to be effective in preventing vomiting in 120 patients receiving high-dose cisplatin. The lorazepam-containing combination was associated with less restlessness and anxiety.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

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