In the article, we consider the instructions for use for adults and children for ampoules and tablets "Metoclopramide". This medical product is a representative of the pharmacological category of antiemetics. They are used in the treatment of a variety of pathologies of the digestive organs, which are accompanied by attacks of vomiting and nausea.
Release Forms
According to the instructions for use, Metoclopramide is produced in several pharmacological forms:
- In the form of tablets: round, flat-cylindrical, with a bevel, white, color heterogeneity or marbling is allowed (50 pieces in blister packs, 1 piece in a cardboard box, 10 pieces in blister blisters, 1-10 packs or blisters in cardboard boxes; 14 pcs. in blister packs, 4 pieces in a cardboard bundle; 50 pcs in polymer or glass darkened banks, 1 can in a cardboard box).
Instructions for use with Metoclopramide tablets are very detailed.
- Solutions for intramuscular injection or intravenous administration (ampoules of 2 ml, in cardboard packaging - 5 or 10 ampoules or in cell contour or plastic pallets, 1 or 2 in a cardboard package).
Instructions for use for injections "Metoclopramide" are available in each pack.
Structure
The composition of one tablet of this medical product includes an active element - metoclopramide hydrochloride and auxiliary components: Extra potato starch, lactose monohydrate, povidone, calcium stearate. The composition of injection solutions of the drug "Metoclopramide" includes an active element - metoclopramide hydrochloride.
Pharmacological properties
As indicated by the instructions for use with Metoclopramide, the main substance of the drug - metoclopramide hydrochloride contributes to the antiemetic effect due to the implementation of the following mechanisms:
- blocking dopamine D2 receptors in the walls of the hollow organs of the digestive tract;
- suppression of serotonin receptors of the structures and organs of the digestive tract;
- an increase in the threshold of chemoreceptors of the trigger zone in the medulla oblongata, which are responsible for the occurrence of sensations of nausea, followed by vomiting.
These mechanisms lead to an increase in the tone of smooth muscles of the upper parts of the intestines and stomach, to an increase in their motility and peristalsis (wave-like contraction of the walls, which are aimed at pushing the contents into the lower sections), and also prevent the development of reflux (back casting) of the stomach contents into the lumen of the esophagus.
In addition, the medicine “Metoclopramide” increases the production of prolactin and the concentration of the hormone aldosterone circulating in the blood, resulting in a temporary fluid retention in the body.
According to the instructions for use with Metoclopramide in tablets, after oral administration of this medicine, the active element is rapidly and almost completely absorbed into the systemic circulation through the intestines. It is evenly distributed in the tissues and undergoes a metabolic process in the liver to decay products excreted by the urinary organs. Part of metoclopramide hydrochloride can be excreted unchanged by the kidneys. The elimination half-life makes 5-7 hours.
Indications for appointment
In accordance with the instructions for use with Metoclopramide, the use of a pharmacological agent is indicated for a variety of pathological conditions, accompanied by nausea and vomiting. Their list includes:
- nausea, vomiting or hiccups of various nature of origin, including, inter alia, a violation of the functioning of the structures of the central nervous system;
- hypotension or atony of the hollow structures of the digestive system (small intestine, stomach) - a pronounced decrease in smooth muscle tone after surgery or the use of certain medications;
- biliary dyskinesia - a change in the tone of the hollow organs of the hepatobiliary system (bile and hepatic ducts of the gallbladder), accompanied by severe nausea and bouts of vomiting;
- bloating - excessive gas formation in the intestinal cavities, which is provoked by a decrease in its peristaltic motility;
- reflux esophagitis is an inflammatory process that affects the mucous membrane of the esophagus, which is a consequence of the reverse casting of gastric contents;
- combination therapy of peptic ulcer.
In addition, tablets and solutions of the drug "Metoclopramide" are used to enhance intestinal motility, which is necessary for certain diagnostic tests (radiography using contrast agents).
Contraindications
As indicated by the instructions for use with Metoclopramide, taking this pharmacological agent in any form of its release is contraindicated in certain physiological and pathological conditions of the body, which include:
- Gastrointestinal bleeding of varying degrees of localization and intensity.
- Mechanical types of intestinal obstruction, which are associated with the presence of obstacles to the passage of food.
- Perforation (the formation of a through hole in the walls of a hollow organ) of the duodenum or stomach.
- Prolactin-dependent benign or malignant tumors, the formation of which is affected by the level of prolactin in the blood.
- Extrapyramidal motor changes and epilepsy (attacks of tonic-clonic generalized seizures, which may be accompanied by loss of consciousness).
- Glaucoma is an increase in intraocular pressure.
- Concomitant use of anticholinergic drugs.
- High sensitivity to metoclopramide hydrochloride or additional elements of this pharmacological agent.
- Pregnancy, lactation.
How to use according to the instructions for use "Metoclopramide" in tablets for children?
Dosage and route of administration
The medicine is used orally, regardless of food intake (in the form of tablets), or intravenously (as an injection solution) and intramuscularly.
Instructions for use with "Metoclopramide" in ampoules must be strictly observed.
The tablets are not chewed and washed down with water. The maximum therapeutic dosage for single use is 20 mg, and the daily dose should not be higher than 60 mg. In accordance with the instructions for use with Metoclopramide, for children under 6 years of age, the recommended dose is 5 mg 3 times a day, after 6 years - 1 mg per kilogram of body weight.
Side effects
The use of tablets and injections of the drug “Metoclopramide” can lead to the development of some negative reactions from certain organs and systems. These include:
- Digestion system - at the beginning of the use of this medication, diarrhea or constipation may develop, less commonly, dry mouth.
- Nervous system - the occurrence of excessive fatigue (especially at the beginning of therapy), drowsiness, cephalalgia, depressive disorder (lowered mood), akathisia (feeling of motor anxiety), dizziness. In children and adolescents, extrapyramidal motor disorders may occur, which can be characterized by hyperkinesis (involuntary movements of skeletal striated muscles), facial spasms, torticollis spastic in nature. With prolonged use of this medication, development of manifestations of parkinsonism may be observed.
- Endocrine system - a change in women’s menstrual cycle, gynecomastia (an increase in the size of the mammary glands in men as a result of an increase in prolactin level), galactorrhea (isolation from breast nipples outside the lactation period).
- Red bone marrow and blood - at the beginning of drug therapy, agranulocytosis may occur (granulocytes disappear from the blood, which include neutrophils, basophils and eosinophils).
- Allergic phenomena - in certain cases, skin rashes develop.
In case of side effects, the use of a pharmacological agent is considered inappropriate.
What else can you learn from the instructions for use with Metoclopramide in ampoules and tablets?
Special recommendations
Before taking this medication, you should carefully read the instructions for it, since there are a number of special recommendations regarding its use, which include:
- The medication is used with caution in concomitant bronchial asthma, arterial hypertension, Parkinson's disease, liver and renal failure.
- The drug is prescribed with caution to children in dosages appropriate for age and weight, since the development of dyskinesia (motor disorders) is often observed.
- The use of the drug in the elderly increases the risk of extrapyramidal motor disorder.
- "Metoclopramide" can interact with medicines of other pharmacological categories (especially with the parallel use of anticholinergics).
- Against the background of the use of this medication, there may be some change in laboratory tests on the level of aldosterone and prolactin in the blood, liver samples.
- It is not recommended to perform work associated with the need to increase concentration and speed of psychomotor reactions.
Symptoms of an overdose
With a significant excess of the recommended therapeutic doses of the drug "Metoclopramide", unwanted side effects appear or intensify. In this case, the pharmacological agent is stopped and symptomatic therapy is carried out.
Price
The average cost of a drug in pharmacies is 35-40 rubles. It depends on the region and the pharmacy network.
Analogs
Structural analogues of the active element are:
- "Apo Metoclop" - refers to the class of antiemetic drugs, a blocker of serotonin and dopamine receptors. It has an antiemetic effect, eliminates the effects of hiccups and nausea, reduces the activity of the esophagus, increases the tone of the lower sphincter in the esophagus, speeds up the process of emptying the stomach and moving food through the small intestine, not contributing to the development of diarrhea. Stimulates the production of prolactin. It is used for vomiting and nausea of various origins.
- "Metamol" - a medicine that effectively eliminates hiccups, vomiting, nausea (not of vestibular origin), increases the tone and activity of the digestive canals, without changing the secretion. It is also prescribed for dyspeptic disorders (pain in the intestines, stomach, flatulence, heartburn, belching), gastroesophageal reflux, gastritis, duodenitis, gallstone disease, before an X-ray diagnosis of diseases of the digestive system.
- "Perinorm" is an antiemetic drug that helps to reduce the severity of nausea and hiccups. The tool stimulates intestinal motility, blocks serotonin receptors, accelerates the emptying of the stomach by relaxing the muscles and increasing the activity of the antrum of the stomach and small intestine.
We will not consider in detail instructions for use with Metoclopramide analogues.
Reviews
There are a lot of positive reviews about this medicine, but there are those in which patients left a negative opinion about this medicine.
Positive reviews say that this medication is highly effective in the event of attacks of vomiting of the most diverse genesis, starting with poisoning and ending with vomiting caused by vegetovascular disorders. The drug, according to patients, begins to act approximately 15 minutes after injection and approximately 30 minutes after oral administration. As a rule, it does not cause such side effects as an indigestion, however, patients noticed a slight upset in the stool.
Negative reviews say that this pharmacological agent is poorly tolerated by children and patients in old age, causes severe dizziness, weakness.
We reviewed the use of Metoclopramide and instructions for use.