Metoclopramide HCl

Metoclopramide HCl is an antiemetic and GI stimulatory drug, whose mechanism of action is not well understood. It seems to act on the dopamine receptors in the brain, which results in a stimulation of the GI tract motility. This drug indeed affects the lower esophageal sphincter, preventing vomiting; stimulates contractions of the stomach, resulting in the accelerated emptying into the intestine; and increases the duodenal and jejunal peristalsis, without stimulating the gastric, pancreatic or biliary secretions. The colon peristalsis is barely affected by this drug.

Since the body adapts to the presence of a gut motility drug, and stops producing its own molecules that normally stimulate the GI tract, it is advisable not to stop the administration of gut motility drugs abruptly. If so, the onset of stasis is often observed. Their dose should be decreased daily over a period of a week or more, so that the body can start the production of its own molecules/hormones gradually again.

The drug may induce central nervous system (CNS) effects (e.g. seizure, hyperactivity, depression, disorientation), effects that can be increased in case of concurrent intake of narcotic or sedative drugs, or tetracycline antibiotics. In case of renal failure, history of epilepsy, or gastric obstruction, the drug should not be used.

The use of GI stimulatory drugs may affect the absorption of other administrated drugs:

· decreased absorption of drugs dissolved in the stomach,

· increased absorption of drugs dissolved in the intestine. This is particularly the case of aspirin, cimetidine, diazepam, tetracycline, sedatives, tranquilisers or narcotics.

Some drugs are incompatible with the use of metoclopramide HCL. This is the case of:

· antibiotics like penicillin G potassium or tetracycline (this also applies to antibiotics that should not be used in rabbits, namely ampicillin or erythromycin),

· calcium gluconate,

· cephalotin sodium,

· chloramphenicol sodium succinate,

· sodium bicarbonate.

Dosage safe for use in rabbits: 0.5 mg/kg tid - qid, PO, SC.

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21 MARCH 2005

updated: MARCH 2006