For the Relief of Symptoms Associated with
Diabetic Gastroparesis (Diabetic Gastric Stasis): If only the
earliest manifestations of diabetic gastric stasis are present, oral
administration of metoclopramide may be initiated. However, if severe symptoms
are present, therapy should begin with metoclopramide injection (IM or IV).
Doses of 10 mg may be administered slowly by the intravenous route over a 1 to 2
Administration of Metoclopramide Injection, USP up to 10 days may be required
before symptoms subside, at which time oral administration of metoclopramide may
For the Prevention of Nausea and Vomiting
Associated with Emetogenic Cancer Chemotherapy: For doses in
excess of 10 mg, Metoclopramide Injection, USP should be diluted in 50 mL of a
The preferred parenteral solution is Sodium Chloride Injection (normal saline),
which when combined with Metoclopramide Injection, USP, can be stored frozen for
up to 4 weeks. Metoclopramide Injection, USP is degraded when admixed and frozen
with Dextrose-5% in Water. Metoclopramide Injection, USP diluted in Sodium
Chloride Injection, Dextrose-5% in Water, Dextrose-5% in 0.45% Sodium Chloride,
Ringer's Injection, or Lactated Ringer's Injection may be stored up to 48 hours
(without freezing) after preparation if protected from light. All dilutions may
be stored unprotected from light under normal light conditions up to 24 hours
after preparation. Intravenous infusions should be made slowly over a period of
not less than 15 minutes, 30 minutes before beginning cancer chemotherapy and
repeated every 2 hours for two doses, then every 3 hours for three doses. The
initial two doses should be 2 mg/kg if highly emetogenic drugs such as cisplatin
or dacarbazine are used alone or in combination. For less emetogenic regimens, 1
mg/kg per dose may be adequate. If extrapyramidal symptoms should occur, inject
50 mg Benadryl® (diphenhydramine hydrochloride) intramuscularly, and EPS usually
For the Prevention of Postoperative Nausea and
Vomiting: Metoclopramide Injection, USP should be given
intramuscularly near the end of surgery. The usual adult dose is 10 mg; however,
doses of 20 mg may be used.
To Facilitate Small Bowel Intubation:
If the tube has not passed the pylorus with conventional maneuvers in 10
minutes, a single dose (undiluted) may be administered slowly by the intravenous
route over a 1 to 2 minute period.
The Recommended Single Dose is: Pediatric patients above 14
years of age and adults-10 mg metoclopramide base. Pediatric patients (6 to 14
years of age)-2.5 mg to 5 mg metoclopramide base; (under 6 years of age)-0.1
mg/kg metoclopramide base.
To Aid in Radiological Examinations: In patients where delayed
gastric emptying interferes with radiological examination of the stomach and/or
small intestine, a single dose may be administered slowly by the intravenous
route over a 1 to 2 minute period.
For dosage, see intubation above.
Use in Patients with Renal or Hepatic Impairment: Since
metoclopramide is excreted principally through the kidneys, in those
patients whose creatinine clearance is below 40 mL/min, therapy should
be initiated at approximately one-half the recommended dosage. Depending
upon clinical efficacy and safety considerations, the dosage may be
increased or decreased as appropriate.
[CRCL >40 ml/min]: No changes.
[10-40 ]: Administer 50% of normal dose.
[<10 ] Administer 25% of normal dose.
Dose as for CrCl<10. Not dialyzable (0% to 5%)- supplemental dose
is not necessary.
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical
judgment. Neither GlobalRPh Inc. nor any other party involved in the
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