Precautions and Warnings With Metoclopramide
To help minimize risks, talk to your healthcare provider about the precautions and warnings with metoclopramide before starting treatment. You should also let him or her know if you have any existing medical conditions or are currently taking other medications. People who are taking antipsychotics or have epilepsy or seizures, gastrointestinal bleeding or perforation, or a gastrointestinal blockage should not take metoclopramide.
- Gastrointestinal bleeding or perforation
- A gastrointestinal blockage
- Seizures or epilepsy
- Depression (or a history of depression)
- Parkinson's disease
- High blood pressure (hypertension)
- Congestive heart failure (CHF)
- Cirrhosis of the liver
- Any other allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Some warnings and precautions to be aware of with metoclopramide include the following:
- Metoclopramide can cause depression. Some cases are mild, while others are quite severe and may involve suicidal thinking or behavior. Make sure to tell your healthcare provider if you have depression or even a history of depression. If you start to notice any depression symptoms while taking metoclopramide, contact your healthcare provider right away.
- Metoclopramide can cause a group of very bothersome and sometimes disturbing side effects known as extrapyramidal symptoms (EPS). These symptoms include:
- Unusual body, facial, or tongue movements
- Muscle tension or contractions
- Feelings of internal restlessness or jitteriness.
It is important to let your healthcare provider know right away if you develop EPS, since letting it go too long increases the chance of the symptoms becoming permanent, even after the medication is stopped.
- Metoclopramide can cause symptoms that look like Parkinson's disease. It can also make Parkinson's disease worse. In general, people with Parkinson's disease should avoid taking metoclopramide.
- Metoclopramide can cause a life-threatening condition called neuroleptic malignant syndrome (NMS). Some symptoms of NMS include:
- A high fever
- Stiff muscles
- Irregular pulse or blood pressure
- A fast heart rate (tachycardia)
- Irregular heart rhythms (arrhythmias).
Tell your healthcare provider right away if think you might have NMS.
- Metoclopramide may make high blood pressure, congestive heart failure, and cirrhosis worse. If you have any of these conditions, check with your healthcare provider before taking metoclopramide.
- Some people may experience withdrawal symptoms (such as dizziness, nervousness, or headaches) after stopping metoclopramide.
- Metoclopramide can interact with other medications (see Drug Interactions With Metoclopramide).
- Metoclopramide is usually considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using metoclopramide during pregnancy (see Reglan and Pregnancy for more information).
- Metoclopramide passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider about using metoclopramide (see Reglan and Breastfeeding for more information).