METOCLOPRAMIDE HYDROCHLORIDE

Posology Adult patients The recommended single dose is 10 mg, repeated up to three times daily. 5mg/kg body weight. The maximum recommended treatment duration is 5 days. 3). 15 mg/kg body weight, repeated up to three times daily by oral route.

5 mg/kg body weight. Dosing table The maximum treatment duration is 5 days for prevention of delayed chemotherapy induced nausea and vomiting (CINV). Metoclopramide tablets are not suitable for use in children weighing less than 61 kg.

Other pharmaceutical forms/strengths may be more appropriate for administration to this population. 5 mg Up to 3 times daily 9-18 years 30-60 kg 5 mg Up to 3 times daily 15-18 years Over 60kg 10 mg Up to 3 times daily Elderly In elderly patients a dose reduction should be considered, based on renal and hepatic function and overall frailty.

Renal impairment:

In patients with end stage renal disease (Creatinine clearance ≤ 15 ml/min), the daily dose should be reduced by 75%. 2). 2). Other pharmaceutical forms/strengths may be more appropriate for administration to these populations.

Diagnostic indications:

A single dose of 'Metoclopramide' may be given 5-10 minutes before the examination, subject to body weight consideration, (see above). 3). 4).

Adverse reactions listed by System Organ Class. Frequencies are defined using the following convention: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1000 to <1/100), rare (≥1/10000 to <1/1000), very rare (<1/10000), not known (cannot be estimated from the available data).

3); Transient increase in blood pressure. *Endocrine disorders during prolonged treatment in relation with hyperprolactinaemia (amenorrhoea, galactorrhoea, gynaecomastia). 4). - Drowsiness, decreased level of consciousness, confusion, hallucination.

Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

g. cerebral irritation. Neurological Disorders Extrapyramidal disorders may occur, particularly in children and young adults, and/or when high doses are used. These reactions occur usually at the beginning of the treatment and can occur after a single administration.

Metoclopramide should be discontinued immediately in the event of extrapyramidal symptoms. These effects are generally completely reversible after treatment discontinuation, but may require a symptomatic treatment (benzodiazepines in children and/or anticholinergic anti- Parkinsonian medicinal products in adults).

2 should be respected between each metoclopramide administration, even in case of vomiting and rejection of the dose, in order to avoid overdose. Prolonged treatment with metoclopramide may cause tardive dyskinesia, potentially irreversible, especially in the elderly.

8). Treatment must be discontinued if clinical signs of tardive dyskinesia appear. 8). Metoclopramide should be discontinued immediately in the event of symptoms of neuroleptic malignant syndrome and appropriate treatment should be initiated.

3) Symptoms of Parkinson’s disease may also be exacerbated by metoclopramide. Methemoglobinemia Methemoglobinemia which could be related to NADH cytochrome b5 reductase deficiency has been reported. In such cases, metoclopramide should be immediately and permanently discontinued and appropriate measures initiated (such as treatment with methylene blue).

8). Special care should be taken when administering metoclopramide, particularly via the intravenous route to the elderly population, to patients with cardiac conduction disturbances (including QT prolongation), patients with uncorrected electrolyte imbalance, bradycardia and those taking other drugs known to prolong QT interval.

g. hypotension, akathisia). 2). Metoclopramide may cause elevation of serum prolactin levels. Care should be exercised when using metoclopramide in patients with a history of atopy (including asthma) or porphyria. Metoclopramide should not be used in the immediate post-operative period (up to 3- 4 days) following pyloroplasty or gut anastomosis, as vigorous gastrointestinal contractions may adversely affect healing.

Special care should be taken when administering metoclopramide intravenously to patients with “sick sinus syndrome” or other cardiac conduction disturbances. There have been very rare reports of abnormalities of cardiac conduction with intravenous metoclopramide.

Metoclopramide should be used with care with other drugs affecting cardiac conduction.

5) • Known history of methaemoglobinaemia with metoclopramide or of NADH cytochrome-b5 deficiency. 4) Metoclopramide should not be used during the first three to four days following operations such as pyloroplasty or gut anastomosis as vigorousmuscular contractions may not help healing.