Metoclopramide

What is metoclopramide?

Metoclopramide (brand names Reglan® and Maxolon®) is used in dogs, cats, and small mammals to stimulate movement in the stomach and upper small intestines to prevent esophageal reflux, a condition where stomach acid backs up into the throat and esophagus (the muscular tube connecting the throat and stomach). In dogs and cats, it is used in the treatment or prevention of vomiting, and also to induce milk let-down and to promote milk production.

The use of metoclopramide in dogs, cats, and other animals is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is metoclopramide given?

• Metoclopramide is available as a tablet or an oral syrup. Measure liquid forms carefully.
• Metoclopramide is also available as an injection that your veterinarian will administer under the skin, especially if vomiting is a concern. Your veterinarian may direct you to inject this at home. Be sure to understand the proper dose, location, and technique if you are administering this drug by injection.
• Oral tablets and syrup may be given by mouth, with or without food.
• If you give it on an empty stomach or before a meal, give it approximately 15–30 minutes before feeding. If vomiting occurs after taking the medication on an empty stomach, try giving the next dose with food.
• If you use the liquid form and vomiting occurs after dosing, wait until the next scheduled dose.
• It is important to give the medication for the length of time your veterinarian has recommended. Do not stop giving the medication to your pet without first speaking with your veterinarian.

This medication should take effect within one to two hours; however, its effects may not be noted outwardly.

What if I miss giving my pet the medication?

If you miss giving your pet a dose, give the next dose as soon as you remember, but if it is close to the next dose, either:

• skip the dose you missed, give it at the next scheduled time, and continue with the regular dosing schedule, or
• give the missed dose when you remember, and then wait the recommended interval before giving the next dose (continue giving it regularly at that new time).

Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Metoclopramide may cause the following side effects in dogs:

• Restlessness or hyperactivity
• Spasms or twitching
• Drowsiness
• Constipation
• Increased urination

Metoclopramide may cause the following side effects in cats:

• Disorientation
• Constipation
• Hyperactivity or frenzied behavior

Serious adverse reactions may occur. If any of the following signs develop, stop giving metoclopramide and contact your veterinarian immediately:

• Aggressive behavior in dogs
• Severe restlessness or twitching
• Severe sleepiness

Contact your veterinarian if any effects worsen, become severe, or continue. Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE metoclopramide in:

• Pets that are allergic to it or similar drugs
• Pets that are allergic to sunscreens containing PABA (para-aminobenzoic acid)
• Pets that have an intestinal blockage or bleeding in their stomach or intestines
• Pets with pheochromocytoma (a type of adrenal gland tumor)
• Dogs with pseudopregnancy

USE WITH EXTREME CAUTION in:

• Pets that have had a head injury

USE WITH CAUTION in:

• Pets that have kidney or heart disease
• Pets that have a seizure disorder (epilepsy) or have had seizures in the past
• Pets that are pregnant or nursing

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with metoclopramide, including:

• Acepromazine
• Antihistamines
• Barbiturates
• Cephalexin
• Certain anesthetics and antidepressants
• Cholinergic drugs
• Cyclosporine
• Mirtazapine
• Selegiline
• Tetracyclines
• Tramadol

Be sure to tell your veterinarian about any medications (including vitamins, supplements or herbal therapies) that your pet is taking before starting any treatment.

Is any monitoring needed with this medication?

• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store metoclopramide?

• Store metoclopramide tablets in a tightly sealed container, protected from light, at room temperature of 68°F–77°F (20°C–25°C).
• Store compounded forms of this medication according to the label.
• Keep the container out of reach of children and pets.

What should I do in case of an emergency?

If you suspect an overdose and your pet is experiencing an adverse reaction, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.