Metoclopramide Side Effects and Alternatives

Gastrointestinal Effects

Metoclopramide may cause gastrointestinal upset, according to the American Family Physician 1

Patients should be regularly monitored for the development of movement disorders, as recommended by Gut 2
Domperidone is a peripheral D2 dopamine receptor antagonist that can be considered as an alternative to metoclopramide for long-term therapy, but requires QTc monitoring due to cardiac risks, as noted by Gut 2
Erythromycin or azithromycin, motilin agonists, can improve gastric emptying, but tachyphylaxis limits long-term use, according to Gut 2
Prucalopride, a selective 5-HT4 receptor agonist, is an alternative for constipation without the cardiac risks of older prokinetics, as recommended by Gut 2