Metoclopramide Administration Guidelines

Primary Indications

• The National Comprehensive Cancer Network recommends metoclopramide 5-10 mg PO QID, 30 minutes before meals and at bedtime, for diabetic gastroparesis to accelerate gastric emptying 1

Secondary Indications

• The American Gastroenterological Association recommends metoclopramide as a second-line therapy for hyperemesis gravidarum after first-line treatments have failed 2, 3, 4, 5
• The American Gastroenterological Association suggests metoclopramide may be used to address intractable hiccups, potentially triggered by gastroesophageal reflux, at a dose of 10 mg orally three to four times daily, however this is based on a lower level of evidence 6

Special Considerations

• The American Gastroenterological Association states that metoclopramide use during pregnancy has not been reported to increase the risk of congenital defects 3, 4, 5

Monitoring and Precautions

• The American Gastroenterological Association advises monitoring for extrapyramidal symptoms, such as dystonic reactions, akathisia, and tardive dyskinesia, especially with high doses or prolonged use of metoclopramide 6