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metoclopramide

MIMS Class : GIT Regulators, Antiflatulents & Anti-inflammatories, Antiemetics 


See available brands of metoclopramide

See related metoclopramide information

Indication &
Oral
Dosage
Diabetic gastric stasis
Adult: 10 mg 4 times/day. To be given 30 minutes before
meals and at bedtime. Usual treatment duration: 2-8 wk. 
Renal impairment: Moderate to severe: Reduce dose by at
least 50%
CrCl (ml/min) Dosage Recommendation
<40 Reduce dose by at least 50%.

Hepatic impairment: Dose reduction may be necessary. 


Oral
Nausea and vomiting associated with cancer
chemotherapy or radiotherapy
Adult: 2 mg/kg/dose, given 1 hr before start of treatment.
Repeat dose 3 times at 2-hrly intervals. May repeat 2
additional doses at 3-hrly intervals if needed. Max: 12
mg/kg/day. 
Child: Neonate: 100 mcg/kg every 6-8 hr; 1 mth-1 yr (up
to 10 kg): 100 mcg/kg (max 1 mg) bid; 1-3 yr (10-14 kg): 1
mg bid-tid; 3-5 yr (15-19 kg): 2 mg bid-tid; 5-9 yr (20-29
kg): 2.5 mg tid; 9-14 yr (≥30 kg): 5 mg tid; 15-19 yr (30-59
kg): 5 mg tid; 15-19 yr (≥60 kg): 10 mg tid. Where wt is
less than that specified for a given age group, use the
dose corresponding to the wt rather than the age, so that a
lower dose is given. Max: 500 mcg/kg. 
Renal impairment: Moderate to severe: Reduce dose by at
least 50%.
CrCl (ml/min) Dosage Recommendation
<40 Reduce dose by at least 50%.

Hepatic impairment: Dose reduction may be necessary.


Oral
Gastro-oesophageal reflux disease
Adult: 10-15 mg up to 4 times/day, given 30 minutes
before meals and at bedtime, depending on severity of
symptoms. If symptoms are intermittent, may give single
doses of 20 mg prior to the provoking situation. 
Max Dosage: 500 mcg/kg
Renal impairment: Moderate to severe: Reduce dose by at
least 50%
CrCl (ml/min) Dosage Recommendation
<40 Reduce dose by at least 50%

Hepatic impairment: Dose reduction may be necessary. 


Oral
Prevent delayed emesis following chemotherapy
Adult: 20-40 mg 2-4 times/day for 3-4 days. 
Oral
Premedication in diagnostic procedures
Adult: 
Child: 1 mth–3 yr and up to 14 kg: 100 mcg/kg (max 1
mg); 3–5 yr and 15–19 kg: 2 mg; 5–9 yr and 20–29 kg: 2.5
mg; 9–15 yr and 30–60 kg: 5 mg; 15–18 yr and >60 kg: 10
mg. To be given as a single dose 5–10 minutes before
examination. 
Parenteral
Diabetic gastric stasis
Adult: 10 mg 4 times/day via IM/IV admin; to be given 30
minutes before meals and at bedtime. Convert to oral
admin when symptoms have subsided sufficiently. Usual
treatment duration: 2-8 wk. 
Max Dosage: 500 mcg/kg
Renal impairment: Moderate to severe: Reduce dose by at
least 50%
CrCl (ml/min) Dosage Recommendation
<40 Reduce dose by at least 50%

Hepatic impairment: Dose reduction may be necessary. 


Intravenous
Nausea and vomiting associated with cancer
chemotherapy
Adult: For highly emetogenic drugs/regimens: 2 mg/kg as
IV infusion to be given 30 minutes before start of
treatment. Repeat twice at 2-hrly intervals after the 1st
dose. For less emetogenic drugs/regimens: 1 mg/kg may
be used. If vomiting is not well-controlled, may continue
with 3 additional doses at 2 mg/kg/dose at 3-hrly intervals;
if vomiting is well-controlled with the 1st 3 doses, may
reduce dose to 1 mg/kg given at 3-hrly intervals for 3
additional doses. 
Child: Neonate: 100 mcg/kg every 6-8 hr; 1 mth-1 yr (up
to 10 kg): 100 mcg/kg (max 1 mg) bid; 1-3 yr (10-14 kg): 1
mg bid-tid; 3-5 yr (15-19 kg): 2 mg bid-tid; 5-9 yr (20-29
kg): 2.5 mg tid; 9-14 yr (≥30 kg): 5 mg tid; 15-19 yr (30-59
kg): 5 mg tid; 15-19 yr (≥60 kg): 10 mg tid. Where wt is
less than that specified for a given age group, use the
dose corresponding to the wt rather than the age, so that a
lower dose is given. Max: 500 mcg/kg. 
Renal impairment: Moderate to severe: Reduce dose by at
least 50%
CrCl (ml/min) Dosage Recommendation
<40 Reduce dose by at least 50%

Hepatic impairment: Dose reduction may be necessary. 


Intravenous
Premedication for radiologic examination of the upper
gastrointestinal tract
Adult: 10 mg. To be given as a single direct IV inj. 
Child: <6 yr: 100 mcg/kg; 6-14 yr: 2.5-5 mg. To be given
as a single direct IV inj. 
Renal impairment: Moderate to severe: Reduce dose by at
least 50%.
CrCl (ml/min) Dosage Recommendation
<40 Reduce dose by at least 50%.

Hepatic impairment: Dose reduction may be necessary 


Intravenous
Intubation of the small intestine
Adult: 10 mg. To be given as a single direct IV inj. 
Child: <6 yr: 100 mcg/kg; 6-14 yr: 2.5-5 mg. To be given
as a single direct IV inj. 
Renal impairment: Moderate to severe: Reduce dose by at
least 50%.
CrCl (ml/min) Dosage Recommendation
<40 Reduce dose by at least 50%.

Hepatic impairment: Dose reduction may be necessary 


Intramuscular
Postoperative nausea and vomiting
Adult: 10 mg, given near the end of the procedure. May
repeat every 4-6 hr when necessary.

Incompatibility: Incompatible with cephalothin sodium,


chloramphenicol sodium, and sodium bicarbonate.
Overdosage
Drowsiness, ataxia, extrapyramidal symptoms, seizures,
methemoglobinaemia (in infants).
Contraindications

Special
Children, elderly. Renal or hepatic impairment, porphyria,
Precautions
epilepsy, Parkinson's disease, history of depression.
Ability to drive or operate machineries may be impaired.
Pregnancy and lactation. Monitor patients on prolonged
therapy. Increased risk of tardive dyskinesia in patients on
prolonged or high-dose treatment.
Adverse Drug
Reactions Diabetic ga

Drug Interactions
Increased sedative effects with CNS depressants. GI
effects antagonised by antimuscarinics and opioids.
Reduces absorption of digoxin. Increases absorption
ofciclosporin, levodopa, aspirin, paracetamol. Interferes
with hypoprolactinaemic effect of bromocriptine. Inhibits
serum cholinesterase and prolongs neuromuscular
blockade produced by suxamethonium and mivacurium.
Potentially Fatal: Serotonin syndrome with sertraline
(SSRI).
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Food Interaction
Avoid ethanol (may increase CNS depression).
Lab Interference
Increased aminotransferase, increased amylase.
Storage
Intravenous: Store intact vial at controlled room
temperature. Protect from light. Dilutions with D5<190W or normal
saline are stable for at least 24 hr and do not require light protection if used within 24

hours. Parenteral: Store intact vial at controlled room temperature. Protect from light. Dilutions with

D<209>5<190W or normal saline are stable for at least 24 hr and do not require light protection if

used within 24 hr.

Mechanism of
Metoclopramide enhances the motility of the upper GI tract
Action
and increases gastric emptying without affecting gastric,
biliary or pancreatic secretions. It increases duodenal
peristalsis which decreases intestinal transit time, and
increases lower oesophageal sphincter tone. It is also a
potent central dopamine-receptor antagonist and may also
have serotonin-receptor (5-HT3) antagonist properties.
Absorption: Rapidly and almost completely absorbed
from the GI tract (oral); peak plasma concentrations after
1-2 hr.
Distribution: Widely distributed; crosses the blood-brain
barrier and placenta; enters breast milk.
Metabolism: Extensively hepatic.
Excretion: Via urine (as unchanged drug, sulfate or
glucuronide conjugates and metabolites), faeces; 4-6 hr
(terminal elimination half-life).
MIMS Class
GIT Regulators, Antiflatulents & Anti-
inflammatories / Antiemetics
Related metoclopramide information:
Drugs interacting with metoclopramide
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Abbreviation Index

Brands : Biclomet amp   Clometide amp   Clomitene amp   Euro-Med


Metoclopramide HCl amp   Metsil amp   Plasil amp   Plasil syr   Plasil
tab   Reglomar syr   Vitamet amp   Vomaine amp   

  

citicoline

MIMS Class : Nootropics & Neurotonics 


See available brands of citicoline
See related citicoline information

Indication &
Oral
Dosage
Head injury
Adult: 200-600 mg daily in divided doses.
Oral
Cerebrovascular disorders
Adult: 200-600 mg daily in divided doses.
Oral
Parkinsonism
Adult: 200-600 mg daily in divided doses.
Parenteral
Head injury
Adult: Up to 1 g IM/IV daily.
Parenteral
Cerebrovascular disorders
Adult: Up to 1 g IM/IV daily.
Parenteral
Parkinsonism
Adult: Up to 1 g IM/IV daily.
Administration
May be taken with or without food. (Take w/ or between
meals.)
Mechanism of
Action
MIMS Class
Nootropics & Neurotonics
ATC
N06BX06 - citicoline; Belongs to the class of other agents
Classification
used as CNS stimulant.
Related citicoline information:
Find citicoline in other countries
Search citicoline in Google
Search citicoline in PubMed
Abbreviation Index

Brands : Cholinerv amp   Cholinerv drops   Cholinerv tab   Citilin amp   Nicholin


amp   Somazine Adult oral drops   Somazine amp   Somazine cap   Zynapse
1000 amp   Zynapse 500 amp   Zynapse Adult Oral drops   Zynapse cap   

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