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Metoclopramide (MCP) is a medicine for nausea and vomiting that also stimulates gastric emptying. Because of the risk of movement disorders, it may only be used short-term – for a maximum of 5 days.
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Never use metoclopramide for longer than 5 days in a row. If uncontrolled movements of the face, tongue or limbs occur, stop taking it immediately and seek medical advice. Metoclopramide (MCP for short, best-known brand name Paspertin®) is a medicine for nausea and vomiting. As a so-called prokinetic, it also stimulates stomach movement and speeds up gastric emptying. Because of the risk of movement disorders, it may only be used short-term – for a maximum of 5 days.
| Property | Details |
|---|---|
| Active ingredient | Metoclopramide (MCP) |
| Brand name | Paspertin® |
| ATC code | A03FA01 |
| Drug class | Prokinetic, antiemetic (dopamine antagonist) |
| Formulation | Drops, tablets, suppositories, solution for injection |
| Intake | Up to 3× daily, about 30 minutes before meals |
| Standard dose | 10 mg per single dose, max. 30 mg/day (adults) |
| Duration of use | Maximum 5 days |
| Prescription required | Yes |
Nausea and vomiting are controlled in the brain by a "vomiting centre". An important messenger substance here is dopamine. Metoclopramide blocks certain dopamine docking sites (receptors) in this area – this dampens the urge to vomit and the nausea subsides, the vomiting eases.
At the same time, MCP acts in the upper digestive tract: it tightens the transition from the oesophagus to the stomach, stimulates stomach movement and thereby speeds up gastric emptying towards the intestine. That is why it also helps with a sluggish, overly full feeling in the stomach and with stomach pain linked to disturbed gastric emptying. It is used, among other things, for acute nausea, in the context of a gastrointestinal infection and as an accompaniment to migraine, where it relieves nausea and improves the absorption of painkillers.
The usual single dose for adults is 10 mg, up to three times daily – ideally about half an hour before meals. The maximum daily dose is 30 mg and should not exceed 0.5 mg per kilogram of body weight. In adolescents and children from the appropriate age, the dose is strictly based on body weight.
| Group / situation | Dosage |
|---|---|
| Adults (standard) | 3× 10 mg/day, max. 30 mg/day |
| Adolescents (15–19 yrs) | 10 mg up to 3×/day by body weight |
| Children from 1 year | 0.1–0.15 mg/kg up to 3×/day, only on medical instruction |
| Impaired kidney function | Reduce dose (to be set by a doctor) |
| Duration of use (all) | Maximum 5 days |
A missed dose is not made up for by a double amount. Simply take the next dose at the usual time. What generally applies to a missed dose is explained in the guide Forgotten medication.
brite reminds you of every intake and warns you when the maximum duration of use has been reached.
The European Medicines Agency (EMA) has significantly restricted the use of metoclopramide with a Red Hand Letter: MCP may now only be used short-term – for a maximum of 5 days. The reason is the risk of neurological side effects, above all uncontrolled movements (dyskinesias). These occur more frequently the higher the dose and the longer the use.
Metoclopramide is therefore a medicine for acute, temporary nausea – not a long-term therapy. If the symptoms persist after 5 days, that is no reason to simply carry on, but rather a reason to have the cause investigated by a doctor.
Common are harmless complaints such as tiredness, diarrhoea or a feeling of weakness. The most important and name-giving danger, however, are movement disorders (extrapyramidal disorders): uncontrolled, often frightening movements of the face, tongue, neck or limbs. They can occur as early as after the first dose – especially in children, adolescents and young adults.
| Side effect | Frequency | What to do? |
|---|---|---|
| Tiredness, drowsiness | Common | Do not drive if you feel dazed |
| Diarrhoea | Common | Make sure to drink enough fluids |
| Restlessness, urge to move | Occasional | Raise with a doctor |
| Uncontrolled movements (face, tongue, limbs), oculogyric crises, muscle cramps | Occasional to rare | Stop taking it – see a doctor immediately |
Metoclopramide speeds up gastric emptying and can thereby influence how quickly other medicines are absorbed. It also enhances the sedating and dopamine-active effects of other agents. Check combinations in the interaction check.
| Substance / medicine | Interaction | Recommendation |
|---|---|---|
| Neuroleptics, other dopamine blockers | Enhanced movement disorders | Do not combine without medical instruction |
| Parkinson's medicines (e.g. levodopa) | Mutual weakening of effect | Only under medical coordination |
| Sedatives, alcohol, opioids | Enhanced tiredness | Avoid; do not drive |
| Anti-diarrhoeal agents such as loperamide | Opposing effect on the intestine | Have the combination checked by a doctor |
Not every case of nausea needs metoclopramide. For mild complaints, rest, small sips of fluid and easily digestible food are often enough. If that is not sufficient, there are other antiemetics depending on the cause – the practice makes the choice. In the case of a gastrointestinal infection, replacing fluids and salts is the priority.
Particular caution applies to children and adolescents as well as older people: in these groups, movement disorders and dazedness occur more frequently. In older people, the dose is often chosen more cautiously, and it is likewise reduced with impaired kidney or liver function. During pregnancy and breastfeeding, a medical case-by-case decision is necessary.
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