Metoclopramide
- Class: Prokinetic / D2 antagonist
- Used for: a sluggish stomach
- Say it: met-oh-KLOH-pruh-mide
- Forms: tablet, oral liquid, injection
Remember the name – CLOP → clop, like hooves
METOCLOPRAMIDE = CLOP, CLOP — the sluggish stomach starts moving forward again.
It is prokinetic: it speeds gastric emptying and pushes contents along. But it also blocks dopamine in the brain, which is why movement disorders are its real risk.
METOCLOPRAMIDE = CLOP, CLOP — the sluggish stomach starts moving forward again.
It is prokinetic: it speeds gastric emptying and pushes contents along. But it also blocks dopamine in the brain, which is why movement disorders are its real risk.
Mnemonic: MetoCLOPramide clops the stomach along
Blocking D2 takes the brake off the gut, so the stomach empties. The same D2 block in the brain is why it can cause movement problems.
Blocking D2 takes the brake off the gut, so the stomach empties. The same D2 block in the brain is why it can cause movement problems.
Side effects
Common: drowsiness, restlessness, diarrhea
Serious: tardive dyskinesia, acute dystonia
Typical dose
10 mg up to three times daily
Maximum five days. Longer use risks tardive dyskinesia, which may not reverse.
Check yourself
Why can Metoclopramide cause involuntary movements?
- It blocks D2 receptors in the brain as well as in the gut
- It blocks serotonin receptors in the brain
- It is an anticholinergic
- It causes a low potassium
Show answer
A. It blocks D2 receptors in the brain as well as in the gut
The drug cannot tell the two D2 populations apart. Gut benefit and movement side effects come from one and the same receptor block, which is why duration matters so much.
See it, don't memorize it
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