Metoclopramide

Metoclopramide

Drug monograph · NCLEX study reference
Trade names	Reglan
Therapeutic class	Antiemetic, prokinetic
Pharmacologic class	Dopamine antagonist
Onset / peak / duration	Onset 30 to 60 minutes PO; faster IV; duration 1 to 2 hours.
Half-life / level	Half-life 5 to 6 hours; no routine level.
Routes	PO (oral), IV
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	Diphenhydramine or benztropine for acute dystonia; discontinue.
Pregnancy / lactation	Used when needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Metoclopramide (brand name Reglan) — Antiemetic, prokinetic; Dopamine antagonist.

Identification

• Therapeutic class: Antiemetic, prokinetic.
• Pharmacologic class: Dopamine antagonist.

Pharmacology

• Mechanism of action: Blocks dopamine to speed gastric emptying and reduce nausea.
• Onset / peak / duration: Onset 30 to 60 minutes PO; faster IV; duration 1 to 2 hours.
• Half-life / therapeutic level: Half-life 5 to 6 hours; no routine level.

Clinical use

• Indications: Gastroparesis, GERD, chemotherapy and postoperative nausea.
• Usual dose, route, frequency: 10 mg PO or IV before meals and at bedtime.
• Maximum dose / adjustments: Limit to 12 weeks; reduce in renal impairment and elderly.

Safety

• Contraindications: GI obstruction or perforation, pheochromocytoma, seizure disorder, Parkinson disease.
• Black box warning: Risk of tardive dyskinesia, which may be irreversible; avoid use beyond 12 weeks.
• Interactions: Antipsychotics (extrapyramidal symptoms), central nervous system depressants, anticholinergics (oppose effect).
• Pregnancy / lactation: Used when needed.
• High-alert: No.

Adverse effects

• Common side effects: Drowsiness, restlessness, fatigue, diarrhea.
• Serious effects to report: Tardive dyskinesia (involuntary movements), extrapyramidal symptoms, neuroleptic malignant syndrome.
• Antidote / reversal: Diphenhydramine or benztropine for acute dystonia; discontinue.

Nursing process

• Assessment before administration: Movement baseline, GI status, neurologic history.
• Interventions during therapy: Give before meals; assess for abnormal movements; limit duration.
• Monitor: Movement disorders, GI emptying, mood.
• Evaluation / expected outcome: Improved gastric emptying and less nausea.

Patient teaching

• Patient teaching: Report any uncontrolled movements of the face or limbs.
• Notify provider if: Involuntary movements, restlessness, muscle stiffness with fever.
• Administration tips: 30 minutes before meals and at bedtime.