Do you sometimes feel full, bloated, or nauseous after eating? Does it feel like the food is stuck in your stomach? The reason for this may be that your stomach is working a little too slowly. In medicine, we call this gastroparesis. So, a special medicine that is given to treat this condition is the nasal spray called Metoclopramide, which we are talking about today.
Simply put, what is Metoclopramide?
Metoclopramide is a medicine that helps your digestive system, especially your stomach, move food through the digestive tract more quickly. Think of it like a police officer moving a few cars in a traffic jam. When your stomach empties, your symptoms of fullness, nausea, and heartburn are greatly reduced.
Doctors may sometimes prescribe this medication for other conditions, so if you have any further questions about this, it's best to ask your doctor.
Things you need to tell your doctor before taking medicine
Before you start using this medicine, it is very important to give your doctor a complete description of your health condition, especially if you have any of the conditions below.
- Breast cancer
- Depression or other mental illnesses
- Diabetes
- If you are a frequent drinker
- Heart failure
- High blood pressure
- Kidney or Liver disease
- Parkinson's disease or another movement disorder
- A condition called Pheochromocytoma
- Seizures
- Stomach obstruction, bleeding, or perforation
- If you have an allergy to Metoclopramide, Procainamide or any other medicine, food, or dye
- If you are pregnant or trying to get pregnant
- If you are a breastfeeding mother
Knowing these things will help your doctor make an accurate decision about whether this medication is right for you or not, and what dosage to give it.
How should I use this medicine?
This is a nasal spray only. Do not take it by mouth for any reason. Follow your doctor's instructions exactly. Do not use more than the prescribed amount. If you are unsure about how to use this nasal spray, ask your doctor again.
Usually, when you are given this medicine, you will receive a special leaflet (`MedGuide`) about it. Read that leaflet carefully every time you take the medicine. It is very important.
What to do if you take an extra dose (overdose)?
If you think you have taken more of this medicine than you should, immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Department (ETU) of the nearest hospital.
What if I miss a dose of medication?
If you miss a dose, skip it. Take the next dose at the scheduled time. Never take two doses at once to make up for a missed dose.
Other things that may interact with this medicine
Metoclopramide can interact with other medications and substances. So tell your doctor about all the medications you take (including vitamins and herbal products). The table below shows some of the things that may interact with this medication.
| Type of substance or medication | Things to consider |
|---|---|
| Alcohol | May cause excessive drowsiness and dizziness. Stop completely. |
| Medicines for allergies, coughs, and colds (Antihistamines) | May increase drowsiness. |
| Medications for depression, anxiety, and insomnia | Side effects may increase. Inform your doctor. |
| Painkillers (especially opioids) | The medicine may affect its effectiveness. |
| Diabetes medications (including insulin) | Dosage may need to be adjusted as it may affect blood sugar levels. |
| Medications for Parkinson's disease | The functioning of both can be affected. |
This list is not complete, so it is important to inform your doctor about all medications you are taking.
Special points to be aware of when taking the medicine
Most importantly: Do not use this medicine for more than 8 weeks at a time. If you take this medicine for a longer period of time, the risk of serious side effects is much higher.
- Uncontrollable movements: Some people may experience uncontrollable movements while taking this medicine. We call this ``Extrapyramidal Symptoms (EPS)''. For example, lip smacking, tongue sticking out frequently, uncontrolled movements of the eyes, head, limbs, and muscles. If you notice anything like this, tell your doctor right away. This risk is higher in people over 65, women, and people with diabetes.
- Mental health: Be aware of your mental health while taking this medication. If you feel like your depression is getting worse, you are having suicidal thoughts, or if you suddenly feel anxious, irritable, or have trouble sleeping, talk to your doctor right away.
- Drowsiness and dizziness: This medicine may make you feel drowsy and dizzy. Therefore, do not drive or operate machinery until you know how this medicine affects you. Do not get up from a sitting position suddenly. Drinking alcohol can make this drowsiness worse.
- Fever: If symptoms such as high fever, muscle stiffness, excessive sweating, rapid heartbeat, and confusion suddenly appear, it may be a sign of a serious condition called `Neuroleptic Malignant Syndrome.` Therefore, do not stay home and take paracetamol at such a time, but seek medical advice immediately.
What side effects can you experience?
Like any medicine, Metoclopramide can cause side effects. Some are serious, while others are common.
| Side effect | Description |
|---|---|
| If you have these symptoms, see a doctor immediately. | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Uncontrollable movements (EPS) | Lip twitching, tongue sticking out, uncontrollable shaking of the limbs, and muscle tension. |
| Neuroleptic Malignant Syndrome | High fever, muscle stiffness, excessive sweating, irregular heartbeat, and confusion. |
| Mental changes | Suicidal thoughts, increased depression. |
| High blood pressure | Sudden increase in blood pressure. |
| Body swelling | Swelling of the ankles, hands, or feet. |
| These are usually not serious, but if they persist, tell your doctor. | |
| Headache | General headache. |
| Tiredness | Feeling tired in the body. |
| Change in taste | Feeling a change in the taste of the mouth. |
This list does not include all possible side effects. If you experience anything different, talk to your doctor about it.
How should I store the medicine?
Keep this medicine out of the reach of children and pets. It is best to store it at room temperature (between 15-30 degrees Celsius). Throw away any medicine left in the bottle after 4 weeks of opening.
Take-Home Message
- Metoclopramide Nasal Spray is a nasal spray used to treat gastroparesis, a condition in which the stomach's function is slow.
- Avoid using this medicine for more than 8 weeks at a time.
- Before taking the medicine, tell your doctor about all your medical conditions and other medications you are taking.
- If you experience uncontrollable movements such as trembling of the limbs or lip twitching, seek medical advice immediately.
- Avoid driving and other activities that require alertness as drowsiness may occur. Do not drink alcohol.
- In case of any problem, do not hesitate to seek advice from your doctor.
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