Metoclopramide is a central dopamine antagonist that also shows peripheral cholinergic activity. There are two main effects of the drug: antiemetic action and the effect of accelerating stomach emptying and passing through the small intestine. The antiemetic action is caused by the effect on the central point of the brain stem (chemoreceptors - the activating zone of the vomiting center), probably due to the inhibition of dopaminergic neurons.
For adults: prevention of postoperative nausea and vomiting; nausea and vomiting caused by radiotherapy; symptomatic treatment of nausea and vomiting, including those associated with acute migraine.
For children: as a second-line drug for the prevention of delayed chemotherapy-induced nausea and vomiting; treatment of postoperative nausea and vomiting.
The drug shouldn’t be used for treatment of chronic diseases, such as gastroparesis, dyspepsia and gastroesophageal reflux disease, or as an adjunct in surgical or radiological procedures.
Patients under 30 years of age are more likely to develop dystonic and dyskinetic disorders when treated with metoclopramide.
Caution should be exercised when prescribing to elderly patients due to the increased incidence of parkinsonism.