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Metoclopramide stimulates motility of the upper gastrointestinal tract without stimulating gastricbiliaryor pancreatic secretionsIts mode of action is unclearIt seems to sensitize tissues to the action of acetylcholineThe effect of metoclopramide on motility is not dependent on intact vagal innervationbut it can be abolished by anticholinergic drugs.
A few cases of neutropenialeukopeniaor agranulocytosisgenerally without clear-cut relationship to metoclopramideMethemoglobinemia in adults and especially with overdosage in neonatessee OVERDOSAGESulfhemoglobinemia in adults.
Symptoms of overdosage may include drowsinessdisorientation and extrapyramidal reactionsAnticholinergic or antiparkinson drugs or antihistamines with anticholinergic properties may be helpful in controlling the extrapyramidal reactionsSymptoms are self-limiting and usually disappear within 24 hours.
Intravenous infusions should be made slowly over a period of not less than 15 minutes30 minutes before beginning cancer chemotherapy and repeated every 2 hours for two dosesthen every 3 hours for three doses.
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