Metoclopramide (nasal)

Metoclopramide (nasal) is used in adults with diabetes to treat symptoms of slow stomach emptying, which may include stomach pain, bloating, nausea, and vomiting.

Metoclopramide may also be used for reasons not mentioned in this medication guide.

High doses or long-term use of metoclopramide can lead to a serious movement disorder that might not go away. The longer you take metoclopramide, the higher the chance you have of developing this disorder, particularly if you are a woman or an older adult.

NEVER USE METOCLOPRAMIDE NASAL IN LARGER AMOUNTS THAN RECOMMENDED, OR FOR LONGER THAN 8 WEEKS AT A TIME.

Contact your doctor immediately if you experience uncontrollable muscle movements in your lips, tongue, eyes, face, arms, or legs.

You should not use metoclopramide if you are allergic to it, or if you have:

• tardive dyskinesia (a disorder of involuntary movements);
• stomach or intestinal problems such as a blockage, bleeding, or perforation (a hole or tear in your stomach or intestines);
• epilepsy or other seizure disorder;
• an adrenal gland tumor (pheochromocytoma); or
• if you've ever had muscle movement problems after using metoclopramide or similar medicines.

Tell your doctor if you have ever had:

• liver or kidney disease;
• problems with muscle movements;
• congestive heart failure or a heart rhythm disorder;
• high blood pressure;
• seizures;
• breast cancer;
• depression or mental illness; or
• Parkinson's disease.

Also tell your doctor if you've been tested for an enzyme that helps break down certain medicines in the body, and you were told you are a poor metabolizer of CYP2D6.

Tell your doctor if you are pregnant. Metoclopramide may harm an unborn baby if you use the medicine during late pregnancy.

Ask a doctor if it is safe to breastfeed while using metoclopramide. If you are breastfeeding, tell your doctor if you notice unusual muscle movement, pale or yellowed skin, dark urine, fever, or weakness in the nursing baby.

Not approved for use by anyone younger than 18 years old.

Get emergency medical help if you notice signs of an allergic reaction: hives, rash, blisters, mouth sores; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking metoclopramide and call your doctor right away if you notice any of these SIGNS OF A SERIOUS MOVEMENT DISORDER, which may happen within the first 2 days of treatment:

• tremors or shaking in your arms or legs;
• uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
• difficulty breathing; or
• any new or unusual muscle movements you cannot control.

Metoclopramide may cause serious side effects. Call your doctor immediately if you experience:

• confusion, depression, thoughts of suicide or self-harm;
• slow or jerky muscle movements, problems with balance or walking;
• a mask-like appearance in your face;
• a seizure;
• anxiety, agitation, feeling jittery, trouble staying still, trouble sleeping;
• swelling, shortness of breath, rapid weight gain;
• missed menstrual periods;
• breast swelling, nipple discharge; or
• severe nervous system reaction—very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might faint.

Common side effects of metoclopramide may include:

• unpleasant taste;
• feeling tired; or
• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Use the nasal spray at least 30 minutes before each meal, and at bedtime.

Metoclopramide nasal is usually prescribed for only 2 to 8 weeks at a time.

NEVER USE METOCLOPRAMIDE NASAL IN LARGER AMOUNTS THAN RECOMMENDED, OR FOR LONGER THAN 8 WEEKS. High doses or long-term use of metoclopramide can cause a serious movement disorder that may not be reversible. The longer you use metoclopramide, the more likely you are to develop this disorder, especially if you are a woman or an older adult.

Avoid using metoclopramide in all forms (nasal, oral, injection) for longer than 12 weeks.

Store at room temperature in a tightly-closed container, away from moisture and heat. Throw away the bottle 4 weeks after opening, even if there is still medicine left inside.

After you stop using metoclopramide, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness.

Skip the dose and use your next dose at the regular time. Do not use two doses at one time.

If you are not sure you received a full dose while spraying the metoclopramide (nasal) into your nose, do not use a second dose. Wait until your next scheduled dose to use the metoclopramide (nasal) again.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include drowsiness, confusion, or uncontrolled muscle movements.

Do not drink alcohol.

Avoid driving or doing anything dangerous until you understand how metoclopramide will affect you. Your reactions could be impaired.

Using metoclopramide (nasal) with other medications that cause drowsiness can make this effect worse. Consult your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Inform your doctor about all the medications you are currently taking. Many drugs can impact metoclopramide (nasal), especially:

• blood pressure medication;
• insulin;
• medicine to treat depression or mental illness;
• medicine to treat Parkinson's disease or restless leg syndrome; or
• an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.

This list is not complete, and many other medications may affect metoclopramide (nasal). This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.