Maxolon (Metoclopramide)

• Preventing delayed nausea and vomiting caused by anti-cancer chemotherapy.
• Treating nausea and vomiting following surgery.

How does metoclopramide work?

• Metoclopramide is a type of medicine called a dopamine antagonist. It is an anti-sickness medicine, sometimes called an anti-emetic.
• Metoclopramide works primarily by blocking dopamine receptors found in an area of the brain known as the chemoreceptor trigger zone (CTZ).
• The CTZ is activated by nerve messages from the stomach when an irritant is present. It is also activated directly by agents circulating in the blood, for example anti-cancer medicines or anaesthetics. Once activated, it sends messages to another area of the brain, the vomiting centre, which in turn sends messages to the gut, causing the vomiting reflex.
• Blocking the dopamine receptors in the CTZ prevents nausea messages from being sent to the vomiting centre. This reduces the sensation of feeling sick and prevents vomiting.
• Metoclopramide also acts in the upper end of the digestive system, where it enhances the action of a natural chemical called acetylcholine. This results in tightening of the muscles at the entry to the stomach, relaxation of the muscles at the exit of the stomach and increased contraction of the muscles in the stomach itself. These actions speed the passage of food through the stomach into the intestine, which physically helps to prevent vomiting.
• Due to its action on the gut, metoclopramide is useful in migraine, not only for relieving feelings of sickness, but also because during a migraine attack stomach emptying is slowed, which can prevent painkillers from being absorbed. Metoclopramide speeds up the passage of painkillers from the stomach to the intestine, from where they can be absorbed to relieve the headache.

Side effects

More common:

• Diarrhea
• drowsiness
• restlessness
• Less common or rare:
• Breast tenderness and swelling
• changes in menstruation
• constipation
• decreased interest in sexual intercourse
• inability to have or keep an erection
• increased flow of breast milk
• increased need to urinate
• loss in sexual ability, desire, drive, or performance
• mental depression
• passing urine more often
• skin rash
• trouble sleeping
• unusual dryness of the mouth
• unusual irritability

What is the dose of metoclopramide and how often should I take it?

• The usual dose of metoclopramide that is prescribed for adults is one 10mg tablet or 10ml liquid taken up to three times a day. However, it is important to follow the instructions given by your doctor. These should be printed on the dispensing label that your pharmacist has put on the packet of medicine.
• You should leave at least six hours between each dose. Even if you vomit soon after taking a dose of metoclopramide, wait six hours before taking another dose, to make sure that you're not taking too much.
• Metoclopramide should only be taken for up to five days. Do not exceed the prescribed dose.
• Should I take metoclopramide with or without food?
• Metoclopramide tablets and liquid can be taken either with or without food. The tablets should be swallowed with a drink of water.
• What should I do if I miss a dose of metoclopramide?
• If you forget to take a dose of metoclopramide, take it as soon as you remember, unless it's nearly time for your next dose. If this is the case, just leave out the missed dose and take the next dose as usual when it's due. Don't take a double dose to make up for a missed dose.

What should I know before taking metoclopramide?

• Metoclopramide can sometimes cause abnormal movements eg tremor, twitching, spasms or rigidity, of the hands, legs, face, neck, tongue or eyes. If you get any unusual movements of your body you should stop taking metoclopramide and see your doctor. Any problems should resolve within 24 hours of stopping the medicine. Metoclopramide should not usually be taken for more than five days at a time to minimise the risk of getting this type of side effect.

Does taking metoclopramide affect your ability to drive?

• Metoclopramide may make some people feel sleepy or dizzy, so you should make sure you know how you react to it before driving or operating machinery. You should avoid doing potentially hazardous activities if affected.

Can I drink alcohol with metoclopramide?

• It's unlikely that you'll want to drink alcohol while feeling sick, however it is important to avoid drinking alcohol while you're taking metoclopramide. Metoclopramide can increase the speed that alcohol is absorbed from the gut, which can increase the level of alcohol in your blood and its effects.

Do I need to avoid any foods or drinks while I'm taking metoclopramide?

• There are no foods or drinks you specifically need to avoid while taking metoclopramide. However, if you're suffering from nausea and vomiting it's a good idea to avoid heavy meals and make sure that you are taking lots of fluids to help prevent dehydration.

Who shouldn't take metoclopramide?

• Children under one year of age.
• People who've had surgery on the gut in the last three to four days, for example pyloroplasty or gut anastomosis
• People with a blockage, bleeding or abnormal hole or tear in the stomach or intestines (gastrointestinal obstruction, haemorrhage or perforation).
• People with a tumour of the adrenal gland (phaeochromocytoma).
• People with Parkinson's disease.
• People with epilepsy.
• People allergic to any ingredient of the medicine. Check the ingredients listed in the leaflet that comes with your medicine if you know you have specific allergies or intolerances.

References:

https://www.drugs.com/sfx/maxolon-side-effects.html

http://www.netdoctor.co.uk/medicines/digestive-health/a28272/things-to-know-about-metoclopramide/

http://www.medicines.ie/medicine/13538/SPC/Maxolon+10+mg+tablets/#MACHINEOPS

https://www.medicines.org.uk/EMC/medicine/20690/SPC/Maxolon+Tablets+10mg/

https://patient.info/medicine/metoclopramide-maxolon