Dopamine D2 antagonist antiemetic / prokinetic

Metoclopramide hydrochloride

Brand names: Maxolon

Adult dose

Dose: 10mg PO/IM/IV TDS (max 30mg/day or 0.5 mg/kg/day, max 5 days)

Route: PO/IV/IM

Frequency: TDS

Clinical pearls

MHRA: max 5 days, max 30mg/day; reserve for nausea/vomiting and migraine — not for GORD
Effective in migraine (combined with NSAID/triptan)
Avoid in young women if alternative available — high acute dystonia risk

Contraindications

GI obstruction/perforation/haemorrhage
Phaeochromocytoma
Parkinson's disease
Children <1 year
Concurrent levodopa
3–4 days post GI surgery

Side effects

Extrapyramidal effects (esp. young women, children — may be acute and severe)
Tardive dyskinesia (long-term)
NMS
Sedation
Galactorrhoea
Methaemoglobinaemia (neonates)

Interactions

Levodopa
Antipsychotics
Other dopamine antagonists
Digoxin

Monitoring

EPSE
Mental state

Reference: BNF; MHRA Drug Safety Update 2014; NICE CG150; https://bnf.nice.org.uk/drugs/metoclopramide-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways