An anti-sickness medicine that speeds stomach emptying
Metoclopramide
A short-term anti-sickness medicine that also speeds stomach emptying; used only briefly because of a risk of movement side effects.
What is Metoclopramide?
Metoclopramide is an anti-sickness (antiemetic) medicine that also speeds up emptying of the stomach. It is used for nausea and vomiting, including some types linked to migraine and to treatments such as chemotherapy.
Education and reference only. This is a plain-language guide to Metoclopramide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Metoclopramide is an anti-sickness (antiemetic) medicine that has the added effect of speeding up the emptying of the stomach. It is used for nausea and vomiting in situations such as migraine, after some operations or treatments, and where slow stomach emptying is part of the problem. Because of a recognised risk of movement-related side effects, regulators (the MHRA in the UK) advise that it is used only for a short course rather than long-term, and it is generally avoided in children except under specialist care. In the UK and US the active ingredient and the original brand (Maxolon) are the same; generic metoclopramide is identical.
How it works
Nausea and vomiting are partly controlled by dopamine signalling in a "trigger" area of the brain and in the gut. Metoclopramide blocks these dopamine receptors, which reduces the sense of sickness and the vomiting reflex. At the same time, by acting on the upper gut it encourages the stomach to empty and move its contents onward — helpful when sluggish stomach emptying is contributing to the nausea, and why it pairs well with painkillers in migraine, where the stomach often slows down. Because it blocks dopamine, it can also affect the brain's movement-control pathways, which is the source of its movement side effects.
Company & origin
Originated / developed by: Laboratoires Delagrange.
Metoclopramide was developed by Laboratoires Delagrange in France (described by Justin-Besançon and Laville) and introduced in 1964 as Primperan.
Practical use
How to take Metoclopramide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Use metoclopramide only for short courses, as longer use raises the risk of movement-related side effects.
- It is normally used only for a short time (usually no more than about five days).
- Stop it and seek advice if you develop unusual muscle movements, such as spasms of the face, neck or eyes.
- Be cautious about driving, as it can cause drowsiness in some people.
- Take particular care in young adults, children and older people, who can be more prone to movement side effects.
- Tell your prescriber about your other medicines, as some can interact with it.
Weighing it up
Advantages & disadvantages of Metoclopramide
Advantages
- Effective for nausea and vomiting and helps the stomach empty.
- Useful in certain situations such as migraine-related sickness.
- Works relatively quickly to settle nausea.
- Available in different forms, including by injection in hospital.
Disadvantages
- Recommended only for short-term use because of side-effect risks.
- Can cause distressing movement disorders, including muscle spasms and restlessness.
- May cause drowsiness or fatigue.
- Needs extra caution in younger and older people and is not suitable for everyone.
Practical use
Good to know
The key practical point is that it is for short-term use only — typically a brief course — because using it for longer raises the risk of movement disorders, including restlessness, muscle spasms and, with longer exposure, a condition of involuntary movements called tardive dyskinesia. These risks are higher in younger people and in older people. It is not used in young children except under specialist supervision. It can interact with medicines for Parkinson's disease (each can work against the other), and adds to drowsiness with alcohol and sedating medicines. If you develop unusual muscle stiffness, spasms of the face, neck or eyes, or restlessness, stop and seek advice promptly.
Who should not take it / use with caution
- It is not for long-term or repeated use — only short courses — because of the risk of movement disorders, which is higher in young people and the elderly.
- People with certain bowel problems (such as obstruction, bleeding or recent gut surgery), a phaeochromocytoma, epilepsy, or a history of certain movement disorders should not use it.
- Avoided in young children except under specialist care, and used with caution in Parkinson's disease, significant kidney or liver impairment, and in pregnancy or breastfeeding.
Monitoring
- Relief of nausea and vomiting
- Any movement side effects (spasms, restlessness, tremor)
- Keeping the course short and reviewing the need to continue
Side effects
- Drowsiness, restlessness, tiredness and diarrhoea are common.
- Movement effects such as muscle spasms (especially of the face, neck and eyes), tremor or a feeling of inner restlessness, more likely with higher or longer use and in young or older people.
- With longer exposure, the involuntary movements of tardive dyskinesia; very rarely, a serious reaction with high fever and muscle rigidity (neuroleptic malignant syndrome) needing emergency care.
Key interactions
- It can work against Parkinson's disease medicines, and they against it, so the combination is generally avoided.
- Adds to drowsiness with alcohol, sedating medicines, and to movement side effects with antipsychotics.
- By speeding stomach emptying it can change how quickly some other medicines are absorbed; care also with certain antidepressants and medicines affecting the heart's rhythm.
Available as: Tablets, an oral liquid, and an injection used in healthcare settings.
Answers
Metoclopramide: frequently asked questions
Why can I only take metoclopramide for a short time?
Used for longer than a short course, metoclopramide raises the risk of movement disorders — including muscle spasms and a longer-term condition of involuntary movements called tardive dyskinesia. Because of this, regulators advise keeping courses short and only continuing if there is a clear need, with review.
Can children take metoclopramide?
It is generally avoided in children and young people except under specialist supervision, because they are more prone to its movement side effects. If a child needs anti-sickness treatment, a doctor will choose the most suitable option for their age.
Why is it used for migraine sickness?
During a migraine the stomach often slows down, which worsens nausea and can stop painkillers being absorbed well. Metoclopramide both eases the sickness and helps the stomach empty, so it can settle the nausea and help a paired painkiller work — which is why the two are sometimes given together.
I feel restless and my muscles are twitching — should I worry?
Unusual muscle spasms (especially of the face, neck or eyes), tremor or a strong feeling of inner restlessness can be movement side effects of metoclopramide. Stop taking it and seek advice promptly — these usually settle once the medicine is stopped, and your team can suggest an alternative.
What is the difference between metoclopramide and Maxolon?
They are the same medicine — metoclopramide is the generic (active-ingredient) name and Maxolon is the original brand name, used in both the UK and US. Generic metoclopramide contains the identical active ingredient.
The wider class
About Anti-sickness medicines
Metoclopramide belongs to the anti-sickness medicines class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF: Metoclopramide hydrochloride.
- electronic Medicines Compendium (SmPC): Metoclopramide (Maxolon).
- NICE CKS: Metoclopramide.
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