A dopamine-blocking anti-sickness medicine
Metopimazine
A dopamine-blocking anti-sickness medicine used to prevent and ease nausea and vomiting.
What is Metopimazine?
Metopimazine is an anti-sickness (antiemetic) medicine used to prevent and treat nausea and vomiting. It works by blocking dopamine signals in the part of the brain that triggers sickness, which calms the feeling of nausea and the urge to vomit. Because it acts on dopamine, it can occasionally cause movement-related (extrapyramidal) effects such as muscle stiffness, restlessness or unusual movements, and it can also cause drowsiness. Any new abnormal movements should be reported. It is taken by mouth.
Education and reference only. This is a plain-language guide to Metopimazine — 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
Metopimazine is an antiemetic, a medicine that prevents and treats nausea and vomiting. It belongs to a group that works by blocking dopamine, a chemical messenger involved in triggering sickness. It is used to ease feeling sick and being sick from a range of causes. It is taken by mouth. As with other dopamine-blocking anti-sickness medicines, it carries a small risk of movement-related side effects, so it is used at the lowest effective amount for the shortest time that is needed, and any unusual movements are taken seriously.
How it works
Nausea and vomiting are partly triggered by dopamine acting on a sickness centre in the brain. Metopimazine blocks these dopamine signals, which reduces the feeling of nausea and the urge to be sick. The same blocking of dopamine elsewhere in the brain is why, occasionally, it can cause movement-related (extrapyramidal) effects such as stiffness, restlessness or unusual movements of the face or limbs. It can also cause drowsiness. Because these effects are linked to how it works, it is used carefully and any abnormal movements are reported promptly.
Company & origin
Originated / developed by: Specialist manufacturer.
An anti-sickness medicine used to prevent and treat nausea and vomiting.
Practical use
How to take Metopimazine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, to prevent or ease nausea and vomiting.
- Report promptly any new muscle stiffness, restlessness or unusual movements of the face, tongue or limbs.
- Be aware it can cause drowsiness, so take care with driving until you know how it affects you.
- Avoid alcohol while taking it, as this adds to the drowsiness.
- Use it for the shortest time needed, and tell your prescriber about your other medicines.
Weighing it up
Advantages & disadvantages of Metopimazine
Advantages
- Effectively prevents and eases nausea and vomiting from a range of causes.
- Taken by mouth.
- Works on the brain's sickness centre to calm the urge to vomit.
Disadvantages
- Can occasionally cause movement-related (extrapyramidal) effects such as stiffness or unusual movements.
- Can cause drowsiness, which affects driving and concentration.
- Movement effects can add up with other dopamine-blocking medicines.
Practical use
Good to know
The key points with metopimazine relate to how it blocks dopamine. Most people simply find their nausea eased, but a small number develop movement-related (extrapyramidal) effects such as muscle stiffness, restlessness, or unusual movements of the face, tongue or limbs; these should be reported promptly, as they can usually be managed. It can also cause drowsiness, so take care with driving and avoid alcohol until you know how it affects you. Younger people and older people can be more sensitive to the movement effects. It is best used at the lowest helpful amount for the shortest time needed. Tell your prescriber about other medicines, particularly other anti-sickness or antipsychotic medicines, as the movement effects can add up.
Who should not take it / use with caution
- People who have had a serious allergic reaction to metopimazine should not take it.
- It is used with caution in people prone to movement-related side effects, including the very young and the elderly.
- It is used with care alongside other medicines that block dopamine, such as antipsychotics.
Monitoring
- Checking that nausea and vomiting are controlled.
- Watching for movement-related effects such as stiffness or unusual movements.
- Reviewing whether it is still needed and keeping use as short as possible.
Side effects
- Drowsiness.
- Movement-related effects such as muscle stiffness, restlessness or unusual movements, which should be reported.
- Less commonly, dizziness or a dry mouth.
Key interactions
- Other dopamine-blocking medicines, such as antipsychotics, can add to the risk of movement effects.
- Alcohol and other sedating medicines add to the drowsiness.
- Tell your prescriber about all your medicines so these effects can be considered.
Available as: Tablets and liquid taken by mouth.
Answers
Metopimazine: frequently asked questions
What is metopimazine used for?
It is an anti-sickness medicine used to prevent and treat nausea and vomiting, by blocking dopamine signals that trigger sickness.
Can it cause unusual movements?
Occasionally, because it blocks dopamine, it can cause movement-related effects such as stiffness or unusual movements, which should be reported promptly.
Will it make me drowsy?
It can cause drowsiness, so take care with driving and avoid alcohol until you know how it affects you.
Who is more sensitive to its side effects?
Younger people and older people can be more sensitive to the movement-related effects, so it is used with extra care in them.
How long should I take it?
It is best used at the lowest helpful amount for the shortest time needed to control the sickness.
The wider class
About Dopamine-antagonist antiemetic (anti-sickness)
Metopimazine belongs to the dopamine-antagonist antiemetic (anti-sickness) 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
- NICE CKS
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