Oral
Prophylaxis of nausea and vomiting associated with radiation therapy
Adult: 10 mg up to tid. Max: 30 mg or 0.5 mg/kg daily. Recommended Max treatment duration: 5 days.
Elderly: Dosage reduction may be needed.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<15 | Reduce dose by 75%. |
15-60 | Reduce dose by 50%. |
Oral
Nausea and vomiting
Adult: 10 mg up to tid. Max: 30 mg or 0.5 mg/kg daily. Recommended Max treatment duration: 5 days.
Elderly: Dosage reduction may be needed.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<15 | Reduce dose by 75%. |
15-60 | Reduce dose by 50%. |
Oral
Prophylaxis of chemotherapy-induced nausea and vomiting
Adult: 10 mg up to tid. Max: 30 mg or 0.5 mg/kg daily. Recommended Max treatment duration: 5 days.
Child: As 2nd line option: Usual dose: 1-18 years 0.1-0.15 mg/kg up to tid. 1-<3 years 10-14 kg: 1 mg; 3-<5 years 15-19 kg: 2 mg; 5-<9 years 20-29 kg: 2.5 mg; 9-18 years 30 kg-60 kg: 5 mg; 15-18 years >60 kg: Same as adult dose. All doses to be given up to tid. Max: 0.5 mg/kg in 24 hours. Recommended Max treatment duration: 5 days.
Elderly: Dosage reduction may be needed.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<15 | Reduce dose by 75%. |
15-60 | Reduce dose by 50%. |
Oral
Gastro-oesophageal reflux disease
Adult: 10-15 mg up to 4 times daily given 30 minutes before each meal and at bedtime, depending on severity of symptoms. If occurrence of symptoms is intermittent, may give doses up to 20 mg as a single dose prior to provoking situation. Max: 60 mg daily. Max treatment duration: 12 weeks.
Elderly: 5 mg up to 4 times daily. Max: 60 mg daily.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<40 | Reduce dose by 50%. |
Oral
Diabetic gastric stasis
Adult: For early manifestations: 10 mg 30 minutes before each meal and at bedtime for 2-8 weeks. Max: 40 mg daily.
Elderly: 5 mg 4 times daily. Max: 40 mg daily.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<40 | Reduce dose by 50%. |
Oral
Premedication for radiologic examination of the upper gastrointestinal tract
Adult: 10 or 20 mg as a single dose given before examination.
Elderly: Initiate at lowest recommended dose.
Oral
Intubation of the small intestine
Adult: 10 or 20 mg as a single dose given before examination.
Elderly: Initiate at lowest recommended dose.
Intravenous
Nausea and vomiting
Adult: 10 mg up to tid. Max: 30 mg or 0.5mg/kg daily.
Child: Usual dose: 1-18 years 0.1-0.15 mg/kg up to tid. 1-<3 years 10-14 kg: 1 mg; 3-<5 years 15-19 kg: 2 mg; 5-<9 years 20-29 kg: 2.5 mg; 9-18 years 30 kg-60 kg: 5 mg; 15-18 years >60 kg: Same as adult dose. All doses to be given up to tid. Max: 0.5 mg/kg in 24 hours. Max duration: 5 days.
Elderly: Dosage reduction may be needed.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<15 | Reduce dose by 75%. |
15-60 | Reduce dose by 50%. |
Reconstitution: Inj: Doses >10 mg: Dilute in 50 mL of compatible solution (e.g. 0.9% NaCl).
Incompatibility: Incompatible with cefalotin Na, chloramphenicol Na, and Na bicarbonate.
Intravenous
Prophylaxis of nausea and vomiting associated with radiation therapy
Adult: 10 mg up to tid. Max: 30 mg or 0.5mg/kg daily.
Child: Usual dose: 1-18 years 0.1-0.15 mg/kg up to tid. 1-<3 years 10-14 kg: 1 mg; 3-<5 years 15-19 kg: 2 mg; 5-<9 years 20-29 kg: 2.5 mg; 9-18 years 30 kg-60 kg: 5 mg; 15-18 years >60 kg: Same as adult dose. All doses to be given up to tid. Max: 0.5 mg/kg in 24 hours. Max duration: 5 days.
Elderly: Dosage reduction may be needed.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<15 | Reduce dose by 75%. |
15-60 | Reduce dose by 50%. |
Reconstitution: Inj: Doses >10 mg: Dilute in 50 mL of compatible solution (e.g. 0.9% NaCl).
Incompatibility: Incompatible with cefalotin Na, chloramphenicol Na, and Na bicarbonate.
Intravenous
Prophylaxis of postoperative nausea and vomiting
Adult: 10 mg as a single dose.
Child: As 2nd line option: Usual dose: 1-18 years 0.1-0.15 mg/kg up to tid. 1-<3 years 10-14 kg: 1 mg; 3-<5 years 15-19 kg: 2 mg; 5-<9 years 20-29 kg: 2.5 mg; 9-18 years 30 kg-60 kg: 5 mg; 15-18 years >60 kg: Same as adult dose. Dose to be given after termination of surgery. Max treatment duration: 48 hours.
Elderly: Dosage reduction may be needed.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<15 | Reduce dose by 75%. |
15-60 | Reduce dose by 50%. |
Reconstitution: Inj: Doses >10 mg: Dilute in 50 mL of compatible solution (e.g. 0.9% NaCl).
Incompatibility: Incompatible with cefalotin Na, chloramphenicol Na, and Na bicarbonate.
Intravenous
Prophylaxis of chemotherapy-induced nausea and vomiting
Adult: Loading dose: 2-4 mg/kg via continuous infusion over 15-20 minutes. Maintenance: 3-5 mg/kg infused over 8-12 hours. Alternatively, initial dose of up to 2 mg/kg via intermittent infusion over at least 15 minutes, may be given before cancer therapy and repeated at 2-hourly intervals. Max total: 10 mg/kg in 24 hours.
Child: As 2nd line option: Usual dose: 1-18 years 0.1-0.15 mg/kg up to tid. 1-<3 years 10-14 kg: 1 mg; 3-<5 years 15-19 kg: 2 mg; 5-<9 years 20-29 kg: 2.5 mg; 9-18 years 30 kg-60 kg: 5 mg; 15-18 years >60 kg: Same as adult dose. All doses to be given up to tid. Max: 0.5 mg/kg in 24 hours. Max duration: 5 days.
Elderly: Dosage reduction may be needed.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<15 | Reduce dose by 75%. |
15-60 | Reduce dose by 50%. |
Reconstitution: Inj: Doses >10 mg: Dilute in 50 mL of compatible solution (e.g. 0.9% NaCl).
Incompatibility: Incompatible with cefalotin Na, chloramphenicol Na, and Na bicarbonate.
Parenteral
Diabetic gastric stasis
Adult: Severe cases: 10 mg up to 4 times daily via IM or slow IV inj over 1-2 minutes up to 10 days and may shift to oral therapy once possible.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<40 | Reduce dose by 50%. |
Reconstitution: Inj: Doses >10 mg: Dilute in 50 mL of compatible solution (e.g. 0.9% NaCl).
Incompatibility: Incompatible with cefalotin Na, chloramphenicol Na, and Na bicarbonate.
Intravenous
Intubation of the small intestine
Adult: 10 mg as a single dose, given over 1-2 minutes.
Child: <6 years 0.1 mg/kg; 6-14 years 2.5-5 mg; >14 years Same as adult dose. All doses to be given as single dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<40 | Reduce dose by 50%. |
Reconstitution: Inj: Doses >10 mg: Dilute in 50 mL of compatible solution (e.g. 0.9% NaCl).
Incompatibility: Incompatible with cefalotin Na, chloramphenicol Na, and Na bicarbonate.
Intravenous
Premedication for radiologic examination of the upper gastrointestinal tract
Adult: 10 mg as a single dose, given over 1-2 minutes.
Child: <6 years 0.1 mg/kg; 6-14 years 2.5-5 mg; >14 years Same as adult dose. All doses to be given as single dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<40 | Reduce dose by 50%. |
Reconstitution: Inj: Doses >10 mg: Dilute in 50 mL of compatible solution (e.g. 0.9% NaCl).
Incompatibility: Incompatible with cefalotin Na, chloramphenicol Na, and Na bicarbonate.
Special Populations: Patients taking strong CYP2D6 inhibitors (e.g. quinidine, bupropion, fluoxetine): Oral: 5 mg up to 4 times daily or 10 mg up to tid. Pharmacogenomics: CYP2D6 poor metabolisers: Metoclopramide is primarily metabolised by CYP2D6. Individuals who are poor metabolisers of CYP2D6 may have an increased exposure to metoclopramide, resulting to increased risk of adverse effects including acute dystonia. Dosage reduction is recommended. The prevalence of CYP2D6 poor metabolisers is estimated at approx 1% in Asians and 5-10% among white populations.