By Rania Gollakner, BS, DVM, MPH

What is metoclopramide?

Metoclopramide (brand names Reglan® and Maxolon®) is used in dogs, cats, and small mammals to stimulate stomach and upper small intestinal movement to prevent esophageal reflux, a condition where stomach acid backs up into the throat and esophagus (the muscular tube connecting the throat and stomach). It is also used in the treatment or prevention of vomiting in dogs and cats. Metoclopramide is also used in dogs and cats to induce milk let-down and to promote milk production.

The use of metoclopramide in dogs, cats, and other animals is off-label. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully.

How is metoclopramide given?

Metoclopramide is available as a tablet and an oral syrup. It is also available as an injection that your veterinarian will administer under the skin, especially if vomiting is a concern. Your veterinarian may direct you to inject this at home. Be sure to understand the proper dose, location, and technique if you are administering this drug by injection.

Oral tablets and syrup may be given by mouth with or without food. If giving it on an empty stomach or before a meal, give it approximately 15-30 minutes prior to feeding. If vomiting occurs after taking the medication on an empty stomach, try giving the next dose with food. If using the liquid form and vomiting occurs after dosing, wait until the next scheduled dose. Liquid forms of metoclopramide must be measured carefully.

"Do not stop giving the medication to your pet without first speaking with your veterinarian."

It is very important to give the medication for the length of time your veterinarian has recommended. Do not stop giving the medication to your pet without first speaking with your veterinarian.

This medication should take effect within one to two hours; however, its effects may not be visibly noticeable.

What if I miss giving my pet the medication?

If you miss giving your pet a dose, give the next dose as soon as you remember, but if it is close to the next dose, either:

• skip the dose you missed, give it at the next scheduled time, and continue with the regular dosing schedule, OR
• give the missed dose when you remember and then wait the recommended interval before giving the next dose (continue giving it regularly at that new time).

Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

There are very few side effects of metoclopramide.

The most commonly reported side effects in dogs are restlessness or hyperactivity, spasms or twitching, drowsiness, constipation, and increased urination. The most commonly reported side effects in cats are disorientation, constipation, and hyperactivity or frenzied behavior. These effects are usually not very serious. Contact your veterinarian if they worsen, become severe, or continue.

More serious side effects that indicate a problem are aggressive behavior in dogs, severe restlessness, twitching, or sleepiness. If you notice your dog has threatening behavior, contact your veterinarian immediately.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

"If you notice your dog has threatening behavior, contact your veterinarian immediately."

Are there any risk factors for this medication?

Metoclopramide should not be used in:

• pets that are allergic to it or similar drugs,
• pets that are allergic to sunscreens containing PABA (para-aminobenzoic acid),
• pets that have an intestinal blockage or bleeding in their stomach or intestines,
• dogs with pseudopregnancy,
• pets with pheochromocytoma (type of adrenal gland tumor).

It should be used with caution in pets that:

• have kidney or heart disease,
• have a seizure disorder (epilepsy), have had seizures in the past, or have had a head injury (use extreme caution),
• Are pregnant or nursing.

Are there any drug interactions I should be aware of?

Other drugs may interact with metoclopramide including certain anesthetics and antidepressants, apomorphine, atropine, cephalexin, cholinergic drugs, antihistamines, amitraz, barbiturates, cyclosporine, dopamine, opioids, mirtazapine, propofol, tetracyclines, tramadol, chlorpromazine, acepromazine, selegiline, xylazine. Tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking to ensure that a suitable dosing schedule can be determined.

Is there any monitoring that needs to be done with this medication?

Monitor to ensure that the medication is working and for any adverse effects. If serious side effects occur, contact your veterinarian.

How do I store metoclopramide?

Metoclopramide tablets should be stored in a tightly sealed container, protected from light, and stored at room temperature (20-25°C or 68-77°F). If your veterinarian has compounded a formulation, follow the instructions on the product.

What should I do in case of an emergency?

If you suspect an overdose and your pet is experiencing an adverse reaction, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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