Overview
Metoclopramide is a prokinetic agent and antiemetic used to treat nausea, vomiting, and delayed stomach emptying (gastroparesis). It helps speed up the movement of food through the stomach and intestines.

Mechanism of Action
It acts as a dopamine D2 receptor antagonist, raising the threshold of activity in the chemoreceptor trigger zone, and as a mixed 5-HT3 receptor antagonist/5-HT4 receptor agonist. This increases upper gastrointestinal motility.

Dosage and Administration
The usual adult oral dose is 10 mg taken 30 minutes before meals and at bedtime, up to four times daily. Treatment should generally not exceed 12 weeks.

Side Effects
Common side effects include restlessness, drowsiness, fatigue, and lethargy. It carries a black box warning for tardive dyskinesia (involuntary muscle movements) with long-term use.

Contraindications
Contraindicated in patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation, and in those with a history of seizures or pheochromocytoma.

Pregnancy and Lactation
Considered relatively safe during pregnancy but should be used only if clearly needed. It is excreted in human milk; caution should be exercised if administered to a nursing woman.