Metoclopramida
Metoclopramide
Metoclopramide HCl
También conocido como: Reglan · Metozolv · Emeprid · Metomotyl · Vomend · Maxolon · AHR-3070-C · DEL-1267 · metoclopramidi hydrochloridum · MK-745 · Metoclopramide hydrochloride
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia posológica v13 auditada
Evidencia estructurada para el cálculoGastrointestinal stasis after obstruction has been excluded
Requiere verificación veterinaria
- q6–8h
Contexto clínico obligatorio (2)
- Exclude emergent diagnoses (obstruction, enterotoxemia)
- Prokinetic agent (after excluding the possibility of obstruction)
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La metoclopramida es un agente procinético gastrointestinal y antiemético ampliamente utilizado en medicina veterinaria.
- Efectos procinéticos: Actúa principalmente en el tracto gastrointestinal superior (estómago e intestino delgado) con un efecto mínimo en el colon. Se utiliza clínicamente para la estasis gástrica, el reflujo gastroesofágico y el íleo postoperatorio.
- Efectos antieméticos: Es altamente eficaz en perros debido a la abundancia de receptores dopaminérgicos en la zona gatillo quimiorreceptora (CRTZ). Por el contrario, los gatos tienen menos receptores D2, lo que hace que la metoclopramida sea un antiemético menos fiable en felinos (donde a menudo se prefieren los antagonistas alfa-2 o los antagonistas NK-1 como el maropitant).
Perlas clínicas:
- A menudo se administra mediante infusión a velocidad constante (CRI) para afecciones graves como la enteritis por parvovirus o la pancreatitis aguda.
- Debido a que atraviesa la barrera hematoencefálica, puede causar efectos secundarios extrapiramidales notables (p. ej., temblores, inquietud, comportamiento frenético), especialmente a dosis más altas o en especies sensibles como los caballos.
Mecanismo de acción
Metoclopramide exerts its effects through both peripheral gastrointestinal and central nervous system mechanisms:
- Peripheral (GI Tract): Sensitizes upper GI smooth muscle to acetylcholine → increases tone and amplitude of gastric contractions, relaxes the pyloric sphincter, and increases duodenal and jejunal peristalsis. It also increases lower esophageal sphincter (LES) pressure, reducing reflux.
- Central (CNS): Antagonizes Dopamine (D2) receptors in the Chemoreceptor Trigger Zone (CRTZ) → blocks emetic signaling to the vomiting center, providing a potent central antiemetic effect.
- Additional Mechanisms: At higher doses, it exhibits weak 5-HT3 (Serotonin) receptor antagonism and 5-HT4 receptor agonism, further contributing to its antiemetic and prokinetic profiles.
Seguridad y advertencias
Contraindicaciones
- GI hemorrhage
- GI obstruction or perforation
- Hypersensitivity to metoclopramide
- Seizure disorders (relatively contraindicated, lowers seizure threshold)
- Head trauma
- Pheochromocytoma (may induce hypertensive crisis)
- Concurrent phenothiazine therapy
- Dogs with pseudopregnancy (stimulates prolactin release)
- Gastrointestinal obstruction
- Gastrointestinal perforation
- Gastrointestinal hemorrhage
- Seizure disorders (epilepsy)
Efectos adversos
- Dogs: Changes in mentation and behavior (motor restlessness, involuntary spasms, aggression, hyperactivity to drowsiness/depression), constipation
- Cats: Frenzied behavior, disorientation, constipation
- Horses: Severe CNS effects (IV use), alternating sedation and excitement, behavioral changes, abdominal pain
- Extrapyramidal effects (tremors, rigid posture)
- Nausea and diarrhea
- Transient hypertension
- Elevated prolactin levels
- Extrapyramidal signs (tremors, twitching, hyperactivity, restlessness)
- Constipation or diarrhea
- Changes in mentation or behavior
Precauciones
Absolute Contraindication: Do not use in patients with suspected or confirmed GI obstruction, perforation, or hemorrhage.
- Use with extreme caution in patients with a history of seizures, as metoclopramide can lower the seizure threshold.
- Dosage adjustment (reduce CRI by 25-50%) may be required in patients with renal failure.
- Avoid use in dogs experiencing pseudopregnancy due to its prolactin-stimulating effects.
- Monitor closely for extrapyramidal signs (involuntary muscle spasms, rigidity, tremors), which can be reversed with anticholinergic agents like diphenhydramine.
Interacciones farmacológicas
Metoclopramide may enhance the absorption of these agents.
Acute hypotension has been reported if metoclopramide is used concurrently IV.
May antagonize the GI motility effects of metoclopramide.
Oral metoclopramide increases cephalexin peak plasma concentrations and AUC in dogs.
May enhance metoclopramide's GI effects.
Metoclopramide may enhance CNS depressant effects.
Metoclopramide increases the rate and extent of GI absorption.
May antagonize the GI motility effects and enhance metoclopramide's CNS effects.
Could cause hypertension.
May potentiate the extrapyramidal effects of metoclopramide.
Reduces induction requirements of propofol by 20-25%.
Potential for enhanced extrapyramidal effects.
Metoclopramide increases the rate and extent of GI absorption.
Increased risk of extrapyramidal effects and CNS depression
May antagonize the gastrointestinal prokinetic effects of metoclopramide
Antagonize the prokinetic effects on the gastrointestinal tract
Monitorización
- Clinical efficacy (resolution of vomiting, improved GI transit)
- Adverse effects (especially CNS and extrapyramidal signs)
- Clinical response (reduction in vomiting, improved gastric emptying)
- Hydration status and electrolyte balance
- Signs of extrapyramidal adverse effects (twitching, restlessness)
Farmacocinética
Vida media
Absorción
Well absorbed after oral administration, but a significant first-pass effect may reduce systemic bioavailability to ~30% (high interpatient variation). Bioavailability after IM administration is 74-96%. Peak plasma levels generally occur within 2 hours after oral dosing.
Distribución
Well distributed in the body and enters the CNS. Weakly bound to plasma proteins (13-22%). Crosses the placenta and enters milk in concentrations approximately twice those of plasma.
Metabolismo
The majority of the drug is metabolized to glucuronidated or sulfated conjugate forms.
Eliminación
Primarily excreted in the urine (20-25% unchanged, the rest as metabolites). Approximately 5% is excreted in the feces.
Sobredosis
The oral LD50 doses are very high (465-870 mg/kg in laboratory animals), making death from oral overdose unlikely in veterinary patients.
Clinical Signs of Toxicity:
- Sedation, ataxia, agitation
- Extrapyramidal effects (tremors, rigidity, spasms)
- Nausea, vomiting, constipation
Treatment:
- No specific antidote exists.
- If ingestion was recent, empty the stomach using standard protocols.
- Anticholinergic agents that enter the CNS (e.g., diphenhydramine at 2.2 mg/kg IV, or benztropine) are highly effective in controlling extrapyramidal effects.
- Peritoneal dialysis or hemodialysis is not effective for drug removal.
Productos disponibles
Formulaciones
- Oral Tablets: 5 mg, 10 mg
- Oral Disintegrating Tablets: 5 mg, 10 mg
- Oral Syrup: 1 mg/mL
- Injection Solution: 5 mg/mL
- Injectable: 5 mg/ml solution
- Oral: 1 mg/ml solution
Veterinario
- None
- Emeprid 5 mg/ml injectable solution
- Emeprid 1 mg/ml oral solution
- Metomotyl
- Vomend
Etiquetado para humanos
- Metoclopramide HCl Oral Tablets: 5 mg & 10 mg (Reglan, Metozolv, generic)
- Metoclopramide HCl Oral Disintegrating Tablets: 5 mg & 10 mg
- Metoclopramide HCl Oral Syrup: 1 mg/mL
- Metoclopramide HCl Injection Solution: 5 mg/mL (Reglan, generic)
- Maxolon
Estado regulador
Classified as POM-V (Prescription Only Medicine - Veterinarian).
Classified as POM-V.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Photosensitive; must be stored in light-resistant containers at room temperature. Tablets should be kept in tight containers. Injection is stable in solutions with a pH of 2-9 and compatible with D5W, 0.9% NaCl, Ringer's, and LRS.
Información para el cliente
La metoclopramida se utiliza para ayudar a vaciar el estómago y prevenir las náuseas y los vómitos.
- Administración: Para obtener mejores resultados como procinético, administre el medicamento unos 30 minutos antes de la comida de su mascota.
- Cambios de comportamiento: Esté atento a comportamientos inusuales. En perros, esto puede parecer inquietud, caminar de un lado a otro o agresividad. En gatos, puede manifestarse como un comportamiento frenético o desorientación.
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Advertencia de emergencia: Comuníquese con su veterinario de inmediato si su mascota desarrolla espasmos musculares involuntarios, espasmos en los ojos/cara/extremidades o una postura rígida. Estos se conocen como signos extrapiramidales y pueden revertirse rápidamente con medicamentos específicos proporcionados por su veterinario.
- Guarde el medicamento a temperatura ambiente y protéjalo de la luz.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.