Nutramid 10mg

Tablet

Pack Size : 10 Tablet x 1 strip

Generics : Metoclopramide Hydrochloride

Manufacturer : Acme Laboratories Ltd.

Best Price * TK 3.50

* Delivery will be done in Dhaka city only.

Alternative Product

Syrup Metocol - 5mg Opsonin Pharma Ltd.

Tk 15.87

Injection Nutramid 1mg/ml Acme Laboratories Ltd.

Tk 9.64

Syrup Nutramid 5mg/5ml Acme Laboratories Ltd.

Tk 10.68

More Information About - Nutramid 10mg

Description

Generic Name

Metoclopramide Hydrochloride

Precaution

Patients w/ underlying neurological conditions, cardiac conduction disturbances, uncorrected electrolyte imbalance, bradycardia. Children, elderly. Renal or hepatic impairment, porphyria, epilepsy, Parkinson's disease, history of depression. Ability to drive or operate machineries may be impaired. Pregnancy and lactation. Monitor patients on prolonged therapy. Increased risk of tardive dyskinesia in patients on prolonged or high-dose treatment. Lactation: Drug crosses into breast milk; use caution; concern may be warranted according to American Academy of Pediatrics

Indication

Gastro-oesophageal reflux disease, Diabetic gastric stasis, Nausea and vomiting associated w/ cancer chemotherapy or radiotherapy, Postoperative nausea and vomiting

Contra Indication

GI haemorrhage, mechanical obstruction or GI perforation; confirmed or suspected pheochromocytoma; history of neuroleptic or metoclopramide-induced tardive dyskinesia; epilepsy, Parkinson's disease; history of methaemoglobinaemia w/ metoclopramide or of NADH cytochrome-b5 deficiency. Concomitant use w/ levodopa or dopaminergic agonists.

Dose

N/A

Side Effect

>10% Extrapyramidal symptoms (dystonic reactions in 25% of young adults 18-30 years old) 1-10% Fatigue (2-10%),Restlessness (10%),Sedation (10%),Headache (4-5%),Dizziness (1-4%),Somnolence (2-3%) Frequency Not Defined Diarrhea,Nausea,Galactorrhea,Gynecomastia,Impotence,Menstrual disorders,Neuroleptic malignant syndrome,Hematologic abnormalities Potentially Fatal: Neuroleptic malignant syndrome; cardiac conduction disorders may occur with IV dosage form.

Pregnancy Category

Name : Not Classified

Description

FDA has not yet classified the drug into a specified pregnancy category.

Mode of Action

Metoclopramide enhances the motility of the upper GI tract and increases gastric emptying without affecting gastric, biliary or pancreatic secretions. It increases duodenal peristalsis which decreases intestinal transit time, and increases lower oesophageal sphincter tone. It is also a potent central dopamine-receptor antagonist and may also have serotonin-receptor (5-HT3) antagonist properties.

Interaction

Increased sedative effects with CNS depressants. GI effects antagonised by antimuscarinics and opioids. Reduces absorption of digoxin. Increases absorption of ciclosporin, levodopa, aspirin, paracetamol. Interferes with hypoprolactinaemic effect of bromocriptine. Inhibits serum cholinesterase and prolongs neuromuscular blockade produced by suxamethonium and mivacurium. Potentially Fatal: Serotonin syndrome with sertraline (SSRI).

Pregnancy Category Note

Pregnancy Published studies, including retrospective cohort studies, national registry studies, and meta-analyses, do not report an increased risk of adverse pregnancy-related outcomes with use of metoclopramide during pregnancy. There are potential risks to neonate following exposure in utero to metoclopramide during delivery; in animal reproduction studies, no adverse developmental effects were observed with oral administration of metoclopramide to pregnant rats and rabbits at exposures about 6 and 12 times the maximum recommended human dose (MRHD) Metoclopramide crosses the placental barrier and may cause extrapyramidal signs and methemoglobinemia in neonates with maternal administration during delivery; monitor neonates for extrapyramidal signs Lactation Limited published data report the presence of metoclopramide in human milk in variable amounts; breastfed infants exposed to metoclopramide have experienced gastrointestinal adverse reactions, including intestinal discomfort and increased intestinal gas formation; metoclopramide elevates prolactin levels; however, published data are not adequate to support drug effects on milk production; developmental and health benefits of breastfeeding should be considered along with mother?s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition Monitor breastfeeding neonates because metoclopramide may cause extrapyramidal signs (dystonias) and methemoglobinemia

Adult Dose

Oral Diabetic gastric stasis Adult: 10 mg 4 times daily for 2-8 wk. Nausea and vomiting associated with cancer chemotherapy or radiotherapy Adult: 10 mg, up to tid. Max duration: 5 days. Gastro-oesophageal reflux disease Adult: 10-15 mg 4 times daily, depending on severity of symptoms. If symptoms are intermittent, may give single doses of 20 mg prior to provoking situation. Max duration: 12 wk. Elderly: 5 mg/dose. Parenteral Diabetic gastric stasis Adult: 10 mg 4 times daily by IM inj or slow IV inj over 1-2 min for up to 10 days. Convert to oral admin when symptoms subside sufficiently. Intravenous Prophylaxis of chemotherapy-induced nausea and vomiting Adult: For highly emetogenic drugs/regimens: Initially, 2 mg/kg by slow inj over at least 15 min, 30 min before chemotherapy. Repeat 2 hrly for 2 doses, then 3 hrly for 3 doses. For less emetogenic drugs/regimens: 1 mg/kg may be used. Max duration: 5 days. Premedication for radiologic examination of the upper gastrointestinal tract; Intubation of the small intestine Adult: 10 mg as a single dose by slow inj over 1-2 min. Parenteral Prophylaxis of postoperative nausea and vomiting Adult: 10 mg as a single dose by IM or slow IV inj over at least 3 min. Hepatic impairment: Severe: Reduce dose by 50%.

Child Dose

Small Bowel Intubation/Radiologic Examination of Upper GI Tract <6 years old: 0.1 mg/kg IV over 1-2 minutes 6-14 years old: 2.5-5 mg IV over 1-2 minutes >14 years old: 10 mg IV over 1-2 minutes Gastroesophageal Reflux Disease Neonate: 0.15 mg/kg IV q6hr Infant: 0.1 mg/kg IV/IM/PO q6-8hr 30 minutes before meals and at bedtime Not to exceed 0.3-0.75 mg/kg/day Diabetic Gastroparesis <6 years old: 0.1 mg/kg PO q8hr; not to exceed 0.1 mg/kg >6 years old: 0.5 mg/kg/day PO divided q8hr Postoperative Nausea & Vomiting 0.1-2 mg/kg IV q6-8hr PRN Chemotherapy-Induced Nausea & Vomiting 1-2 mg/kg IV (infused over at least 15 minutes) 30 minutes before chemotherapy; repeat q2-4hr; pretreatment with diphenhydramine decreases risk of extrapyramidal adverse effects

Renal Dose

Renal impairment: CrCl <40 mL/min, decrease dose by 50%; CrCl <10 mL/min, decrease dose by 75%

Administration

Should be taken on an empty stomach. Take ? hr before meals. IV Administration NS is preferred diluent because drug is most stable in this solution Dose <10 mg: IV push over 1-2 minutes Dose >10 mg: Dilute in 50 mL D5W or NS, and infuse over at least 15 minutes

Disclaimer

The information provided herein are for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please note that this information should not be treated as a replacement for physical medical consultation or advice. Great effort has been placed to provide accurate and comprehensive data. However, Medicart along with its authors and editors make no representations or warranties and specifically disclaim all liability for any medical information provided on the site. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company.