Metoclopramide Dosages: Your GoodRx Guide

Metoclopramide (Reglan) is a medication that’s approved to treat gastroesophageal reflux disease (GERD) and gastroparesis in people with diabetes. It’s also used off-label to treat nausea and vomiting in some people, including those receiving chemotherapy. 

Below, we’ll cover everything you need to know about metoclopramide dosages.

What’s the typical metoclopramide dosage for adults?

The best metoclopramide dosage depends on what you’re treating. It's available as a tablet, orally disintegrating tablet, and oral liquid. It’s also available as a nasal spray (Gimoti) and injection. Gimoti is only FDA approved for gastroparesis from diabetes. The injection is FDA approved for more conditions than the oral forms, including certain types of nausea and vomiting.

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In this article, we’ll focus on the oral forms of metoclopramide.

GERD

If you’re taking metoclopramide for GERD, you can take it throughout the day or as needed. If you have symptoms all day, you can take 10 mg to 15 mg half an hour before meals and at bedtime for 4 to 12 weeks (1 to 3 months). It’s best to avoid taking metoclopramide for more than 12 weeks (3 months) due to the risk of tardive dyskinesia, a type of movement disorder.

If you only experience occasional GERD symptoms, it may be best to use metoclopramide immediately before situations where you tend to experience symptoms. This is typically a single dose of up to 20 mg.

The maximum dose for GERD is 60 mg per day.

Good to know: Metoclopramide isn’t a first-choice medication option for GERD (first-choice medications are typically proton-pump inhibitors). In fact, the American College of Gastroenterology recommends against using metoclopramide for GERD unless there’s evidence of gastroparesis. 

Gastroparesis is a medical situation where your stomach isn’t working properly. Food and liquid can’t leave your stomach as they normally would, causing pain, nausea, and vomiting. Metoclopramide works by increasing contractions in the stomach and intestines, which helps food move along the gastrointestinal tract and allows the stomach to empty.

Gastroparesis from diabetes

For adults with gastroparesis from diabetes, the typical dose is 10 mg four times daily (before each meal and bedtime). Treatment typically lasts 2 to 8 weeks, depending on how you respond. It’s recommended to limit metoclopramide use to no more than 12 weeks (3 months).

The maximum recommended daily dosage is 40 mg.

Good to know: Gastroparesis can occur in people with diabetes because high blood sugar levels can damage your nerves, including the nerve that controls your stomach and small intestine. In fact, diabetes is the most common cause of gastroparesis.

Nausea and vomiting from chemotherapy (off-label use)

Metoclopramide isn’t FDA approved to prevent or treat chemotherapy-induced nausea and vomiting (CINV). But the National Cancer Institute considers it an option.

For prevention of CINV, metoclopramide is usually given by injection by a healthcare provider. For treatment of CINV, the typical dose is 10 mg to 40 mg by mouth every 4 to 6 hours.

Good to know: Metoclopramide works in various ways to treat nausea and vomiting. First, it blocks the area of the brain (the chemoreceptor trigger zone) and other areas of the body (called serotonin receptors) that can cause vomiting when activated. It also may help treat nausea by encouraging the stomach to empty.

Nausea and vomiting during pregnancy (off-label use)

Although metoclopramide isn’t FDA approved to prevent or treat pregnancy-induced nausea and vomiting, the American College of Obstetricians and Gynecologists considers it an option when lifestyle measures and other medications haven’t worked.

The typical dose is 5 mg to 10 mg mg every 6 to 8 hours by mouth or injected into a muscle. It can also be given intravenously in a healthcare setting if necessary.

Are there any dosage adjustments for medical conditions?

Yes. Your metoclopramide dosage may be lower if you:

• Are older than 65 years old: Older adults may be more sensitive to side effects of metoclopramide. So it may be best to start at a lower dose. Your healthcare provider may increase your dose if you tolerate it well.

• Have existing liver problems: Your provider may check how well your liver is working before prescribing metoclopramide. This is done using blood tests called liver function tests. Your dose will depend on how severe your liver problems are.

• Have existing kidney kidney problems: If you have kidney disease, your healthcare provider may run blood tests to see how well your kidneys work. Your dose will depend on how severe your kidney problems are.

• Take certain medications that block metoclopramide from being broken down (metabolized) by the liver: You may take other medications that interact with metoclopramide. This may increase levels of metoclopramide in the body and raise your risk for side effects. Examples of medications that increase metoclopramide levels include antidepressants such as paroxetine (Paxil), fluoxetine (Prozac), and bupropion (Wellbutrin).

• Are a poor metabolizer of metoclopramide: Some people don’t metabolize metoclopramide normally due to certain genetic factors. In this case, you may experience increased levels of metoclopramide in your system and a higher risk of side effects.

Below is a summary of metoclopramide dosage adjustments for the various situations discussed above.

Can children take metoclopramide?

Metoclopramide isn’t FDA approved for use in children. Tardive dyskinesia and movement-related side effects of metoclopramide are thought to be more common in children than adults. And very young infants may experience a side effect from metoclopramide called methemoglobinemia (a condition where red blood cells don’t work as they normally do).

While some research shows that children may not be more likely to experience side effects from metoclopramide, it’s not clear how safe or effective metoclopramide is in children for conditions such as GERD. If your child’s healthcare provider recommends metoclopramide, talk to them about the risks versus benefits.

What happens if you miss a dose of metoclopramide?

If you miss a dose of metoclopramide, take it as soon as you remember. 

However, if it’s close to the time of your next dose, skip the missed dose. Don’t take double the amount of metoclopramide to make up for a missed dose. This increases your risk of side effects.

What should you do if you take too much metoclopramide?

Taking too much metoclopramide increases your risk of side effects, including drowsiness, confusion, and movement problems. If you take too much metoclopramide, call Poison Control at 1-800-222-1222 right away, or seek emergency treatment immediately.

How to save on metoclopramide

GoodRx may be able to help you save over 60% off the average retail price of generic metoclopramide. The price of generic metoclopramide (thirty 10 mg tablets) at certain pharmacies is as low as $3.00 with a free GoodRx discount.

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Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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