Metoclopramide is generally not recommended for long-term use due to the potential for adverse effects, particularly neurological ones such as tardive dyskinesia.
Neurological adverse effects
- Chronic use of metoclopramide, defined as use for more than 12 weeks, should be avoided due to the increased risk of developing movement disorders such as tardive dyskinesia
- Regulatory agencies in North America and Europe have re-evaluated the safety of metoclopramide, resulting in recommendations and restrictions to minimize the risk of neurological and other adverse reactions associated with its use
Use in specific populations
- In pregnant patients, metoclopramide should be used only if clearly needed, and chronic use should be avoided due to the risk of movement disorders
- In critically ill patients, metoclopramide is considered effective in enhancing gastric emptying and facilitating early enteral nutrition. However, its use should be carefully monitored due to the potential for adverse effects
While metoclopramide can be effective in certain clinical situations, its long-term use is generally not recommended due to the potential for serious adverse effects, particularly neurological ones. The decision to use metoclopramide should be based on a careful consideration of the risk-benefit ratio in each individual patient.