Latest advice from the TGA;
Health professionals are advised of the risk of neurological adverse events, including extrapyramidal disorders and tardive dyskinesia, associated with the use of metoclopramide. A risk of rare cardiac conduction disorders has also been identified.
In response to these identified risks, the following changes have been made to the PI for prescription metoclopramide:
- it is contraindicated for children aged under one year
- for young adults (aged under 20 years) and children over one year of age, it is only indicated as second-line therapy
- the total daily dosage, especially for children and young adults, should not normally exceed 0.5 mg/kg bodyweight, with a maximum of 30 mg daily
- the maximum dose for adults is 10 mg three times daily
- the maximum recommended treatment duration is now five days in all age groups.
Dubious clinical efficacy urging higher doses from the British Journal of Anaesthesia83 (5): 761–71 (1999).
Should we just forget about it?