Metoclopramide + Paracetamol

Indications

Metoclopramide + Paracetamol is used for: Migraine

Adult Dose

Oral Migraine Adult: Each tablet containing paracetamol 500 mg and metoclopramide 5 mg: >20 yr: Initially, 2 tablets at first warning of an attack. May repeat doses at 4 hrly intervals. Max: 6 tablets/24 hr. 15-20 yr and ?60 kg: Initially, 2 tablets at first warning of an attack. May repeat doses at 4 hrly intervals. Max: 5 tablets/24 hr. 15-20 yr and 30-59 kg or 12-14 yr and >30 kg: Initially, 1 tablet at first warning of an attack. May repeat doses at 4 hrly intervals. Max: 3 tablets/24 hr.

Child Dose

Renal Dose

Administration

Contra Indications

Lactation. Children <12 yr.

Precautions

Porphyria, epilepsy, parkinsonism, history of depression, pregnancy. Renal or hepatic impairment. May impair ability to drive or operate machinery. Risk of acute hypersensitivity reactions in patients with phaeochromocytoma. Exclude the possibility of an underlying disorder if patient has persistent vomiting.

Pregnancy-Lactation

Interactions

Action of metoclopramide may be antagonised by anticholinergics and opioid analgesics. Metoclopramide may affect the absorption of orally administered drugs when given together.

Adverse Effects

Side effects of Metoclopramide + Paracetamol : Nausea, allergic reactions, skin rashes, acute renal tubular necrosis. Constipation or diarrhoea; drowsiness, headache, depression, lassitude, extrapyramidal reactions (especially if combined with phenothiazines); galactorrhoea; parkinsonism; neuroleptic malignant syndrome; tardive dyskinesia. Potentially Fatal: Paracetamol: Very rare, blood dyscrasias (e.g. thrombocytopenia, leucopenia, neutropenia, agranulocytosis); liver damage. Metoclopramide: Very rarely, hypertensive crisis in patients with pheochromocytoma. Cardiac conduction disorders (IV admin).

Mechanism of Action

Metoclopramide is a dopamine antagonist, which binds to D2 receptors in the central and peripheral nervous system. It has anticholinesterase and antiemetic effects. Paracetamol is a centrally and peripherally acting non-opioid analgesic and antipyretic.