Common adverse drug reactions associated with metoclopramide therapy include agitation (akathisia) and focal dystonia. Rare UAWs include hypertension, hypotension, hyperprolactinemia leading to galactorrhea, headache, and extrapyramidal effects such as oculogyric crises.
Metoclopramide may be the most common cause of drug-induced movement disorders. The risk of extrapyramidal effects is increased in people younger than 20 years and with high-dose or prolonged therapy. Tardive dyskinesia may be persistent and irreversible in some people. Most reports of tardive dyskinesias occur in people who have taken metoclopramide for longer than three months.
Dystonic reactions can be treated with benzatropine, diphenhydramine, trihexyphenidyl or procyclidine. Symptoms usually resolve with diphenhydramine injected intramuscularly. Agents of the benzodiazepine class can be helpful, but the benefit is usually small, and the side effects of sedation and weakness can be problematic.
In einigen Fällen stehen die Akathisieeffekte von Metoclopramid in direktem Zusammenhang mit der Infusionsrate, wenn das Medikament intravenös verabreicht wird. Die Nebenwirkungen traten in der Regel in den ersten 15 Minuten nach der Dosis von Metoclopramid auf.
LD50 (rat, oral): 750 mg/kg