Abstract

Metoclopramide (Maxolon; Primperan) which we last discussed in 1972¹ is widely used to treat heartburn and flatulent dyspepsia, and to facilitate intubation and radiological studies of the upper intestine. It is believed to help by increasing the pressure in the lower oesophageal sphincter and the rate of gastric emptying. It is also valuable in the management of nausea and vomiting due to drugs (including premedicants and anaesthetics), motion sickness, gastrointestinal disorders, and after radiotherapy. Unwanted effects mainly involve the central nervous system and include athetosis, dyskinesias, dystonia, oculogyric crisis and drowsiness. Metoclopramide can cause hyperprolactinaemia and this may occasionally result in galactorrhoea and impotence. The manufacturers advise against its use in early pregnancy.