Metoclopramide - has anyone any experience of this ?

[gingeroots]

GP has prescribed for my 92 year old mother's reflux on eating but having googled it I'm panicking a bit .

I can cope with all the warnings about care needed in the elderly ,those with congestive heart failure and those with kidney failure - all of which she has - but am anxious about possibilty that she has undiagnosed gastric bleeding .

She's on 300mg aspirin daily and in the past became so anemic that she had to have blood transfusions . But she refused any invasive testing to investigate causes of anemia .

She's v.aneamic at moment and still going down ,so I'm worried that she might have some internal bleeding .

GP is aware of anemia but I didn't raise my concern about internal bleeding because I only googled when I got the prescription .

I don't want the GP to think I'm questioning her judgement ( it wasn't my mums usual GP ) and I know googling is a bit indiscriminate ,but should I ring surgery and raise this ?

Hi, sorry about your mum's illness. Hope to help but I am a bit confused. Is it the metoclopramide you are worried about, as per the thread title, or the anaemia? Do you know what the Hb (haemoglobin) level actually is i.e. how anaemic she is?

I'm allergic to Asprin - it causes internal bleeding- but have taken metoclopromide for hyperemisis with no ill effect (but no respite from the hyperemisis).

Sorry -I didn't word things well . Thank you for replying anyway !

I'm worried because one of the "contra indications " in giving this drug is internal bleeding ,and I'm not sure the GP took the possibilty that this might be happening into account .

Drugs always have a long list of " use with care if ... " and I don't know how important this particular one is .

Can you speak to an all night pharmacist? They are usually really good with things like this.

However i woukd say that if you read the contraindications of every drug, you wouldnt even take paracetamol.

moss -absolutely .
But this one does sound scary - don't take for longer than 12 weeks for example . No mention of that by GP . Plus review date of October on prescrip ....all makes me nervous .

I guess I'll have to ring surgery in morning .

I've not collected prescrip yet .

Ask a pharmacist, they're usually much more knowledgeable about the contraindications of certain medications and whether they are suitable for elderly patients with other health conditions. I've been on Metoclopramide for much longer than 12 weeks and was fine until started having muscle twitches, but I should say that I was on a lot of other medication at the time, so may have been any of them causing it. I think it only recommends being on them for 12 weeks because any symptoms of reflux, severe indigestion, anaemia or losing weight that have been going on for this long are supposed to be investigated by OGD or a scope down the throat looking at your stomach, but in my case I had had such investigations done and nothing was found. If she doesn't react well there are other medications that can be used for reflux, Domperidone springs to mind.

Thanks hello .

I know I shouldn't google ,but ....it's all so complicated with elderly ,lots of drugs and stuff that my mother doesn't really tell GP .

I feel responsible and not able to totally rely on GP .
Which TBH I feel ok about ,they're not magicians .

Sounds as though you've been through the mill hello ,do hope you're on the mend .

Can I ask hello were you aware of it's effects ,other than not having reflux/being sick ?

The GP said only that " it speeds everything up " and I'm wondering if that will affect the bowels and if my mother will be rushing to the loo ?

And really what I'm concerned with is not so much the interaction with other medication but the physical affect ( IYSWIM ) - I imagine it making muscles squeeze harder and if she does have internal bleeding that it will exacerbate that .
And also her irregular heart beat .

I hate all this and don't know how I can ring the GP and basically tell her that now I've been looking on line I want to query her judgement .

I've taken it for hyperemesis, but also, way back when, I had appalling food poisoning (campylobacter) with a bowel bleed (yes as ghastly as it sounds). A day after losing a lot of blood, and before they knew what was wrong with me, I was prescribed it to curb the horrendous nausea and vomiting that was the second stage of the infection. Ok so I was an otherwise healthy young 21 year old, but they did prescribe it to me following a gastric bleed of unknown cause.

That said, I would agree with others who have said pop into a pharmacist and ask them for reassurance. I had to do that once during pregnancy when I read too much into the contraindications on some ABs. They were very reassuring. I also don't think any GP would mind reassuring a worried carer who respectfully rang just to check it was ok to take the drug given the medical history.

In terms of side effects - I had muscle twitches but these are more kind of twitches in large muscles of limbs, so a nasty restless leg feeling really. I felt drowsy and a bit depressed too. It did get rid of nausea tho, and yes I was given it indefinitely til the nausea cleared up.

Hi gingeroots, I was aware of it's effects because I also Googled it because I always like to know about the possible side-effects etc. but with being on lots of medication for the past few years I've now realised it's not always the best thing to do because you're almost anticipating getting side-effects. Metoclopramide can speed things up - it works by helping the stomach empty faster, the reasoning being if the stomach's less full you won't feel so sick or have the problems to do with reflux. It can also affect the bowels, which is why they usually start you out on a low dose, but if the effects are too much for your mother there are lots of other drugs she could take instead, or you could consider maybe giving a low dose of Immodium to negate the effects, but then again you probably don't want to be giving her anymore pills. There are plenty for nausea - Domperidone works in a similar way to Metoclopramide so if it doesn't agree with your mother it might not be the best alternative, but there are others such as Cyclizine and Buccastem. I can see what you mean about the internal bleeding and your mother's irregular heartbeat, in this case I actually would advise you maybe to question the medication she's been prescribed. GPs are not gods and although they frown upon patients Googling symptoms they are also there to set your mind at ease that what they have prescribed is appropriate for that individual case. Although if ringing the GP I would be very nice to them as some can get quite upset if you're seen to question their professional judgment. I would go in with the premise that you've only got your mother's best interests at heart, they should be quite understanding and sympathetic of that. Or if you don't want to go down the route of asking the GP, maybe ask a pharmacist - I have on more than one occasion had pharmacists advise me of bad drug combinations and actually double-check with the GP that what they're prescribing is actually correct.

I have a working diagnosis of IBS with extreme nausea and occasional vomiting and have suffered for the past 3 years with it. I say a working diagnosis of IBS because IBS in my case stands for we haven't a bloody clue so we'll call it that! Many doctors underestimate the impact nausea can have on you - I've been in extreme pain and would prefer that any day to unrelenting nausea, which leaves you so lethargic and if it goes on for a long time, quite depressed. My symptoms are a lot better now that I take Domperidone and Cyclizine for the nausea, but there are still many foods I can't tolerate and when it's really bad I go on a completely liquid diet to get some symptom relief!

I do hope your mother feels better soon! If you're worried about weight loss you can always ask your GP about prescribing some nutritional supplements such as Fortisip, which is like Complan. It's a milkshake type drink that contains quite a lot of calories and contains a lot of vitamins and minerals that are sometimes hard to get if you're on a very restrictive diet.

All the best

Oh thank you mumofstan and hello - lovely MN people to take the time to talk to me .

I'm very deferrential by nature ,hence my hesitation in phoning Gp ,so will be very polite .

Mmm...Fortisip .... if only my mum was the sort of person who could be persuaded to try something like that .
If only they made it in the form of pork pies and cheese straws ... my mums idea of a balanced diet !

But thanks .. maybe I'll suggest it ,she might surprise me .