Cerucal®-Teva (Metoclopramide) 10 mg/2 ml, 10 ampoules

Other/Common brand names: Reglan® (USA, Canada), Maxolon® (UK, Australia, New Zealand), Pramin® (Australia, Israel), Clopra® (India), Degan® (EU), Metozolv ODT® (USA), Gastrosil®, Pylomid® (Latin America)

What is Cerucal®-Teva (Metoclopramide) and how does it work?

Cerucal®-Teva is a medication that contains the active ingredient metoclopramide, which is widely used to treat and prevent nausea and vomiting.

It belongs to a class of drugs known as gastrointestinal prokinetics, which help improve the movement of the stomach and intestines, allowing food to move more smoothly through the digestive system.

Metoclopramide works by blocking dopamine receptors in the brain, particularly in the area responsible for triggering nausea and vomiting (the chemoreceptor trigger zone or CTZ).

By doing this, the medication reduces the signals that cause nausea and vomiting.

Additionally, it stimulates the muscles of the stomach, helping with gastric emptying and improving digestion, making it particularly useful in conditions where slowed digestion is an issue, such as gastroparesis (slow stomach emptying).

Cerucal®-Teva is often prescribed in situations such as post-surgery or cancer treatment (chemotherapy or radiation therapy), where nausea and vomiting are common side effects.

It's also effective in managing nausea caused by migraine attacks and, in some cases, for diagnostic procedures involving the upper gastrointestinal tract.

What is Metoclopramide used for?

Cerucal®-Teva is used for various conditions related to nausea and vomiting, including:

• Prevention of post-operative nausea and vomiting.
• Treatment of nausea and vomiting caused by migraines.
• Prevention of nausea and vomiting induced by radiation therapy.

In children (aged 2 to 18), it is used for:

• Prevention of delayed nausea and vomiting induced by chemotherapy (second-line treatment).
• Treatment of post-operative nausea and vomiting (second-line treatment).

How should Cerucal®-Teva be administered?

Cerucal®-Teva is available as a solution for injection, which can be administered either intravenously (IV) or intramuscularly (IM), depending on the specific needs of the patient and the condition being treated.

Administration in Adults:

For adults, the standard dose is 10 mg, which can be given 1 to 3 times a day, depending on the severity of the symptoms. The maximum single dose is 10 mg, and the maximum daily dose is 30 mg. Intravenous doses should be given as a slow bolus injection over at least 3 minutes to reduce the risk of side effects, such as low blood pressure or agitation.

Administration in Children:

For children aged 2 to 18 years, the dosage is based on body weight:

• Ages 2 to 5 years: 0.1 to 0.15 mg/kg body weight per dose, with a maximum total daily dose of 0.5 mg/kg body weight.
• Ages 5 to 9 years: 2.5 mg per dose, administered up to 3 times a day, depending on the child’s weight.
• Ages 9 to 18 years: 5 mg per dose, up to 3 times a day, not exceeding a daily total of 30 mg.

It's important to keep a minimum 6-hour interval between doses to avoid excessive accumulation of the drug, which could increase the risk of side effects, especially in children and young adults.

Special Considerations:

• Elderly Patients or those with kidney or liver impairment may require a lower dose due to slower metabolism and excretion of the drug.
• Treatment duration is usually short-term. For nausea and vomiting caused by chemotherapy, for example, the maximum recommended duration is 5 days, and for post-operative nausea, no more than 48 hours.

Method of Administration:

The solution can be administered through IV injections or IM injections. When given intravenously, the injection should be slow (at least 3 minutes) to reduce risks of adverse reactions like hypotension (low blood pressure) or restlessness (akathisia).

In some cases, particularly for diagnostic tests or procedures involving the upper gastrointestinal tract, the medication is given 10 minutes before the procedure to help with stomach emptying and reduce nausea.

Are there any side effects of Metoclopramide?

Common side effects include:

• Drowsiness
• Fatigue
• Diarrhea
• Muscle stiffness or twitching (especially in children or when using high doses).

More serious side effects, although less common, may include:

• Neurological disorders such as involuntary muscle movements, known as tardive dyskinesia, especially in elderly patients.
• Heart problems such as bradycardia (slow heart rate) or changes in heart rhythm.

If any severe side effects occur, it’s important to discontinue use and seek medical attention immediately.

Who should not use Cerucal®-Teva?

Cerucal®-Teva is contraindicated for people who:

• Have a history of gastrointestinal bleeding or blockages.
• Suffer from epilepsy or Parkinson's disease.
• Are in the first or third trimester of pregnancy.
• Are children under 2 years of age.

Additionally, it should not be used in conjunction with certain medications such as levodopa or dopaminergic agonists due to the risk of adverse reactions.

What precautions should be taken while using Metoclopramide?

Before starting treatment with Cerucal®-Teva, patients should inform their doctor about any pre-existing medical conditions, especially neurological disorders, kidney or liver issues, and heart problems.

Special care is needed for elderly patients and those with an electrolyte imbalance or slow heart rate, as they are more susceptible to side effects.

Metoclopramide may cause drowsiness, so it is advised to avoid operating heavy machinery or driving while taking this medication.

How should Cerucal®-Teva be stored?

Cerucal®-Teva should be stored at temperatures below 30°C (86°F) and kept out of direct light.

Ensure that it is kept in a safe place, out of the reach of children.

Do not use the product beyond its expiration date.