The Safety of Metoclopramide in Children: A Systematic Review and Meta-Analysis

Abstract

The most commonly reported adverse effects associated with the use of metoclopramide in children-EPS, diarrhea, and sedation-were reversible and of no long-term significance. Adverse effects that were life threatening or slow to resolve were rarely associated with its use in children.

Guideline for the Treatment of Breakthrough and the Prevention of Refractory Chemotherapy‐Induced Nausea and Vomiting in Children With Cancer

“…[11] In a recent systematic review and meta-analysis of adverse effects of metoclopramide in children, the mean proportion of children reported to have EPS was 9% (95% CI: 5 to 17%) or diarrhea was 6% (95% CI: 3 to 9%). [5] In singledose and multiple-dose metoclopramide studies, the mean proportion of children reported to experience sedation was 2% (95% CI: 1 to 5%) and 6% (95% CI: 3 to 12%), respectively. Since Health Canada and the European Medicines Agency have recently issued warnings regarding the risk of EPS in young children receiving metoclopramide, the panel recommends that metoclopramide be avoided in children less than 1-year old.…”

“…Therefore systematic reviews evaluating the safety of metoclopramide [5] and prochlorperazine [6] were undertaken, and an existing systematic review of the safety of olanzapine [7] in children was considered by the panel. Primary studies reported separately for patients ࣘ18 years of age or the mean or median age pf participants was ࣘ18 years; iii.…”

Fever in Children: Pearls and Pitfalls

“…Intoxication from hyperthermia-inducing drugs may result in severe hyperthermia; involved drugs include stimulating/sympathomimetic drugs (cocaine, methamphetamine, MDMA), anticholinergic drugs (e.g., antihistamines, tricyclic antidepressants), serotoninergic drugs (serotonin syndrome), and salicylates. Neuroleptic malignant syndrome is a severe idiosyncratic reaction to antipsychotic agents, but also antiemetic agents such as metoclopramide [ 34 ], characterized by altered mental status, muscular rigidity, movement disorders, hyperthermia and autonomic dysfunction [ 35 ]. Malignant hyperthermia is a rare genetic disorder (1 in 14,000 pediatric general anesthesia) associated with several forms of congenital myopathy and triggered by succinylcholine or inhalational anesthetics agents; clinical features include rapid onset of extremely high temperature (38.5–46 °C), usually heralded by masseters spasm, muscle rigidity, metabolic acidosis, and hemodynamic collapse.…”

Seftriakson Dirençli Shigella flexneri’nin Neden Olduğu Ensefalopati Olgusu

“…Olgumuz ateş, bilinç bulanıklığı, halüsinasyon takibinde gelişen kanlı ishal bulgularıyla şigelloz tablosuna uymaktaydı. Metoklopramid gibi santral sinir sistemi üzerine yan etkileri olduğu bilinen ilaç kullanımı mevcuttu ancak literatürde metoklopramide bağlı yan etkilerin daha çok tekrarlayan kullanımlarda ve ekstrapramidal sistem üzerinde olduğu bildirilmiştir (7). Şigelloza bağlı en sık nörolojik komplikasyon nöbetler olsa da nadiren halüsinasyonlar da bildirilmiştir.…”