How should Clopram be stored?
Tablets and syrup should be stored between 15 C - 30 C (59 F - 86 F). Injectable Clopram should be stored at room temperature 20 C - 25 C (68 F - 77 F).
What should I discuss with my veterinarian before giving Clopram to my pet:
Tell your veterinarian if your pet has kidney disease, diabetes, high blood pressure or recent stomach surgery. Inform your veterinarian if your pet is pregnant or lactating.
Pregnancy Category B
Reproduction studies performed in rats, mice and rabbits by the I.V., I.M., S.C., and oral routes at maximum levels ranging from 12 to 250 times the human dose have demonstrated no impairment of fertility or significant harm to the fetus due to Clopram. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Adverse effects of Clopram use include extrapyramidal symptoms including the following:,,,,
1. Cerner Multum, Inc. "Australian Product Information." O 0
2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
3. "Product Information. Reglan (Clopram)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Clopram stimulates motility of the upper gastrointestinal tract without stimulating gastric, biliary, or pancreatic secretions. Its mode of action is unclear. It seems to sensitize tissues to the action of acetylcholine. The effect of Clopram on motility is not dependent on intact vagal innervation, but it can be abolished by anticholinergic drugs.
Clopram increases the tone and amplitude of gastric (especially antral) contractions, relaxes the pyloric sphincter and the duodenal bulb, and increases peristalsis of the duodenum and jejunum resulting in accelerated gastric emptying and intestinal transit. It increases the resting tone of the lower esophageal sphincter. It has little, if any, effect on the motility of the colon or gallbladder.
In patients with gastroesophageal reflux and low LESP (lower esophageal sphincter pressure), single oral doses of Clopram produce dose-related increases in LESP. Effects begin at about 5 mg and increase through 20 mg (the largest dose tested). The increase in LESP from a 5 mg dose lasts about 45 minutes and that of 20 mg lasts between 2 and 3 hours. Increased rate of stomach emptying has been observed with single oral doses of 10 mg.
The antiemetic properties of Clopram appear to be a result of its antagonism of central and peripheral dopamine receptors. Dopamine produces nausea and vomiting by stimulation of the medullary chemoreceptor trigger zone (CTZ), and Clopram blocks stimulation of the CTZ by agents like ldopa or apomorphine which are known to increase dopamine levels or to possess dopamine-like effects. Clopram also abolishes the slowing of gastric emptying caused by apomorphine.
Like the phenothiazines and related drugs, which are also dopamine antagonists, Clopram produces sedation and may produce extrapyramidal reactions, although these are comparatively rare (see WARNINGS). Clopram inhibits the central and peripheral effects of apomorphine, induces release of prolactin and causes a transient increase in circulating aldosterone levels, which may be associated with transient fluid retention.
The onset of pharmacological action of Clopram is 1 to 3 minutes following an intravenous dose, 10 to 15 minutes following intramuscular administration, and 30 to 60 minutes following an oral dose; pharmacological effects persist for 1 to 2 hours.
How to use Clopram Hcl
See also Warning section.
Read the Medication Guide provided by your pharmacist before you start taking Clopram and each time you get a refill. If you have any questions, consult your doctor or pharmacist.
Take this medication by mouth 30 minutes before meals and at bedtime, usually 4 times daily or exactly as directed by your doctor. If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
If you are using the disintegrating tablet, do not remove the tablet from the blister pack until right before your dose. Dry your hands before using this medication. Do not use the tablet if it is broken or crumbled. Immediately after removing the tablet, place it on the tongue. Allow it to dissolve completely, then swallow it with saliva. You do not need to take this product with water.
The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
If heartburn only occurs at certain times (such as after the evening meal), your doctor may direct you to take a single dose before those times instead of taking it throughout the day. This will reduce your risk of side effects.
Because of the risk of tardive dyskinesia, do not take this more often, in larger doses, or for longer than directed by your doctor. According to the manufacturer, treatment should not exceed 12 weeks.
To treat diabetic gastroparesis, this medication is usually taken for 2 to 8 weeks until your gut is working well. This condition may recur from time to time. Your doctor may direct you to start taking this medication as soon as your symptoms reappear and stop when you feel better. Ask your doctor for directions for starting and stopping this medication.
Take this medication regularly as directed to get the most benefit from it. To help you remember, take it at the same times before a meal each day.
If you suddenly stop using this medication, you may have withdrawal symptoms (such as dizziness, nervousness, headaches). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used Clopram for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.
Tell your doctor if your condition persists or worsens.
How it Works:
When motility (movement) in the stomach is reduced, food pools and creates a sensation of nausea and bloating. In some cases, bile refluxes from the intestine back into the stomach, causing irritation and more nausea. Clopram normalizes stomach contractions so that food and bile can pass in the correct direction. Additionally, Clopram is able to cross a biochemical blood-brain barrier to control nausea. Clopram helps the vomiting pet by acting directly on the brain to reduce the sensation of nausea.
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Clopram is also available in combination with painkillers for the management of migraine headache in association with nausea. For more information on these medicines please see our separate medicine leaflets Paracetamol and Clopram for migraine (Paramax) and Aspirin and Clopram for migraine (MigraMax).
How should I use Clopram?
Take Clopram exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Use the medicine exactly as directed.
A Clopram injection is given into a muscle or as an infusion into a vein. A healthcare provider will give the injection, usually during surgery, chemotherapy, or a medical procedure.
Clopram oral is taken for only 4 to 12 weeks.
NEVER USE METOCLOPRAMIDE IN LARGER AMOUNTS THAN RECOMMENDED, OR FOR LONGER THAN 12 WEEKS. High doses or long-term use of Clopram can cause a serious movement disorder that may not be reversible. The longer you use Clopram, the more likely you are to develop this movement disorder. The risk of this side effect is higher in diabetics and older adults (especially women).
Clopram is usually taken 30 minutes before meals and at bedtime, or only with meals that usually cause heartburn. Follow your doctor's dosing instructions very carefully.
Do not use two different forms of Clopram (such as tablets and oral syrup) at the same time.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
To take the orally disintegrating tablet (ODT):
Remove a tablet from its blister pack only when you are ready to take the tablet. Use dry hands and take care not to damage a tablet while pushing it out of the blister.
Place the tablet in your mouth and allow it to dissolve, without chewing or swallowing it whole. You may sip liquid if needed to help swallow the dissolved tablet.
Store at room temperature in a tightly-closed container, away from moisture and heat. Keep the bottle tightly closed.
After you stop taking Clopram, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness.
Clopram oral tablet is a prescription drug that’s available as the brand-name drugs Reglan and Metozolv ODT. It’s also available as a generic drug. Generic drugs usually cost less than brand-name versions. In some cases, they may not be available in all strengths or forms as a brand-name drug.
Clopram also comes in an oral solution as well as injectable forms that are only given by a healthcare provider.