Patient/caregiver was educated on how to take Metoclopramide as follows:

1. Take this medication as ordered by your physician. Do not change the dose and frequency on this medication without consulting your doctor. Take the medication dose for the duration prescribed without fail.
2. Take the medication dose at the same time, every day, to avoid forgetting the intake of medication. Taking the medication at regularly spaced intervals help maintain appropriate blood levels of Metoclopramide needed to derive the beneficial effects.
3. Metoclopramide use can sometimes cause nausea and vomiting. Metoclopramide may be taken with a small snack, as this can help avoid the unpleasant gastrointestinal symptoms.
4. Metoclopramide intake can induce some dizziness and results in sleep. Starting Metoclopramide on a low dose and gradually increasing it to the desired dose can help accommodate to the dizzy symptoms. If the dizziness becomes bothersome, report it to your physician and other health care personnel, for any change in plan of care to be considered. Stay away from activities, such as, driving and operating heavy machinery, until they are used to the side effects caused by Metoclopramide.
5. Do not take Metoclopramide with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the confusion caused by Metoclopramide. A number of OTC cough medications, antihistamines, and antianxiety medications, can potentiate the confusion caused by Metoclopramide and so, must be avoided taking along with Metoclopramide.
6. Take the Metoclopramide regular tablet as a whole, using a glass of water. If you encounter difficulty swallowing the whole tablet, you may cut the tablet and swallow it in pieces with a glass of water. You can also crush the regular tablet and sprinkle the powder on a spoon of apple sauce or jello or pudding, to facilitate an easy swallow.
7. When taking Metoclopramide as an oral liquid/suspension, use a measuring spoon/cup to measure the correct dose being taken, in order to avoid risk for over/under dosing. Also, do not forgot to shake the suspension well before you use it.
8. Metoclopramide is also available as an orally disintegrating tablet, which absorbs moisture from the atmosphere around rapidly and can start to dissolve. So, remove only one dose from the package at a time, just when it is time for intake of the dose. Make sure the hands are dry before getting the tablet out of the package. The orally disintegrating tablet can be very delicate and start to crumble, while taking out from the package. Handle the tablet carefully to avoid this damage to the tablet. If the tablet crumbles during this process, discard the tablet and take a new tablet out from the package. This orally disintegrating tablet must be placed on the tongue, allow it to dissolve in the mouth for one minute, before swallowing the remnants in the mouth with saliva.
9. For individuals with swallowing difficulties and extremely unpleasant gastrointestinal symptoms, such as, severe nausea and vomiting with oral Metoclopramide intake, it could also be administered parenterally, by either IM or IV route, as ordered.
10. If you are prescribed metoclopramide to manage symptoms of nausea and vomiting or to treat the symptoms of slow stomach emptying due to diabetes, take the medication 30 minutes before the meal time. If you are prescribed metoclopramide to treat symptoms of GERD, it may be taken around the time of the day, when the symptoms of GERD are more prominent.
11. Metoclopramide can interact with a number of medications and OTC products and can precipitate serious reactions. If you are being newly started on Metoclopramide, discuss with your physician regarding all your current medications and their safety with Metoclopramide. Also, notify your physician regarding any current Metoclopramide intake, if you are being started on any new medications and discuss their safety with Metoclopramide.
12. Metoclopramide carries the risk of causing and aggravating some underlying cardiac arrhythmias, leading to severe debility and death. Individuals can present with signs and symptoms of arrhythmias, such as, frequent episodes of fatigue, lightheadedness, near fainting, shortness of breath, chest pain or discomfort, and/or pounding heartbeat. Discuss with your physician regarding your heart health, if you are newly started on Metoclopramide. If you are newly diagnosed with any cardiac conditions, discuss with your physician regarding your safety with regards to continuing on Metoclopramide, if you have been using the medication for long.
13. Metoclopramide also can induce a life-threatening reaction called Neuroleptic malignant syndrome. Individuals taking Metoclopramide can present with high fever, episodes of confusion, muscle rigidity, elevated blood pressure and rapid heart rate. Severe cases can present with muscle breakdown, elevated potassium levels in the blood due to muscle destruction, life-threatening cardiac arrhythmias due to the elevated blood potassium, and seizures.
14. Metoclopramide use can induce symptoms of parkinson’s disease, such as, tremors, muscle spasms, rigidity, and difficulty initiating movements. Metoclopramide use can aggravate these symptoms in individuals with history of parkinson’s disease and so, Metoclopramide must be avoided or used cautiously in individuals with history of parkinson’s disease. Also, Metoclopramide has potential to cause seizure episodes, especially in individuals with seizure history and so, must be avoided or cautiously uses in individuals with seizure history. Discuss with your physician regarding your status on seizures and parkinson’s disease, if any, and your safety with using Metoclopramide.
15. Metoclopramide intake can result in abnormal involuntary muscle movementscalled tardive dyskinesia, when individuals present with movements such as, lip smacking, chewing, grimacing, frowning, and sticking out of tongue. Individuals can also present with spasms of the laryngeal muscles, resulting in stridor and difficulty breathing. Metoclopramide intake can also result in akathisia, characterized by a sense of restlessness, inability to stay still, foot tapping, and pacing. Discuss with your physician and other health care personnel regarding your history of tardive dyskinesia, if any, and your safety with Metoclopramide.
16. Metoclopramide use carries the risk of inducing mood changes and depressive symptoms. Patients with history of mood disorders, secondary to Metoclopramide intake, can experience deterioration and worsening of symptoms of mood disorders. Individuals can present with complaints such as, feeling low, anxiety, panic attacks, trouble sleeping, hallucinations, gross appetite changes, impulsiveness, agitation, aggression, and suicidal thoughts. Discuss with your physician regarding history of mood disorders, if any, and your safety with Metoclopramide use.
17. Metoclopramide can take some time to fairly adjust to your body and reach a therapeutic level in your blood, before providing relief from symptoms of nausea and vomiting, GERD, and slow stomach emptying. Do not discontinue taking the medication without your physician’s consult, as you failed to see the desired result immediately after taking the medication.
18. Continue taking Metoclopramide as ordered, even if you experience relief from the symptoms. Abrupt discontinuation on Metoclopramide intake can result in recurrence of the nausea and vomiting and symptoms of GERD and delayed stomach emptying. Sudden discontinuation of Metoclopramide intake, after prolonged use, can also result in onset of severe withdrawal symptoms, such as, nervousness and anxiety. Discontinuation on Metoclopramide, after prolonged use, must be slow and gradual, using tapering doses and only on your physician’s recommendation.
19. Your physician could change the dose of Metoclopramide, based on the relief obtained or side-effects developed. So, maintain compliance with follow-up physician appointments, to update on the relief from symptoms. Be accommodative to the plan of dose changes, if need be, until you show an optimum response. Observe compliance with any lab draws ordered.
20. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.