Metoclopramide for the treatment of diabetic gastroparesis
Abstract
Introduction : Gastroparesis is a chronic disorder of the stomach characterized by delayed gastric emptying without mechanical obstruction. Diabetes is the most commonly known cause of gastroparesis. Management of diabetic gastroparesis involves lifestyle modifications, glycemic control, pharmacological drugs, and for refractory cases surgical treatments. Metoclopramide remains the only drug approved by the Food and Drug Administration for diabetic gastroparesis. The aim of this article is to provide a concise review of the pharmacology, clinical efficacy and tolerability of metoclopramide. Areas covered : We searched PubMed using the key words 'metoclopramide', 'diabetic gastroparesis', and 'gastric emptying'. The relevant articles and their bibliography were reviewed. Metoclopramide acts on several different receptors; primarily as a dopamine receptor antagonist, both peripherally improving gastric emptying, and centrally resulting in an anti-emetic effect. Metoclopramide side effects, mostly related to its ability to cross the blood-brain barrier, include drowsiness, restlessness, hyperprolactinemia, and tardive dyskinesia (TD), a movement disorder that may be irreversible. Expert opinion : Metoclopramide carries a black box warning for use >12 weeks due to the risk of TD. However, gastroparesis patients experience chronic symptoms often requiring prolonged treatments. Physicians and patients look forward to FDA approval of new agents for gastroparesis with better efficacy…
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Metoclopramide is the only drug approved by the FDA for gastroparesis, and its use is limited to <12 weeks due to extrapyramidal and tardive dyskinesia risk.
“Metoclopramide, the only drug approved by the FDA for gastroparesis, is limited to < 12 weeks due to extrapyramidal and tardive dyskinesia risk [3, 14, 120, 121]”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [121]
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- Authors
- Shakhatreh, M., Jehangir, A., Malik, Z., & Parkman, H. P.
- Affiliations
- Temple University (US)
- Corresponding author
- Parkman, Henry P.
- Venue
- Expert Review of Gastroenterology & Hepatology
- Publisher
- Informa UK Limited
- Published
- 2019-07-30
- Volume
- 13
- Issue
- 8
- Pages
- 711-721
- ISSN
- 1747-4124 (ISSN-L)
- 1747-4132
- OpenAlex
- W2959362507
- Cited by
- 83
- References
- 0
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 17 · 2023: 14 · 2022: 9 · 2021: 10 · 2020: 9 · 2019: 5
- FWCI
- 7.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Review of Gastroenterology & Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- metoclopramide, diabetic gastroparesis, delayed gastric emptying, dopamine antagonists, antiemetic effect, tardive dyskinesia, hyperprolactinemia, adverse drug reactions, black box warning, clinical efficacy, tolerability
- MeSH terms
- Gastric Emptying, Humans, Metoclopramide, Treatment Outcome, Gastroparesis, Upper Gastrointestinal Tract, Diabetes Complications, Dopamine D2 Receptor Antagonists
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