Metoclopramide

Metoclopramide is a prescription medication in the phenothiazine class, which vets sometimes prescribe for nausea in canines. It’s especially effective at reducing nausea in dogs undergoing chemotherapy. Phenothiazines act on the nervous system to stop the production of chemical messengers that cause nausea and vomiting. 

In addition to its neurological activity, metoclopramide also stimulates movement in the bowels and causes the stomach to contract. These physiological effects aid digestion and prevent food from backing up into the esophagus, making it harder to regurgitate.  

This medication is sometimes given off-label to induce lactation in nursing dogs with low or no milk supply. Metoclopramide’s lactation-inducing abilities stem from its action as a dopamine receptor antagonist. One function of dopamine is to control the body’s levels of prolactin (the hormone responsible for milk production). By preventing dopamine from binding to the receptors, metoclopramide enables the body to produce more prolactin (and thus more milk) without inhibition.  

Dosage

The standard dosage of metoclopramide for dogs is 0.1 to 0.2 mg per lb of body weight, 2 to 4 times daily.

This medication is available as an injectable solution, oral solution, and 5 mg and 10 mg oral tablets. Most vets prescribe the tablet form for canines since it doesn’t contain artificial sweeteners and is easier to administer than other formulations. 

Dosage instructions

Crush the metoclopramide tablet and mix it thoroughly into wet food. You’ll need to give this medication every 6 to 8 hours or according to your vet’s recommendation. Your vet may instruct you to administer metoclopramide 30 minutes before feeding your dog to help them keep food down.

Depending on your pet’s size, you may have to divide the pill into segments before crushing to ensure the right dose. 

Efficacy

A study comparing metoclopramide with Zofran for parvo-infected dogs found that both drugs controlled hyperemesis and noted no adverse effects when combined with other parvo treatments. 

A separate study determined that giving metoclopramide before administering intravenous opioids reduced nausea in the study group. Another study of dogs treated with cisplatin, a chemotherapy drug, found that metoclopramide was more effective at controlling nausea and vomiting in dogs than other phenothiazines. 

Side effects

Although side effects are usually mild, metoclopramide for dogs can cause an array of side effects in canines, including:

• Stomach cramping

• Nervousness

• Mood changes

• Upset stomach

• Fatigue

• Tics

• Tremors

• Excitability

• Trouble using the bathroom

• Peeing more than usual

• Seizures in dogs with epilepsy

• Strange behavior or confusion

• Water retention

Considerations

MAOIs, including some psychiatric and flea-preventative medications, can cause high blood pressure in dogs taking metoclopramide. Inform your vet of any antidepressants or flea preventatives (including flea collars) that your pet takes to make sure metoclopramide is safe. 

Metoclopramide influences digestive motility, so it shouldn’t be given to dogs with gastrointestinal obstructions or internal bleeding.

Metoclopramide can lower the seizure threshold in dogs with epilepsy. Ask your vet about safer alternatives if your dog has a history of seizures.

Drug interactions

Metoclopramide for dogs is known to interact with many different types of drugs, including: 

• Certain antibiotics

• MAOIs

• Bronchodilators

• Blood pressure drugs

• Dramamine

• Insulin

• Digoxin

• Immunosuppressants (particularly cyclosporine)

• Levodopa

• Mepenzolate

• Dicyclomine

• IBS medications

• Flea collars

• Tramadol

Allergic reactions and sensitivity

Some dogs are sensitive to metoclopramide and experience adverse reactions — especially if they take an unusually strong dose. Seek immediate veterinary care if your dog shows symptoms like: 

• Aggression 

• Sedation 

• Extreme behavioral changes

• Disorientation

• Loss of consciousness

• Unusual muscle movements

A metoclopramide allergy is different from hypersensitivity and is distinguishable by respiratory problems, hives, and swelling of the mouth, throat, face, or extremities. Don’t give this medication to dogs with a history of reactions to phenothiazines, para-aminobenzoic acid, or any of metoclopramide’s inactive ingredients. 

Frequently asked questions

Why can’t I give my dog human anti-nausea meds?

Ask your vet before giving any over-the-counter medicines to your dog, since many human medications are toxic to other mammals. Tylenol, for instance, is safe for humans, but it can cause liver damage and even death in dogs. Some vets suggest Pepto-Bismol and Imodium for dogs with stomach upset, but you should run it by your vet before giving these medications. 

What should I do if my dog can’t keep their metoclopramide down?

Call your vet if your dog repeatedly vomits after taking this medication — they may need a different antiemetic. Do not double up on your pet’s dose since this can cause serious complications.  

How should I store metoclopramide for dogs?

This medication should be kept between 68 and 77 degrees Fahrenheit. Ensure the seal on the medication bottle is tight since moisture in the air may cause it to spoil or disintegrate. 

Can I give an extra dose if the metoclopramide isn’t working for my dogs?

Never give your dog more of this medication than your vet recommends.