Abstract
Aims: Metoclopramide has been used as a gastro-kinetic agent but the safety and effects of different preparations of metoclopramide on preparation for outpatient endoscopy are largely unknown. The study aimed to evaluate the (1) Safety of using ODT (orally disintegrating tablet) or TT (traditional tablet) metoclopramide pre-endoscopy in non-fasting patients compared with placebo (2) Impact of ODT or TT metoclopramide on sedation and recovery times compared with placebo. Methods: A double blind randomized placebo-controlled trial with 3 arms; Metoclopramide ODT (n = 43), Metoclopramide TT (n = 43) and Placebo (n = 43). Results: Metoclopramide ODT had fewer adverse events compared with TT or placebo. Recovery time was significantly shorter with use of either metoclopramide versus placebo (P < 0.001) & total sedation time was also significantly shorter in the metoclopramide groups versus placebo (P < 0.001). Conclusion: Metoclopramide ODT is safe and beneficial in endoscopic procedures requiring limited access to food and liquid.
Highlights
Study results demonstrated significantly reduced sedation times for both TT and ODT preparations of metoclopramide when compared with placebo but these times did not differ significantly between TT and ODT (Figure 1)
A similar trend was observed in recovery times for patients (Figure 2)
Tolerability was significantly better with metoclopramide ODT preparation compared with metoclopramide TT preparation or placebo
Summary
Central nervous system action of metoclopramide may impact sedation and recovery of patients when used with some sedatives (e.g., propofol) [2].An orally disintegrating tablet formulation of metoclopramide that is bioequivalent to traditional metoclopramide tablets has been developed to be taken without liquid [5].
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