Warnings on Metoclopramide Treatment

In his discussions of treatment of diabetic gastroparesis, Dr Camilleri never clearly defines the use of metoclopramide.1, 2 Other articles have emphasized that treatment beyond 3 months is associated with a 1%–10% incidence of tardive dyskinesia.3, 4

The Food and Drug Administration (FDA) has now come out with a Black Box warning that must be attached to all metoclopramide labeling. Janet Woodcock, the director of the FDA Center for Drug Evaluation and Research, states, “The chronic use of metoclopramide therapy should be avoided in all but rare cases where the benefit is believed to outweigh the risk. The FDA wants patients and health-care professionals to know about this risk so they can make informed decisions about treatment.”5