Table 6Patient and study characteristics of trials comparing metoclopramide with placebo or active agents

ComparisonAuthor, Year, Country
Study Fesign
Timepoints Measured in the ED (Post ED Followup)Intervention, N Randomized, Dosage, Route of AdministrationMean Age (SD), Females (%), White (%)Description of Migraine Severity: Mean (SD); Duration of Migraine Prior to Coming Into EDPrimary Outcomes; Secondary Outcomes
Metoclopramide vs. placeboCete, 2004, Turkey, RCT8330min, (24 hr)G1: MET, n=37, 10 mg IV

G2: MgSO4, n=36, 2 g IV

P: Placebo, n=40, 100 mlIV
G1: 40 (13), 33 (89.2), NR

G2: 40 (12), 27 (75.0), NR

P: 40 (11), 35 (87.5), NR
G1: VAS: 73 mm (25), NR

G2: VAS: 70 mm (22), NR

P: VAS: 69 mm (19), NR
1: pain intensity at 30 min (VAS)

2: adverse reactions, need for rescue medication, recurrence at 24 hr
Cicek, 2004, Turkey, RCT11345 min, (4 hr)G1: MET, n=196 (Vascular headache); 140 (tension headache), IM Placebo + MET 10 mg IV

G2: MET+PET, n=49, MET 10 mg IV+PET 50 mg IM

G3: PET, n=49, IV Placebo+PET 50 mg IM

P: Placebo, n=48, NR IV/IM
Total: 38.8 (11.1) vascular headache; 42.1 (13.8) for tension headache; mean age of all subjects 40.2 (12.4), 7.1 (female to male ratio for vascular headache), 2.5 (in tension headache group)G1: NR, NR

G2: NR, NR

P: NR, NR
1: pain intensity (VAS)

2: side effects
Coppola, 1995, U.S., RCT9230 min, (48hr)G1: MET, n=24, 10mg IV

G2: PCZ, n=22, 10mg IV

P: placebo, n=24, NR IV
G1: NR, NR, NR

G2: NR, NR, NR

P: NR, NR, NR
G1: nonhatched VAS: 8.1, NR

G2: nonhatched VAS:8.7, NR

P: nonhatched VAS: 7.6, NR
1: median pain scores (nonhatched VAS)

2: median nausea scores, median sedation scores
Jones, 1996, U.S., RCT9160 min (48 hr)G1: PCZ, n=28, 10 mg IM

G2: MET, n=29, 10 mg IM

P: Placebo, n=29, 2 ml IM
Total: 32.1 (2.1), 63 (73.3), NRG1: VAS: 8.1 (range 6–10), NR

G2: VAS: 8.5 (range 7–10), NR

P: VAS: 8.0 (range 6–10), NR
1: median pain scores (VAS)

2: nausea and vomiting
Klapper, 1989, U.S., RCT10730 min, (24 hr)G1: MET+DHE, n=11, 5–10mg MET and 0.75–1.0mg DHE IV

G2: MET+DEX, n=9, 5–10mg MET IV, and 6mg DEX IV

P: Placebo, n=10, NR IV
G1: NR, NR, NR

G2: NR, NR, NR

P: NR, NR, NR
G1: NR, NR

G2: NR, NR

P: NR, NR
1: improvement by at least one unit (4-pt scale)

2: level of functioning (4-pt scale)
Tek, 1990, U.S., RCT9560 min (48hr)G1: MET, n=24, 10mg IV

P: Placebo, n=26, 2 ml IV
G1: NR, NR, NR

P: NR, NR, NR
G1: NR, NR

P: NR, NR
1: mean relief score
Metoclopramide vs. neurolepticsCameron, 1995, U.S., RCT6545 min, (48hr)G1: CPZ, n=47, 0.1mg/kg IV

G2: MET, n=44, 0.1mg/kg IV
G1: Mean (range): 32.6(17–55), 38 (80.9), NR

G2: Mean (range): 31.6(19–54), 35 (79.5), NR
G1: VAS: 7.15 cm; 38.9 hr

G2: VAS: 7.76 cm; 47.2 hr
1: pain relief (VAS)

2: treatment failure, systolic blood pressure, headache recurrence
Coppola, 1992, U.S., RCT9230 min, (48hr)G1: MET, n=24, 10mg IV

G2: PCZ, n=22, 10mg IV

P: Placebo, n=24, NR IV
G1: NR, NR, NR

G2: NR, NR, NR

P: NR, NR, NR
G1: nonhatched VAS: 8.1, NR

G2: nonhatched VAS:8.7, NR

P: nonhatched VAS: 7.6, NR
1: median pain scores (nonhatched VAS)

2: median nausea scores, median sedation scores
Friedman, BW, 2008, U.S., RCT22120 min, (24 hr)G1: PCZ, n=39, 10 mg IV

G2: MET, n=38, 20 mg IV (Both groups receive 25mg of DPH as well)
G1: 34 (10), 33 (84.6), Hispanic: 24 (61.5); Nonhispanic: 15 (38.5); White: 20 (51.3); Black: 35.9); Asian: 1 (2.6); Other: 4 (10.3)

G2: 38 (12), 36 (94.7), Hispanic: 26 (68.4); Nonhispanic 12(31.6); White: 20 (52.3); Black: 16 (42.1); Asian: 0 (0.0); Other: 2 (5.3)
G1: 11-pt numerical rating scale: 8.4, 48 hr (median)

G2: 11-pt numerical rating scale: 8.8, 72 hr (median)
1: change in pain intensity

2: sustained pain-free; sustained headache relief; sustained normal functioning; 2hr pain free; 2hr headache relief; rescue medication; adverse events; akathisia; drowsiness
Jones, 1996, U.S., RCT 9160 min (48 hr)G1: PCZ, n=28, 10 mg IM

G2: MET, n=29, 10 mg IM

P: Placebo, n=29, 2 ml IM
Total: 32.1 (2.1), 63 (73.3), NRG1: VAS: 8.1 (range 6–10), NR

G2: VAS: 8.5 (range 7–10), NR

P: VAS: 8.0 (range 6–10), NR
1: median pain scores (VAS)

2: nausea and vomiting
Metoclopramide versus other active agentsAktas, 2011, Turkey, NRCT10560 min, (NA)G1: Ondansetron + Paracetamol, n=30, 4mg Ondansetron IV + 1g Paracetamol IV

G2: MET+ Paracetamol, n=30, 10mg MET IV+1g paracetamol IV
G1: 35.3 (9.3), NR, NR

G2: 37 (9.3), NR, NR
G1: NR, NR

G2: NR, NR
1: pain severity (10-pt numeric rating scale; 0 is absence of pain, 10 is severe pain)

2: additional analgesia, mean durations of ED stay
Cete, Y, 2004, Turkey, RCT8330min, (24 hr)G1: MET, n=37, 10 mg IV

G2: MgSO4, n=36, 2 g IV

P: Placebo, n=40, 100 mlIV
G1: 40 (13), 33 (89.2), NR

G2: 40 (12), 27 (75.0), NR

P: 40 (11), 35 (87.5), NR
G1: VAS: 73 mm (25), NR

G2: VAS: 70 mm (22), NR

P: VAS: 69 mm (19), NR
1: pain intensity at 30 min (VAS)

2: adverse reactions, rescue medication, recurrence at 24 hr
Cicek, 2004, Turkey, RCT11345 min, (4 hr)G1: MET, n=196 (Vascular headache); 140 (tension headache), IM placebo + MET 10 mg IV

G2: MET+PET, n=49, MET 10 mg IV + PET 50 mg IM

G3: PET, n=49, IV placebo + PET 50 mg IM

P: Placebo, n=48, NR IV/IM
Total: 38.8 (11.1) vascular headache; 42.1 (13.8) for tension headache; mean age of all subjects 40.2 (12.4), 7.1 (female to male ratio for vascular headache), 2.5 (in tension headache group),G1: NR, NR

G2: NR, NR

P: NR, NR
1: pain intensity (VAS)

2: side effects
Friedman, BW, 2005, U.S., RCT82120 min, (24 hr)G1: MET, n=40, 20 mg IV

G2: SUM, n=38, 6 mg SC
G1: 34, 35 (87.5), Latino: 25 (62.5); Black: 12 (30.0; White: 2 (5.0)

G2: 34, 32 (84.2), Latino: 24 (63.2); Black: 10 (26.3); White: 2 (5.3)
G1: NR, 32 hr

G2: NR, 29 hr
1: change in NRS score

2: 24-hr pain score, pain-free headache response at 2 and 24 hr, need for rescue medication, adverse reactions
Friedman, BW, 2006, U.S., RCT79ED discharge, (24 hr)G1: TMB and DPH, n=20, TMB 200 mg SC + DPH 25 mg SC

G2: SUM, n=20, 6mg SC
G1: 34 (9.7); 17 (85.0); Latino: 11 (55.0), Black: 8 (40.0), White: 1 (5.0)

G2: 32 (8.9); 20 (100.0); Latino: 14 (70.0), Black: 5 (25.0), White: 0 (0.0)
G1: NR, 37 hr (SD: 24)

G2: NR, 32 hr (SD: 36)
1: change in pain intensity between BL and 2 hr (11-point NRS for pain)

2: pain-free and headache response, pain intensity >24 hr, rescue therapy, nausea, limitation to usual daily activities

BL = baseline; CPZ = chlorpromazine; DEX = dexamethasone; DHE = dihydroergotamine; DPH = diphenhydramine; ED = emergency department; G1 = group 1; G2 = group 2; G3 = group 3; IM = intramuscular; IV = intravenous; MET = metoclopramide; MgSO4 = magnesium sulfate; NR = not reported; NRCT = non randomized controlled trial; NRS = Numerical Rating Scale for Pain; P = placebo; PET = pethidine; PCZ = prochlorperazine; pt = point; RCT = randomized controlled trial; SC = subcutaneous; SD = standard deviation; SUM = sumatriptan; TMB = trimethobenzamide; VAS = visual analogue scale

From: Results

Cover of Acute Migraine Treatment in Emergency Settings
Acute Migraine Treatment in Emergency Settings [Internet].
Comparative Effectiveness Reviews, No. 84.
Sumamo Schellenberg E, Dryden DM, Pasichnyk D, et al.

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