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Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-.

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Metoclopramide

Published online: October 1, 2021.

This sheet is about exposure to metoclopramide in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is metoclopramide?

Metoclopramide is a medication that has been used to treat gastrointestinal (stomach / bowel) motility issues, for nausea and vomiting caused by surgical operations, chemotherapy, or pregnancy, and to help with lactation. This medication has been sold under band names such as Reglan®, Maxolon® or Metozolv ODT®.

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

If you are experiencing nausea and vomiting or gastrointestinal problems that are affecting your ability to function, speak with your healthcare provider about which treatment(s) would be best for you during pregnancy. For more information on nausea and vomiting of pregnancy, please see the MotherToBaby fact sheet on Nausea and Vomiting in Pregnancy at https://mothertobaby.org/fact-sheets/nausea-vomiting-pregnancy-nvp/.

I take metoclopramide. Can it make it harder for me to get pregnant?

Studies have not suggested that metoclopramide would affect fertility (a person’s ability to get pregnant).

There have been some reports of menstrual problems and galactorrhea (milk production that is not related to breastfeeding) among people who have taken metoclopramide. Those who have these side effects might have a harder time becoming pregnant.Answer if info available; otherwise: It is not known if XXX can make it harder to get pregnant.

Does taking metoclopramide increase the chance for miscarriage?

Miscarriage can occur in any pregnancy. A small number of studies did not find an increased chance for miscarriage among people taking metoclopramide.

Does taking metoclopramide increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the studies reviewed, an increased chance for birth defects is not expected when metoclopramide is used in pregnancy.

Does taking metoclopramide in pregnancy increase the chance of other pregnancy related problems?

Based on the studies reviewed, it is not known if metoclopramide can cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces at birth). One study showed no increased risk of stillbirth in pregnancies exposed to metoclopramide.

There are case reports of people who developed severe side effects while taking metoclopramide during pregnancy which required them to be admitted to a hospital for treatment. In these reports, two people developed movement disorders (known as tardive dyskinesia) and two other people developed intermittent porphyria (a condition that affects the body’s ability to make red blood cells) which led to psychiatric conditions. All reports showed that these people got well with treatment and went on to have healthy newborns.

Another report describes a person with high blood pressure who was pregnant and taking metoclopramide. It was suggested that the use of metoclopramide was related to headache, fast heart rate (tachycardia) and severe high blood pressure in this person.

These reports do not tell us how often these side effects may occur during pregnancy. If you are taking metoclopramide tell your healthcare provider about any changes in your mood, changes in movement such as lip smacking, jerky eye movements, or jerky limb movements, headache, fast heart rate, or high blood pressure.

Does taking metoclopramide in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if metoclopramide can cause behavior or learning issues for the child.

Breastfeeding while taking metoclopramide:

There is limited information on the use of metoclopramide during breastfeeding. Metoclopramide can cross into the breast milk. Most reports have not listed any side effects in nursing infants. If you suspect the baby has any symptoms (such as stomach discomfort and gas), contact the child’s healthcare provider.

Metoclopramide use while breastfeeding might increase your chance for post-partum depression. Any changes in your mood should be reported to your healthcare provider. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

Metoclopramide is sometimes used to try and increase milk supply (galactagogue). Studies looking at whether metoclopramide increases or causes milk production are limited, and results of these studies have been mixed. If you are having trouble with milk production, talk with your healthcare provider or a lactation consultant.

If a male takes metoclopramide, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?

Studies have not been done to see if metoclopramide could affect male fertility or increase the chance of birth defects. There is no evidence that suggests that a male’s use of metoclopramide would cause any problems during a pregnancy. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Selected References:

  • Allen RW. 2012. Metoclopramide--a safe anti-emetic? [letter] S Afr Med J; 77: 219, 1990. [PubMed: 2300861]
  • Anderka M, et al. 2012. Medications used to treat nausea and vomiting of pregnancy and the risk of selected birth defects. Birth Defects Res (Part A); 94:22-30. [PMC free article: PMC3299087] [PubMed: 22102545]
  • Andersen AN, Tabor A. 1982. Prl, TSH, GH and LH responses to metoclopramide and breastfeeding in normal and hyperprolactinaemic women. Acta Endocrinol (Copenh); 100:177-83. [PubMed: 7202316]
  • Balikci A, Balibey H. 2012. [Postpartum depression due to use of metoclopramide: A case report]. Anatolian J Clin Invest; 6:258-60.
  • Bérard A, et al. 2019. New Evidence for Concern Over the Risk of Birth Defects from Medications for Nausea and Vomiting of Pregnancy. J Clin Epidemiol; 116: 39-48. [PubMed: 31352006]
  • Berkovitch M, et al. 2002. Metoclopramide for nausea and vomiting of pregnancy: a prospective multicenter international study. Am J Perinatol; 19:311-6. [PubMed: 12357422]
  • Çekmez Y, et al. 2016. Does metroclopramide exposure alter endometrial receptivity and decrease pregnancy rates? J Matern Fetal Neonatal Med 29(16): 2703-6 [PubMed: 26421644]
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  • Fife S, et al. 2011. Metoclopramide to augment lactation, does it work? A randomized trial. J Matern Fetal Neonatal Med; 24:1317-20. [PubMed: 21410420]
  • Finnis WA, et al. 1976. Metoclopramide hydrochloride and galactorrhea. Can Med Assoc J; 115:845. [PMC free article: PMC1879081] [PubMed: 1033026]
  • Foong, S. C, et al. 2020. Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. The Cochrane database of systematic reviews, 5(5), CD011505. [PMC free article: PMC7388198] [PubMed: 32421208]
  • Ingram J, et al. 2012. Metoclopramide or domperidone for increasing maternal breast milk output: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed; 97:F241-5. [PubMed: 22147287]
  • Kauppila A, et al. 1981. Metoclopramide increases prolactin release and milk secretion in puerperium without stimulating the secretion of thyrotropin and thyroid hormones. J Clin Endocrinol Metab; 52:436-9. [PubMed: 6780593]
  • Kauppila A, et al. 1983. Metoclopramide and breast feeding: transfer into milk and the newborn. Eur J Clin Pharmacol; 25:819-23. [PubMed: 6662181]
  • Kauppila A, et al. 1985. Metoclopramide and breast feeding: efficacy and anterior pituitary responses of the mother and the child. Eur J Obstet Gynecol Reprod Biol; 19:19-22. [PubMed: 3884406]
  • Lewis PJ, et al. 1980. Controlled trial of metoclopramide in the initiation of breast feeding. Br J Clin Pharmacol; 9:217-9. [PMC free article: PMC1429870] [PubMed: 6986894]
  • Matok I, et al. 2009. The Safety of Metoclopramide Use in the First Trimester of Pregnancy. N Engl J Med; 360:2528-2535. [PubMed: 19516033]
  • Milo R, et al. 1989. Acute intermittent porphyria in pregnancy. Obstet Gynecol 73:450-2. [PubMed: 2915870]
  • Nageotte MP, et al. 1996. Droperidol and diphenhydramine in the management of hyperemesis gravidarum. Am J Obstet Gynecol; 174:1801-1805. [PubMed: 8678143]
  • Negro, A, et al. 2021. Unrecognised pheochromocytoma in pregnancy discovered through metoclopramide-triggered hypertensive emergency. Blood pressure, 30(5), 322–326. [PubMed: 34176388]
  • Pasternak B, et al. 2013. Metoclopramide in pregnancy and risk of major congenital malformations and fetal death. JAMA. 310(15):1601-11. [PubMed: 24129464]
  • Sakha R, Behbahan AG. 2008. Training for perfect breastfeeding or metoclopramide: which one can promote lactation in nursing mothers? Breastfeed Med; 3:120-3. [PubMed: 18564001]
  • Shen Q, et al. 2021. Efficacy and safety of domperidone and metoclopramide in breastfeeding: A systematic review and meta-analysis. Breastfeed Med. 16:516–29. [PubMed: 33769844]
  • Shenhav S, et al. 1997. Acute intermittent porphyria precipitated by hyperemesis and metoclopramide treatment in pregnancy. Acta Obstet Gynecol Scand;76:484-5. [PubMed: 9197454]
  • Suarez, E. A et al. 2021. Ondansetron use in early pregnancy and the risk of miscarriage. Pharmacoepidemiology and drug safety, 30(2), 103–113. [PubMed: 33000871]
  • Sun, L, et al. 2021. Use of metoclopramide in the first trimester and risk of major congenital malformations: A systematic review and meta-analysis. PloS one, 16(9), e0257584. [PMC free article: PMC8452057] [PubMed: 34543335]
  • Tabrizi SO, et al. 2017. The effect of metoclopramide on prolactin levels in breastfeeding mothers: A systematic review and meta-analysis. Int J Pediatr (Mashhad). 5:5827–38.
  • Winterfeld U, et al. 2012. Management of deficient lactation in Switzerland and Canada: A survey of midwives' current practices. Breastfeed Med. 2012;7:317–8. [PubMed: 22224508]

OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.

Copyright by OTIS, October 1, 2021.

This work is available under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported license (CC BY-NC-ND 3.0)

Bookshelf ID: NBK582840PMID: 35952113

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