I have seen a surprisingly high number of children presenting with tardive dyskinesia after getting prescribed metoclopramide in peripheral health centers. Do pediatricians in other nations still use metoclopramide? Or are they switching to other drugs?
In the US, use of metoclopramide as a prokinetic agent in neonates and infants has diminished greatly over the past 10 years because of its association with TD on long-term use (i.e. greater than 6 months). It is discontinued often at discharge. See http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2009/ucm149533.htm for more information. Best wishes.
As a pediatric surgeon I do prescribe Metoclopramide regularly in babies (under one year) with GE reflux for several months. Fortunately we have faced only occasional case of TD.
Metoclopramide available in the market under different names, i,m still using metoclopramide in infants for a short period (2-4 days), over the past 24 years i faced only 2 cases of TD.
I feel it is a problem of overdosage at the peripheral level that pushes many children to our hospital. Erroneous prescriptions can cause a great deal of distress to the child and the family, who have to witness the side effects playing out in front of them. Good dosage practice should reduce these considerably.
No, I don't use metoclopramide in chikldren. In fact, in Spain is a contraindicated drug in infants under 12 monts and it's recommended avoit it until adult age..
In the cases we need to give an antiemetic (vomiting postchemotherapy or in some gastroenteritis with much vomiting), we use ondansetron.
I'm a pediatrician.
Similar usage from my PoV. We use Ondansetron or Domperidone. No significant adversities are encountered.
I have been regularly using the syrup Metoclopramide and have only encountered three cases of Tardive dyskinesia in last 18 years. All the three cases were above 08 years of age and occured at higher range of recommended dosage
In Iraq, use of metoclopramide as a prokinetic agent is still sued even it has been diminished greatly over the last years because of its association with TD . Domperidone is used more nowadays.
In La Paz - Bolivia, we live at high altitude (3800 m), our prevalence of GERD is high in children under one year old, and treating them with PPI alone do not reach success so we associate metoclopramide, fortunately at this time we didn't have any case of TD.
I'm pediatric gastroenterologist
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