Prescribing of oral metoclopramide for nonapproved indications

All physician orders for metoclopramide tablets at a 500-bed hospital were monitored for a one-year period to determine whether the drug was being used exclusively for the one indication approved by the Food and Drug Administration, diabetic gastroparesis. Eighteen patients received a total of 20 courses of therapy with dosage schedules ranging from 5 mg tid to 10 mg qid. The drug was prescribed for a wide variety of indications, but no patient received it for the symptomatic treatment of diabetic gastroparesis. Extensive literature documentation was lacking for some of the uses, and the doses employed may have been insufficient in some cases. Uses of metoclopramide for both approved an nonapproved indications may increase as clinical studies further define its potential uses and physicians become more familiar with the drug.