What Is Adco Contromet?
Adco Contromet is a brand name for the medication metoclopramide, a potent anti-emetic and prokinetic agent. A prokinetic drug is one that increases the movement of the gastrointestinal (GI) tract. It works by increasing the contractions of the stomach and intestines to help move food along more quickly. Adco Contromet is available as tablets and syrup and is prescribed for several digestive disorders where normal motility is impaired. Due to the risk of serious side effects, metoclopramide is generally intended for short-term use, typically not exceeding 12 weeks.
Primary Medical Uses of Adco Contromet Tablets
Adco Contromet is effective in treating and preventing symptoms of several gastrointestinal conditions:
- Diabetic Gastroparesis: This condition causes slow stomach emptying due to nerve damage from diabetes, leading to symptoms like nausea, vomiting, heartburn, and a persistent feeling of fullness. Adco Contromet helps to restore more normal gastric emptying.
- Gastroesophageal Reflux Disease (GERD): For severe cases of GERD that have not responded to other treatments, Adco Contromet can relieve symptoms by increasing the tone of the lower esophageal sphincter and helping the stomach empty faster, reducing acid reflux.
- Nausea and Vomiting: It is used as an anti-emetic to prevent and treat nausea and vomiting caused by various factors, including:
- Chemotherapy for cancer
- Post-operative recovery
- Migraine headaches
- Irradiation sickness
- Adjunct to X-ray Procedures: As an adjunct during radiologic examination of the stomach and duodenum, Adco Contromet helps improve the quality of imaging by speeding up the transit of contrast media.
How Adco Contromet Works
The active ingredient in Adco Contromet, metoclopramide, acts on two main areas of the body to produce its effects:
- Central Nervous System (CNS): Metoclopramide is a dopamine receptor antagonist that works in the chemoreceptor trigger zone (CTZ) of the brain, a key area involved in the vomiting reflex. By blocking dopamine receptors here, it prevents nausea and vomiting signals from reaching the brain.
- Gastrointestinal Tract: It enhances the effect of acetylcholine, a neurotransmitter that promotes GI muscle contractions. This prokinetic action increases the frequency and strength of contractions in the stomach and small intestine, speeding up gastric emptying and transit through the digestive tract. This helps relieve symptoms such as bloating and fullness.
Important Safety Information and Black Box Warning
In 2009, the FDA required a boxed warning (black box) for metoclopramide, highlighting the risk of a serious, potentially irreversible movement disorder called tardive dyskinesia (TD).
- Tardive Dyskinesia (TD): This condition is characterized by involuntary, repetitive movements of the face, limbs, and trunk. The risk increases with the duration of treatment and total cumulative dosage. Older adults, especially women, and patients with diabetes are at higher risk. Treatment should not exceed 12 weeks to minimize this risk.
- Other Side Effects: Common side effects include drowsiness, fatigue, restlessness (akathisia), diarrhea, headache, and dizziness. More serious, but less common, side effects include depression, neuroleptic malignant syndrome (NMS), and other extrapyramidal symptoms (EPS), such as muscle spasms and tremors.
- Contraindications: Adco Contromet should not be used in patients with:
- Gastrointestinal hemorrhage, mechanical obstruction, or perforation
- Pheochromocytoma (a tumor that secretes hormones)
- Seizure disorders or epilepsy
- A history of tardive dyskinesia or a dystonic reaction to metoclopramide
- Pregnancy and Breastfeeding: The safety of metoclopramide during pregnancy is not fully established, though it is sometimes used for severe nausea under medical supervision. It can pass into breast milk, and caution is advised.
Drug Interactions
It is crucial to inform your doctor about all other medications you are taking, as metoclopramide can interact with several types of drugs:
- CNS Depressants: Taking metoclopramide with alcohol, sedatives, opioids, or certain antidepressants can increase drowsiness and sedation.
- Medications for Parkinson's Disease: The effects of anti-Parkinson drugs like levodopa can be counteracted by metoclopramide.
- Anticholinergic and Antidiarrheal Medications: These can reduce the effectiveness of metoclopramide's prokinetic action.
- Absorption of Other Drugs: Metoclopramide can affect the absorption rate of other oral medications, including digoxin, tetracycline, and cyclosporine, by altering gastric emptying.
Adco Contromet vs. Other Anti-emetics
While Adco Contromet (metoclopramide) is an effective treatment for nausea and vomiting, other medications exist with different mechanisms and side effect profiles. The best choice depends on the underlying cause and patient-specific risk factors.
| Feature | Adco Contromet (Metoclopramide) | Ondansetron (e.g., Zofran) | Domperidone (e.g., Motilium) |
|---|---|---|---|
| Drug Class | Prokinetic, Dopamine Antagonist | Serotonin (5-HT3) Receptor Antagonist | Prokinetic, Dopamine Antagonist |
| Primary Uses | Gastroparesis, GERD, nausea/vomiting (chemotherapy, post-op) | Nausea/vomiting (chemotherapy, post-op, pregnancy) | Gastroparesis, nausea/vomiting |
| Mechanism | Blocks dopamine in CTZ, increases GI motility | Blocks serotonin receptors centrally | Blocks dopamine receptors centrally and peripherally; does not cross blood-brain barrier easily |
| Key Side Effect Concern | Tardive Dyskinesia (Black Box Warning) | Headache, constipation, QTc interval prolongation (cardiac risk) | QTc interval prolongation (cardiac risk); restricted in many countries |
| Duration of Use | Short-term only (<12 weeks) | Generally short-term for specific indications | May be used long-term under specialist supervision |
| Availability (US) | FDA-approved, widely available | FDA-approved, widely available | Not FDA-approved, available through special access programs in some countries |
Conclusion
Adco Contromet Tablets, containing metoclopramide, serve as a valuable tool for the short-term treatment of debilitating conditions like diabetic gastroparesis, severe GERD, and various forms of nausea and vomiting. Its dual anti-emetic and prokinetic actions are highly effective in managing these symptoms. However, due to the significant risk of irreversible neurological side effects, particularly tardive dyskinesia, its use is strictly limited to short-term therapy, and potential drug interactions must be carefully managed. Patients should discuss all potential risks and benefits with their healthcare provider and adhere to the prescribed short-term duration to ensure safety.
For more detailed information on metoclopramide, consult the drug information provided by MedlinePlus: Metoclopramide: MedlinePlus Drug Information.
