Paracetamol + Metoclopramide

Oral
Migraine

Lactation. Children <12 yr.

Porphyria, epilepsy, parkinsonism, history of depression, pregnancy. Renal or hepatic impairment. May impair ability to drive or operate machinery. Risk of acute hypersensitivity reactions in patients with phaeochromocytoma. Exclude the possibility of an underlying disorder if patient has persistent vomiting.

Nausea, allergic reactions, skin rashes, acute renal tubular necrosis. Constipation or diarrhoea; drowsiness, headache, depression, lassitude, extrapyramidal reactions (especially if combined with phenothiazines); galactorrhoea; parkinsonism; neuroleptic malignant syndrome; tardive dyskinesia.
Potentially Fatal: Paracetamol: Very rare, blood dyscrasias (e.g. thrombocytopenia, leucopenia, neutropenia, agranulocytosis); liver damage. Metoclopramide: Very rarely, hypertensive crisis in patients with pheochromocytoma. Cardiac conduction disorders (IV admin).

Overdose may cause damage to the liver. May be treated by gastric lavage with supportive measures. IV admin of N-acetylcysteine or oral methionine given within 10 hr of paracetamol overdosage may exert a protective effect on the liver.

Action of metoclopramide may be antagonised by anticholinergics and opioid analgesics. Metoclopramide may affect the absorption of orally administered drugs when given together.

Decreased rate of absorption with food.

Description: Metoclopramide is a dopamine antagonist, which binds to D₂ receptors in the central and peripheral nervous system. It has anticholinesterase and antiemetic effects. Paracetamol is a centrally and peripherally acting non-opioid analgesic and antipyretic.

Antimigraine Preparations