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Intranasal metoclopramide for acute and recurrent diabetic gastroparesis in adults

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A Correction to this article was published on 22 October 2021

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Abstract

Metoclopramide is a prokinetic agent used to promote gastrointestinal motility. It is available for intramuscular, intravenous, subcutaneous and oral administration. In June 2020, metoclopramide nasal spray (MNS) 15 mg (administered 30 min before each meal and at bedtime for 2–8 weeks), received FDA-approval for the acute and chronic management of diabetic gastroparesis (DG) in adults. Four studies that evaluated the efficacy and tolerability of MNS in patients with DG were identified, but none evaluated MNS 15 mg. Of the four studies, one found MNS more effective than metoclopramide tablets: per-protocol patients receiving MNS 10 mg and 20 mg experienced a statistically significant reduction in total symptom scores at six weeks, versus metoclopramide 10 mg tablets. In three placebo-controlled 4-week studies, DG symptom improvements seen with MNS 10 mg or 14 mg were statistically insignificant in men but were statistically significant in women. Adverse events of mild-to-moderate severity included headache, cough, nasal discomfort and dysgeusia. Further research is needed to assess the efficacy (e.g., individual and combined symptom scores, hospitalizations due to acute flares), tolerability, pharmacokinetics and cost-effectiveness of MNS 15 mg over 8–12 weeks in patients with DG.

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Acknowledgements

The authors of this study gratefully acknowledge Fabio Franco, BS, for his careful review of this manuscript.

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Authors and Affiliations

  1. Health Professions Division, College of Pharmacy, Nova Southeastern University, 3200 S University Drive, Fort Lauderdale, FL, 33328, USA

    Devada Singh-Franco & William R. Wolowich

  2. Martin and Gail Press Health Professions Division Library, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL, 33328, USA

    Daisy De La Rosa

Authors
  1. Devada Singh-Franco
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  2. William R. Wolowich
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  3. Daisy De La Rosa
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Correspondence to Devada Singh-Franco.

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Author contributions

DSF: conception and design of the review, study selection, data extraction, analysis and interpretation of data, drafting the article and critically revising overall content submitted by co-author, final approval of the version to be submitted. WRW: study selection, data extraction, analysis and interpretation of data, drafting a section of the article and critically revising overall content, final approval of the version to be submitted. DR: literature search, de-duplication of citations, drafting a section of the article and final approval of the version submitted.

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The original article has been updated: Due to textual changes.

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Singh-Franco, D., Wolowich, W.R. & De La Rosa, D. Intranasal metoclopramide for acute and recurrent diabetic gastroparesis in adults. Drugs Ther Perspect 37, 581–589 (2021). https://doi.org/10.1007/s40267-021-00862-x

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