Metoclopramide should not be used when stimulation of muscular contractions might adversely affect gastrointestinal haemorrhage, obstruction, perforation, or immediately after surgery. There have been reports of hypertensive crises in patients with phaeochromocytoma given metoclopramide, thus its use is not recommended in such patients. Children, young patients, and the elderly should be treated with care as they are at increased risk of extrapyramidal reactions. Patients in prolonged therapy should be reviewed regularly. Care should also be taken when metoclopramide is administered to patients with renal impairment, epilepsy, Parkinson's disease, or a history of depression. Metoclopramide may cause drowsiness or impaired reactions; patients so affected should not drive or operate machinery.
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