What is the typical IV dose for metoclopramide used in the ED?

• A. 10 mg IV
• B. 5 mg IV
• C. 15 mg IV
• D. 20 mg IV

Answer: (A)

Metoclopramide given in the ED as an antiemetic is typically 10 mg IV. This dose provides reliable, rapid relief of nausea for most adults because the drug blocks dopamine receptors in the chemoreceptor trigger zone and also has a prokinetic effect that speeds gastric emptying, which can help nausea from gastric stasis. It’s usually given as a quick IV push or over a short infusion, and can be repeated every 6–8 hours as needed, staying within a daily maximum. A 5 mg IV dose can be used in certain frail patients or specific situations, but the standard starting dose for the general adult ED patient is 10 mg. Higher doses such as 15 or 20 mg increase the risk of extrapyramidal side effects (like dystonia or akathisia) and are not the typical ED dosing.