Maxolon (Anti-nausea)

What is Maxolon?

Maxolon is a prescription-only medicine widely used to prevent and treat severe nausea and vomiting. It is frequently prescribed to manage acute migraines, post-operative sickness, and nausea associated with chemotherapy or radiotherapy.

Belonging to a class of drugs known as dopamine D2 receptor antagonists and gastric prokinetic agents, it is chemically synthesized to work directly on the brain's vomiting center to stop nausea while accelerating stomach emptying in the gastrointestinal tract.

Generic Names:

• Metoclopramide: The widely recognized generic name for the active ingredient used globally to manage nausea and gastric motility.

Global Brand Names:

Metoclopramide is available under various brand names depending on the region and manufacturer.

• Maxolon (美素隆): A long-standing brand-name anti-emetic available in tablets and injection form in Hong Kong.
• Meclopram (美克拉): A commonly available generic version found in local Hong Kong pharmacies.
• Promet: A locally manufactured metoclopramide hydrochloride product available in Hong Kong.
• Reglan: A prominent brand name widely prescribed for gastroesophageal reflux and diabetic gastroparesis in the United States.

These names all refer to the same medication. It's important to note that while the active ingredient is the same, different countries may have different regulations and available medication formulations.

What is Maxolon used for?

Maxolon is used to relieve:

• Nausea and vomiting caused by acute migraines, radiotherapy, or chemotherapy.
• Post-operative nausea and sickness.
• Symptoms of gastroesophageal reflux disease (GERD).
• Gastroparesis (delayed stomach emptying, especially in diabetic patients).

How do you use Maxolon?

Availability:

• Oral tablets
• Injections

Dosage Information:

• Adults: 10 mg taken up to three times daily, not exceeding a maximum of 30 mg per day.
• Children (1 to 18 years): 0.1 to 0.15 mg/kg of body weight, up to three times daily, strictly as a second-line option for specific types of nausea.

Suitability:

• Adults: Yes, for short-term use up to 5 days.
• Elderly: Yes, but with caution due to a higher risk of involuntary movement side effects.
• Children over 1 year: Yes, strictly under specialist guidance.
• Infants under 1 year: No, contraindicated due to the high risk of extrapyramidal reactions.

Who cannot take Maxolon?

Allergies and unsuitability:

• Rare, but possible allergic reactions to metoclopramide.

Conditions where the drug should not be used:

• Gastrointestinal hemorrhage, blockage, or perforation.
• Epilepsy.
• Pheochromocytoma.
• History of tardive dyskinesia or other drug-induced movement disorders.

Maxolon is generally safe for short-term use, but it can cause common side effects such as drowsiness, restlessness, fatigue, and diarrhea. Because the medication affects the central nervous system, exceeding the recommended dosage or duration significantly increases the risk of more serious complications.

Severe adverse reactions include extrapyramidal symptoms (EPS), which manifest as involuntary muscle spasms and facial twisting, especially in children and young adults. Prolonged use, particularly in the elderly, can lead to tardive dyskinesia—a potentially irreversible condition causing rhythmic, uncontrollable movements of the tongue, face, or jaw. Rarely, patients may experience Neuroleptic Malignant Syndrome, a medical emergency characterized by high fever and muscle rigidity.

• Do not exceed 5 days of continuous treatment to minimize the risk of serious movement disorders like tardive dyskinesia.
• Avoid alcohol completely to prevent severe increases in the sedative effects of the drug.
• Allow at least 6 hours between doses, even if vomiting occurs, to prevent accidental overdose and neurological side effects.
• Avoid concurrent use of anticholinergic agents or narcotic analgesics like morphine, which neutralize the medication's effects on the stomach.
• Check with a doctor if you take medications that dissolve in the stomach or small intestine (like digoxin, aspirin, or paracetamol), as Maxolon alters how quickly they are absorbed.
• Do not take concurrently with levodopa or other dopamine agonists due to direct chemical antagonism.

Storage information:

• Keep in a cool, dry place below 25°C.
• Protect the medication from direct light and moisture.
• Keep the medication safely out of reach of children.
• Leave tablets in their original blister packaging until it is time to take a dose.

Handling instructions:

• Swallow the tablet whole with a glass of water.
• Take the medication exactly as directed, ensuring at least a 6-hour gap between doses.
• Do not crush or chew the tablet unless specifically instructed by a healthcare provider.

Where is Maxolon available in Hong Kong?

In Hong Kong, Maxolon (metoclopramide) is strictly classified as a "Prescription Only Medicine". This means that patients must present a valid prescription from a registered doctor before they can legally purchase the medication.

It can only be obtained at registered hospital dispensaries or authorized pharmacies that feature the "Rx" logo, operating under the direct supervision of a registered pharmacist. It is not available for free purchase over the counter in general retail stores.