Cerucal - instructions for use of the version of the drug produced in the form of injections for injections and droppers. Cerucal for gastrointestinal disorders: instructions for use for children

To eliminate vestibular disorders of the brain, doctors prescribe the drug Cerucal - the instructions for its use contain data on the mechanism of operation and composition. The medication is an antiemetic and has a central action. Due to the active substance, it blocks the receptors responsible for motion sickness and prevents the urge to vomit in children and adults.

Medicine Cerucal

According to the accepted medical classification, Cerucal belongs to antiemetic drugs-inhibitors of central action, which blocks dopamine receptors. This allows you to increase the threshold of irritation of the vomiting center and prevent the urge to nausea, eliminate dyskinesia. This effect is achieved due to the active substance of the drug - metoclopramide hydrochloride monohydrate.

Composition and release form

There are two known forms of release of Cerucal - tablets for oral administration and solution for parenteral administration:

	Pills	Injection solution
Description	White round flat with notch	Transparent colorless liquid
Concentration of metoclopramide hydrochloride, mg		5 per 1 ml (10 per 1 ampoule)
	Magnesium stearate, potato starch, silicon dioxide, gelatin, lactose monohydrate	Water, sodium sulfite, sodium chloride, disodium edetate
Package	Bottles of 50 pcs.	5 ampoules of 2 ml

Pharmacological properties

The drug belongs to specific drugs with the effect of blockers of dopamine and serotonin receptors, eliminates nausea. The principle of operation is associated with the central and peripheral action of metoclopramide. Due to the blockade of dopamine receptors in the brain, the antiemetic effect of the drug is determined; it increases the threshold of irritation of the vomiting center, eliminates nausea and vomiting.

The drug does not cause diarrhea. He is also able to eliminate the symptoms of gallbladder dyskinesia and stimulate the secretion of prolactin. The tablets begin to act in half an hour, the solution - faster. The bioavailability of Cerucal in plasma is 70%, metabolism occurs in the liver, and is excreted by the kidneys in 6-10 hours. The drug reduces the motor activity of the esophagus, increases the tone of the lower esophageal sphincter, accelerates gastric emptying and the movement of food through the small intestine.

Indications for use

In the instructions for use, the main indication for use is Cerucal for nausea. Other factors that require taking the drug are:

vomiting, hiccups, nausea;
atony, hypotension of the stomach, intestines, digestive tract;
diabetic gastroparesis;
tardive biliary dyskinesia, reflux esophagitis;
increased stomach tone;
increased peristalsis of the gastrointestinal tract during radiocontrast studies;
gastric paresis due to diabetes mellitus;
facilitating duodenal intubation (accelerating intestinal motility).

How to take Cerucal

Each pack of tablets or ampoules of solution contains instructions for using Cerucal. Depending on the form of release, the method of use also differs. Tablets are taken orally, and the solution is used for intramuscular or intravenous administration. The course of use, regimen and duration of therapy is prescribed by a specialist, depending on the patient’s age and the severity of the tract disease.

In tablets

According to the instructions, Cerucal tablets are taken half an hour before meals, washed down with water. for adults, the recommended dose is 1 tablet (10 mg metoclopramide) 3-4 times a day; persons over 14 years old should take 0.5-1 tablet. 2-3 times/day. The maximum single dose is two tablets, and the maximum daily dose is six. Treatment lasts about 4-6 weeks, sometimes it can last up to six months.

In ampoules

Cerucal injections, according to the instructions, are administered intramuscularly or slowly intravenously. Adults and adolescents over 14 years of age receive one injection ampoule 3-4 times a day. Children 3-14 years old are prescribed a 0.1 mg dose of metoclopramide/kg body weight. A maximum of 0.5 mg of the active substance can be consumed per day. If there are problems with the liver and kidneys, the dose is reduced several times.

There are two treatment regimens for Cerucal for vomiting and nausea caused by the use of cytostatic drugs:

A short-term drip infusion is given for 15 minutes. The dose is 2 mg/kg half an hour before taking cytostatic drugs. The procedure is repeated 1.5, 3.5, 5.5 and 8.5 hours after taking the medication. The drug is first diluted in 50 ml of infusion solution. This eliminates dyskinesia.
Long-term drip infusion at a dose of 0.5-1 mg/kg body weight per hour. The procedure is carried out two hours before taking cytostatics, then 0.25-05 mg/kg of body weight per hour is applied over the next 24 hours. The medication can be diluted with sodium chloride solution or glucose solution. The course of treatment with injections continues throughout the duration of cytostatic therapy.

special instructions

Doctors prescribe Cerucal for children with vomiting and adults with nausea. It is useful to study the special instructions in the instructions for use:

the medication reduces concentration and speed of psychomotor reactions, which requires abstaining from driving cars and dangerous machinery;
the drug is ineffective when vomiting of vestibular origin occurs;
in injections and tablets is not compatible with alcohol; during treatment you should refrain from taking ethanol;
in case of severe renal impairment, the likelihood of side effects is high, the same applies to adolescents;
During treatment with metoclopramide, test results for liver function indicators are distorted.

During pregnancy

The instructions for use of Cerucal warn that the drug is contraindicated for use in the first trimester of pregnancy. This is due to the penetration of the active substance through the placenta and an increased risk of developmental defects. If vital indications exist, the medication can be used in the second and third trimesters of pregnancy. During lactation it is prohibited, because it passes into breast milk.

Cerucal for children

Cerucal is prescribed only by injection for children aged 2-14 years. This is done for the purpose of correct and accurate dosing. Children over 14 years of age can take tablets in a dose that differs from adults and depends on body weight. The instructions warn that children and adolescents have an increased risk of side effects, so their treatment with the drug should be monitored by doctors.

Drug interactions

Doctors prescribe Cerucal - the instructions for use of the drug contain information about its drug interactions with other medications:

anticholinergics weaken the effect;
metoclopramide enhances the absorption of tetracyclines, Paracetamol, Levodopa, lithium preparations, alcohol, and the effect of drugs that depress the central nervous system;
modifies the effects of tricyclic antidepressants;
reduces the absorption of Digoxin, Cimetidine in the intestine;
antipsychotics increase the risk of developing extrapyramidal disorders;
Metoclopramide increases the bioavailability and risk of hepatotoxicity of hepatotoxic drugs and reduces the effectiveness of Pergolide.

Side effects

While using Cerucal, the following side effects and negative reactions indicated in the instructions may develop:

fatigue, headaches;
depression;
tic-like muscle twitching;
tremor, parkinsonism, limited muscle mobility, fever;
increased blood pressure, changes in consciousness, tachycardia;
dry mouth;
gynecomastia;
problems with the menstrual cycle, its slowdown or acceleration;
The risk of any adverse reactions increases in patients with renal impairment.

Overdose

Manifestations of an overdose of Cerucal are confusion and convulsions. According to reviews, a person experiences bradycardia, increased or decreased blood pressure. Mild symptoms of poisoning disappear within a day after discontinuation of therapy; no deaths have been identified. According to the instructions, the patient is prescribed symptomatic treatment - extrapyramidal disorders are eliminated by administering biperiden. Diazepam is used for sedation. Patients undergo gastric lavage and are given activated charcoal or sodium sulfate to absorb toxins.

Contraindications

Cerucal is prescribed with caution for Parksinson's disease, in the second and third trimesters of pregnancy, for arterial hypertension, bronchial asthma, liver and kidney dysfunction, and in old age. Contraindications for the use of the medication, according to the instructions, are:

hypersensitivity to components;
age up to 2 years for solution, up to 14 years for tablets;
pheochromocytoma;
mechanical intestinal obstruction;
pyloric stenosis;
gastrointestinal bleeding;
prolactin-dependent tumor;
epilepsy, extrapyramidal symptoms;
first trimester of pregnancy, lactation.

Terms of sale and storage

You can buy Cerucal only with a prescription. It is stored in a dry, dark place away from children at temperatures up to 25 degrees for five years.

Analogs

On the shelves of domestic pharmacies you can find direct and indirect substitutes for Cerucal. The first includes drugs with the same active substance in the composition, the second - with the same therapeutic effect. Analogues of Cerucal:

Metoclopramide;
Perinorm;
Metamol;
Vero-Metoclopramide;
Metoclopramide-Vial;
Metoclopramide-Eskom;
Metukal;
Brullium.

Cerucal price

You can buy Cerucal in pharmacies or through online platforms. The cost of medicines is influenced by the form of release and the markup percentage. Approximate prices for medications in Moscow pharmacies.

If a remedy such as Cerucal is used, then the instructions for use of these injections must be followed impeccably, otherwise there is a risk of damaging the liver and causing other harm to one’s own body.

About the drug

Cerucal is a common dopamine receptor blocker and antiemetic drug. Available as an injection solution in standard 2 ml ampoules.

Each 1 ml of the drug contains 5 mg of Metoclopramide hydrochloride, the key active ingredient. Additionally, it may contain sodium chloride or water for injection.

How to use?

Although the use of the drug may vary depending on the individual patient's indications, on average it is carried out as follows:

Persons over 14 years of age are administered 2 ml of liquid intravenously/intramuscularly 3 times a day.
For persons under 14 years of age, the amount of fluid administered at a time is determined strictly individually by the attending physician. Typically, 0.1 mg of active drug is prescribed for each kilogram of the patient's body weight.

If administered intravenously, then an additional 5% glucose solution or sodium chloride solution is used. If the administration is carried out intramuscularly, there is no need to dilute the medicine with anything.

The drug can be administered by short-term (up to 15 minutes) or long-term (more than 15 minutes) drip infusion (dropper) before and after the use of cytostatic agents during joint treatment.

Storage conditions

The drug is stored where children do not have access to it, at temperatures up to 25 degrees and without the possibility of direct sunlight. Under these conditions, the storage duration can be 2 years.

Indications

The drug can be used in a number of different situations, which may include the following:

hypotension of the stomach, which occurs after surgery and is accompanied by a feeling of nausea and decreased comfort;
reflux esophagitis;
feeling of nausea or vomiting for a variety of reasons - from eating insufficient quality food and medications to manifestations of diseases of the pancreas or stomach;
gastric paresis resulting from the development of diabetes mellitus;
dyskinesia developing in the biliary tract;
consequences of endoscopic examination.

Contraindications

Metoclopramide, an injection solution, has both absolute contraindications, in which it cannot be used in any case, and relative contraindications, in which its use is undesirable, but is permissible in emergency situations. Absolute contraindications include:

pregnancy (exclusively in the first trimester);
age up to two years (the drug in other forms at a young age may be acceptable to use);
extrapyramidal type disorders;
intestinal obstruction or pathologies that match its symptoms;
personal intolerance to certain elements of the drug;
pheochromocytoma;
pyloric stenosis;
prolactin-dependent tumor;
tendency to epilepsy.

Relative contraindications are the following:

retirement/post-retirement age (usually from 65 years);
thrombophlebitis;
pregnancy in the second and third trimesters;
arterial type hypertension;
Parkinson's disease;
liver/kidney dysfunction;
asthma of the bronchial type, as well as a history of severe development of bronchospasm.

In case of relative contraindications, only the attending physician can decide whether to use the drug or not.

Side effects

In some cases, the use of the drug in the form of injections can cause a number of adverse reactions in quantities from one to several. The probability of their occurrence is very small and does not exceed one percent, but still not excluded.

These include the following:

The occurrence of subcutaneous hematoma, painful infiltrate or air thromboembolism.
Endocrine system disorders, including impotence and gynecomastia in men and menstrual irregularities and galactorrhea in women.
Pathologies and problems of the nervous system, including spasms, apathy, dizziness, tinnitus, insomnia, tremors.
Deviations in the functioning of the cardiovascular system, for example, tachycardia or fluctuations in blood pressure in any direction.
Problems with the digestive system, for example, belching, heavy feeling in the stomach, constipation, and so on.

Short-term manifestation of these effects is absolutely normal, but if this manifestation does not go away for a long time or is especially severe, it is necessary to adjust the treatment and prescribe an alternative drug.

Problems caused by drug overdose may also occur. If this occurs, treatment is promptly stopped, otherwise you can damage the liver and kidneys and cause other negative changes in the body. Symptoms of overdose include the following:

violation of spatial orientation;
disturbance of perception;
anxiety;
increased drowsiness;
sudden change in pressure level;
deviations of extrapyramidal type;
bradycardia;
convulsions.

If an overdose occurs, the patient should be under medical supervision until the problems subside.

Use with other medications

Cerucal injections can not only have a separate effect on the patient, but also modify the effects of other drugs. Here are some examples of possible reactions when combined:

The effectiveness of drugs belonging to the category of H2-histamine blockers is reduced.
When used together with hepatotoxic drugs, there is an increased risk of liver damage.
Ethanol begins to have a stronger depressant effect on the nervous system.
The absorption of Cimetidine and/or Digoxin decreases, and that of Paracetamol and a number of antibiotics increases.

There may be other possible combinations, so if you are currently undergoing treatment with other medications, it is strongly recommended that you check their effects with your doctor.

Additional instructions for use

There are several nuances that are important to consider:

There is a possibility of a less predictable reaction of the body when using the drug in adolescence, therefore, in this case, additional supervision by the attending physician is required.
During the period of treatment, you should avoid activities that require concentration, for example, driving, because emergency situations will be possible.
In some situations, it is necessary to deviate from the recommended dosages and prescribe the latter individually, for example, if a person has serious liver or kidney diseases.
If there is a need to replace the medicine with an alternative, then in most cases the attending physician will choose a solution of Perinorm or Metoclopramide.

Let's sum it up

The use of Cerucal in the form of injections should be carried out strictly according to the official instructions. Then potential harm will be minimized, and the fight against nausea or vomiting will be effective. But even if problems arise when using the drug according to the instructions, you should promptly consult a doctor to replace the drug with an alternative one.

Diaskintest instructions for use in adults and children

Cerucal is a drug that normalizes gastric and intestinal motility, as well as stopping vomiting. Cerucal is used to relieve vomiting of any origin in children and adults, to expand the lower part of the stomach in the area of its connection with the duodenum during pyloric stenosis, to eliminate heartburn and epigastric discomfort, in the complex treatment of reflux esophagitis, as well as intestinal and stomach atony. In addition, Cerucal can be used to prepare a person for gastroesophagoscopy and sounding, as it relaxes the muscles of the esophagus and stomach, facilitating diagnostic manipulation.

International name, release forms and composition of Cerucal

Currently, Cerucal is available in two dosage forms:
1. Tablets for oral administration;
2. Solution for intravenous and intramuscular administration.

Tablets are usually called simply Cerucal, and the injection solution is called “Cerucal injections” or “Cerucal in ampoules.”

The international nonproprietary name (INN) of Cerucal is Metoclopramide. INN is the official, generally accepted name of the active substance in a medicinal product. Since the active substance in Cerucal is metoclopramide, the INN of the drug is Metoclopramide, respectively.

The active substance in both dosage forms of Cerucal includes metoclopramide in various dosages. So, one tablet contains 10 mg of metoclopramide, and in solution its concentration is 5 mg per 1 ml. Since the solution is poured into hermetically sealed 2 ml ampoules, one ampoule contains 10 mg of metoclopramide. Thus, a solution from one ampoule and a Cerucal tablet contain the same amount of active substance. This ratio can be used to convert the number of tablets required for taking into ampoules and vice versa.

Cerucal tablets contain the following substances as auxiliary components:

Potato starch;
Gelatin;
Silica;
Magnesium stearate.

Cerucal solution contains the following as excipients:

Sodium sulfite;
Disodium edetate;
Sodium chloride;
Distilled sterile water for injection.

Cerucal tablets are painted white, have a round flat shape and a score on one side, and are available in cardboard packs of 50 pieces. The solution is a clear, colorless liquid and is available in 2 ml glass ampoules, packed in cardboard boxes of 10 pieces. The ampoules with the solution are made of transparent glass, on which three stripes are applied - blue at the bottom, green at the top and white in the area where the bottle transitions to the narrow sealed part. Some ampoules may have a notch and a dot above it instead of a white stripe.

Cerucal - therapeutic effect

Cerucal has an antiemetic and antihiccup effect due to the suppression of these reflexes at the level of the central nervous system. All other therapeutic effects of Cerucal are derived from these basic ones.

The effect of the drug is due to its penetration into the bloodstream and brain, and blocking dopamine and serotonin receptors in all organs and tissues. As a result of blocking receptors in the brain, its special zone, called the vomiting center, ceases to function, as a result of which irritants from the digestive and respiratory tract are not processed, and the gag reflex does not occur. Thus, vomiting occurs. And since the vomiting center of the brain is also responsible for hiccups, both vomiting and hiccups are suppressed at the same time.

In addition to stopping vomiting and hiccups, Cerucal effectively eliminates constant and painful nausea caused by various reasons, with the exception of motion sickness.

In addition, due to its effect on dopamine and serotonin receptors in the digestive tract, Cerucal has the following therapeutic effects:

Reduces the motor and contractile activity of the esophagus, which helps to expand its lumen and facilitate the passage of a bolus of food through it;
Increases the tone of the esophageal sphincter, which separates it from the stomach. As a result, the number of gastroesophageal refluxes is prevented and reduced;
Accelerates the transition of the food bolus from the stomach to the duodenum, eliminating the feeling of heaviness and discomfort;
Accelerates the movement of the food bolus through the intestines, stimulating its peristalsis and without causing diarrhea;
Normalizes the release of bile in response to food entering the intestines;
Reduces spasm of the sphincter of Oddi, which is located at the junction of the bile duct and duodenum. Thanks to this, bile regularly leaves the gallbladder and enters the duodenum without remaining in the duct;
Normalizes the contractile activity of the gallbladder, eliminating its dyskinesia.

Cerucal does not change the level of secretion of gastric juice, pancreatic enzymes and bile.

The therapeutic effect of Cerucal develops an hour after oral administration, 10–15 minutes after intramuscular injection and a few minutes after intravenous administration. The duration of action is determined by the method of drug administration and is 30 minutes for intravenous injection, 1.5 - 2 hours for intramuscular injection and 6 hours for a tablet taken orally.

Indications for use of Cerucal (tablets and ampoules)

Cerucal tablets have a narrower range of indications for use compared to solution. Therefore, tablets are usually used at home on the recommendation of a doctor, and the solution is used in a medical facility to achieve certain therapeutic effects.

Cerucal tablets and solution

Indications for the use of Cerucal tablets and solution are the following conditions and diseases:

Vomiting of any origin;
Nausea of any origin;
Hiccups of any origin;
Atony and hypotension of the stomach and intestines;
Diabetic gastroparesis (complete absence of stomach contractions);
Symptoms of indigestion (belching, heartburn, flatulence, etc.) with irritable stomach syndrome, reflux esophagitis, pyloric stenosis and biliary dyskinesia;
As part of complex therapy for gastric and duodenal ulcers, cholelithiasis and gastritis.

Solution for injection Cerucal

Cerucal injection solution, in addition to the above diseases, is indicated for use in the following conditions:

To facilitate duodenal intubation;
To speed up the passage of a bolus of food through the stomach and small intestine during an X-ray examination of these organs.

In principle, both dosage forms of Cerucal are used for the same conditions, but the solution is additionally used for diagnostic procedures.

Instructions for use of the drug Cerucal

What to prefer - tablets or injections?

Cerucal tablets and injections are used to achieve the same therapeutic effects associated with the need to stop vomiting and speed up the movement of food through the stomach and intestines.

Tablets are preferred in cases where a relatively long-term therapeutic effect is required, since their effect lasts for 5.5 - 6 hours. As a rule, this is a complex therapy for various chronic diseases of the digestive tract, in which the movement of the food bolus through the intestines and stomach is disrupted, as a result of which symptoms of dyspepsia develop (heartburn, flatulence, heaviness in the stomach, etc.). Typically, Cerucal is used in the complex treatment of reflux esophagitis, gastritis, gastric and duodenal ulcers, pyloric stenosis and biliary dyskinesia, in which food stagnates in the stomach and intestines, causing unpleasant symptoms.

For vomiting, hiccups and nausea, the choice between tablets and injections is made based on the person’s ability to take the drug orally. In other words, if a person can swallow a tablet and not vomit for 15 to 20 minutes afterward, then this particular form of the drug should be chosen. And only if it is impossible to take Cerucal in tablets, injections should be used to relieve vomiting, hiccups and nausea. However, at the first opportunity, Cerucal injections should be replaced with tablets.

For diabetic gastroparesis, it is optimal to administer Cerucal intramuscularly in the morning after breakfast, and take tablets throughout the rest of the day.

To carry out diagnostic procedures, such as probing of the duodenum, x-ray of the small intestine and stomach, intravenous or intramuscular administration of Cerucal solution should be used, since in this case its effect occurs quickly and lasts a short period of time (no more than 2 hours), which is very convenient . With the injection of Cerucal, the stomach and intestines are freed from the food bolus, the insertion of the probe and contrast agent is facilitated, which provides optimal conditions for high-quality diagnostics. Moreover, these effects do not last long and, thus, do not cause concern to the person after the procedure is completed.

For children over 14 years of age, you can follow the recommendations described above for choosing the dosage form of Cerucal. Children aged 2 to 14 years should use Cerucal exclusively in the form of injections, since the solution allows for precise dosing of the drug.

Cerucal tablets - instructions for use

The tablets should be taken orally half an hour before meals, swallowed whole, without chewing, biting or crushing in any other way, but with a small amount of water (100 - 200 ml).

Approximately equal intervals should be maintained between taking tablets, lasting at least 6 hours, since this is how long the effect of the drug lasts. It is recommended to take tablets every 5 to 6 hours during the daytime, and to take a longer break during nighttime sleep.

For various diseases of the gastrointestinal tract, accompanied by impaired passage of food (reflux esophagitis, gastritis, peptic ulcer, biliary dyskinesia, pyloric stenosis, etc.), adults take Cerucal in the same dosage - 1 tablet 3-4 times a day . Children aged 14 - 18 years with the same diseases of the digestive tract should take Cerucal 1/2 - 1 tablet 2 - 3 times a day. The duration of therapy ranges from 4–6 weeks to six months, depending on the speed of cure of the underlying disease. Taking Cerucal is usually stopped after completing the course of treatment for the disease.

To relieve vomiting, hiccups and nausea, it is recommended to take one tablet at a time. If it does not work within an hour, then you can take another Cerucal tablet. The third tablet can only be taken after six hours.

If nausea, vomiting and hiccups are not one-time, but constant, accompanying any diseases or conditions, then Cerucal is taken for a long time according to the same regimen as part of the complex treatment of gastrointestinal pathologies. That is, adults over 18 years old take 1 tablet 3 - 4 times a day, and children from 14 to 18 years old take 1/2 - 1 tablet 2 - 3 times a day. In this case, the drug is continued until the condition normalizes and the painful symptoms disappear.

The maximum permissible single dosage of Cerucal for adults is 20 mg (2 tablets), and the daily dosage is 60 mg (6 tablets). For teenagers, the maximum permissible dosage is two times less, that is, a single dose is 10 mg (1 tablet), and a daily dose is 30 mg (3 tablets).

Cerucal injections (in ampoules) – instructions for use

Cerucal solution is administered intramuscularly or intravenously. The ampoule with the solution is opened immediately before the injection and is used for a maximum of 15 - 30 minutes. An opened ampoule cannot be stored until the next injection. It is only permissible to store an open ampoule for a maximum of several hours in the refrigerator. In this case, the hole in the ampoule should be plugged with sterile cotton wool, a bandage or an adhesive plaster.

For intramuscular injection it is necessary to use relatively thick and long needles, and for intravenous injection, on the contrary, thin and short ones. In principle, if there is an urgent need, an intravenous injection can be done with an intramuscular needle. But under no circumstances should an intramuscular injection be given with an intravenous needle, since it is too short and may not reach the muscles through the layer of skin and subcutaneous tissue. As a result, the medicine will end up in the subcutaneous tissue, from where it will be very poorly absorbed into the blood and, accordingly, will not have a therapeutic effect. Therefore, you should carefully purchase injection syringes, indicating to the pharmacist which needle is needed in this case. Some syringes are sold only with thin intravenous needles, in which case you will have to purchase intramuscular needles separately. It is optimal to do this in Medtekhnika stores.

To make an intramuscular or intravenous injection, you should open the ampoule, take a new sterile syringe from the package, attach a needle to it and draw out the required amount of solution. Then the syringe is turned upside down with the needle and, holding it in a vertical position, the wall is tapped with a fingernail in the direction from the piston to the needle holder so that the air bubbles come off and rise to the surface of the solution. Then lightly press the piston, releasing a few drops of solution, along with which the air is removed. After completing these manipulations, the syringe is put aside on a clean surface or in a sterile tray and the site is prepared for intravenous or intramuscular injection.

An intramuscular injection is best done in the upper outer lateral part of the thigh, the upper third of the shoulder or in the abdomen (if the person is not overweight), since it is in these places that the muscles come closest to the skin and the risk of introducing the solution into the subcutaneous layer is minimal. The solution should not be injected into the buttock, since in this area of the body the muscles lie very deep and the risk of injecting the drug into the subcutaneous fatty tissue is high.

The selected site for intramuscular injection is wiped with a cotton swab moistened with an antiseptic, for example, alcohol, chlorhexidine, etc. If injections have already been made in this area, then you should find a new place by eye so that the new injection is at a distance of 1 cm from each previous hole. The needle is quickly inserted into the selected area to the end, holding it perpendicular to the skin. Then slowly release the solution into the tissue, press the skin on both sides of the needle with the index and middle fingers, and remove it. The injection site is again wiped with an antiseptic.

Intravenous injection should only be given by a qualified nurse or doctor, since if the drug is not administered correctly into the perivenous space, irritation and severe allergic reactions may occur. The solution is injected in a stream, that is, the required amount of Cerucal is drawn into a syringe, a vein is pierced and it is slowly released into the blood.

For the relief of nausea, vomiting and hiccups of any origin, as well as for the rapid elimination of dyspeptic symptoms (heartburn, flatulence, heaviness in the abdomen, etc.) in diseases of the gastrointestinal tract associated with impaired passage of food (reflux gastritis, peptic ulcer, gastritis, biliary dyskinesia tract and pyloric stenosis), a single dose of 10 mg (whole ampoule) of solution is administered intravenously or intramuscularly. If 30 minutes after the intramuscular injection or 15 minutes after the intravenous injection, vomiting, nausea or hiccups have not stopped, then another 10 mg of Cerucal is administered. The next administration of the drug can be carried out only after 3 hours.

If a person is bothered by constant nausea, vomiting and hiccups of any origin, or is undergoing treatment for gastrointestinal diseases associated with impaired passage of food through the intestines and stomach, then it is preferable to take Cerucal in tablets. But if it is impossible to take tablets, injections are allowed for a maximum of 2 to 4 weeks. In this case, the Cerucal solution for the relief of hiccups, nausea and vomiting, as well as dyspeptic manifestations of gastrointestinal diseases is administered intramuscularly, one ampoule 3-4 times a day for adults, and half an ampoule 3 times a day for children 14-18 years old.

In principle, the solution is only an emergency aid when it is necessary to urgently and quickly normalize a person’s condition by eliminating painful symptoms. And after the ambulance, he is transferred to taking Cerucal tablets, and they do this as soon as possible.

In children 2–14 years old, Cerucal solution is used according to the same rules as in adults, however, the dosage is determined by body weight and is as follows:

The child's body weight is less than 20 kg– a single dosage is 0.4 ml of solution, which corresponds to 2 mg of the active substance. The maximum daily dosage is 10 mg (2 ml solution);
Child’s body weight 20 – 30 kg– single dosage is 3 mg (0.6 ml of solution), daily dosage is 15 mg (3 ml of solution);
Child’s body weight 30 – 50 kg– a single dosage is 5 mg (1 ml of solution), and a daily dosage is 25 mg (5 ml of solution).

Children weighing more than 50 kg, regardless of age, should receive Cerucal in dosages for adolescents from 14 to 18 years.

To prepare for duodenal probing, x-ray of the stomach or intestines, Cerucal is administered to adults and adolescents over 14 years of age, 1 to 2 ampoules intravenously 10 minutes before the start of the diagnostic study. For children 2–14 years old, the dose is calculated individually based on body weight, based on the ratio of 0.1 mg per 1 kg of weight, and is also administered intravenously 10 minutes before the start of the examination.

In order to prevent nausea and vomiting in people receiving treatment with cytostatics, Cerucal is used according to two possible regimens:
1. Intravenous drip administration of the solution for 15 minutes at a dosage calculated at the ratio of 0.2 mg per 1 kg of body weight, half an hour before the start of cytostatic treatment. Then Cerucal in the same dosage is administered intravenously in a bolus 1.5, 3.5, 5.5 and 8.5 hours after the end of the use of the cytostatic;
2. Long-term continuous drip administration of Cerucal at the rate of 0.5 mg per 1 kg of weight per hour. The calculated amount of the drug is administered two hours before and within 24 hours after the end of the use of the cytostatic.

For long-term drip administration of Cerucal, it is diluted in saline solution or 5% glucose.

Cerucal - dosage for various diseases

Cerucal tablets are used in the following identical dosages for all indicated conditions:

Children 14 - 18 years old - 1/2 - 1 tablet 2 - 3 times a day;
Adults over 18 years old – 1 tablet 3 – 4 times a day.

The maximum permissible single dosage of Cerucal is 20 mg (2 tablets) for adults and 10 mg for adolescents, and the daily dosage is 60 mg (6 tablets) for adults and 30 mg for adolescents.

Cerucal solution is also used in the same dosages for the indicated diseases and conditions:

Children over 14 years of age and adults – 1 ampoule 1 – 3 times a day;
Children 2 – 14 years old – calculated individually according to the ratio of 0.1 – 0.5 mg per 1 kg of weight.

For liver pathology accompanied by ascites, the usual dosage is divided in half. In case of kidney pathology, the dosage of Cerucal is prescribed based on creatinine clearance, determined by the Rehberg test. If creatinine clearance is less than 10 ml/min, then Cerucal can be taken only 1 tablet or 1 ampoule once a day. With creatinine clearance from 11 to 60 ml/min, Cerucal is allowed to take 15 mg per day, divided into two doses - in the morning 10 mg (1 whole tablet or 1 ampoule) and in the evening 5 mg (half a tablet or 1 ml of solution). When creatinine clearance is more than 60 ml/min, Cerucal should be taken in normal dosages according to age.

special instructions

During the entire period of treatment with Cerucal, you should avoid drinking alcohol.

Teenagers, older adults over 65, and people with kidney disease, liver disease, asthma, and hypertension are at higher risk of developing side effects. If any appear, the drug must be discontinued.

While taking Cerucal, the concentrations of bilirubin, protein, AST, ALT and prolactin in the blood plasma may change. These changes are reversible and do not require discontinuation of the drug.

It is not recommended to use the drug for epilepsy, glaucoma and extrapyramidal disorders, since it may worsen the course of the disease.

Impact on the ability to operate machinery

Cerucal may reduce the rate of reactions, so during therapy it is necessary to refrain from potentially dangerous activities associated with the need to operate mechanisms.

Compatibility with other drugs

Anticholinergic drugs (Atropine, Scopolamine, Promethazine, Diphenhydramine, etc.) weaken the effect of Cerucal. And Cerucal weakens the effect of Levodopa, Pergoline and H2-histamine blockers (Ranitidine, Famotidine, etc.).

Cerucal slows down the absorption into the bloodstream from the intestines of Digoxin and Cimetidine, but accelerates it for antibiotics (Tetracycline, Ampicillin, etc.), Paracetamol, Aspirin, Levodopa, lithium preparations and alcohol.

When taken simultaneously, Cerucal leads to an increase in the concentration of lithium and bromocriptine in the blood. In addition, Cerucal enhances the effects of alcohol and sedatives, and prolongs the effect of succinylcholine. Cerucal also changes the effects of tricyclic antidepressants (Amitriptyline, etc.), monoamine oxidase inhibitors (Iproniazid, Selegiline, etc.) and sympathomimetics (Adrenaline, Oxymetazoline, Xylometazoline, etc.).

When taken with neuroleptics (Aminazine, Phenothiazine, etc.), the likelihood of extrapyramidal disorders increases.

Cerucal causes inactivation of vitamin B1, so they should not be used simultaneously.

Overdose

Overdose is manifested by the following symptoms:

Confusion;
Anxiety;
Extrapyramidal disorders;
Increased blood pressure.

In case of mild overdose, all symptoms go away on their own within 24 hours after discontinuation of the drug without any treatment. In case of more severe poisoning, it is necessary to rinse the stomach, give the person sodium sulfate and carry out symptomatic treatment aimed at relieving painful manifestations. In this case, extrapyramidal disorders are usually eliminated with Biperedene, and anxiety is relieved with Diazepam.

Cerucal for children

General provisions

Cerucal is a drug that is often used to relieve vomiting in children, including those under 2 years of age, although this is prohibited. Despite the contraindication to the use of Cerucal in tablets for children under 14 years of age, it is actively used to stop vomiting. Since children, as a rule, do not suffer from other gastrointestinal diseases, the only purpose of using Cerucal for them is to stop vomiting.

Year after year, women share with each other information about how they gave their children Cerucal when vomiting, advising them not to pay attention to the prohibition of use specified in the instructions, since, according to their observations, nothing bad happened to the child. Of course, women want to help each other by sharing their life experiences and their own observations, but in this case they are not entirely correct.

The fact is that vomiting in a child under 2 years of age is a signal to call an ambulance. To stop vomiting, a child over 2 years old should be given Cerucal not in tablets, but buy a solution and administer it intramuscularly. This use of the drug will be correct and safe, since the solution allows you to accurately dose Cerucal, minimizing the risk of overdose.

Cerucal (injections, tablets) – instructions for use for children

Tablets can only be given to children over 14 years of age half an hour before meals. In this case, a single dosage of the drug to relieve vomiting, nausea or hiccups is 0.5 - 1 tablet. The maximum permissible daily dosage for children 14 – 18 years old is 3 tablets. When vomiting, the drug is taken 2-3 times a day as needed. And as part of the complex treatment of diseases of the digestive tract associated with impaired motility of the stomach and intestines (gastritis, peptic ulcers, reflux esophagitis), Cerucal should be taken 0.5 - 1 tablet 2 - 3 times a day for 6 weeks - 6 months.

Cerucal injections in children should be used as an emergency remedy to relieve vomiting, nausea or hiccups of any origin. In this case, children 14–18 years old are administered 1 ampoule of solution 1–3 times a day, and the dosage for children 2–14 years old is calculated individually based on body weight.

Cerucal for children - dosage for various diseases

The dosage of Cerucal tablets and solution is the same for all diseases for which the use of the drug is indicated, and is 0.5 - 1 tablet 2 - 3 times a day, or 1 ampoule 1 - 3 times a day for children 14 - 18 years old.

For children 2–14 years old, only Cerucal solution is used, the dosage of which is calculated individually according to body weight, based on the ratio: 0.1 mg per 1 kg of weight. That is, for a child weighing 10 kg, a single dosage of Cerucal is 0.1 * 10 = 1 mg, which corresponds to 0.2 ml of solution. If necessary, the dosage can be increased to 0.5 mg per 1 kg of body weight. The maximum daily dosage of the solution for children weighing less than 20 kg is 10 mg (2 ml of solution), 20 - 30 kg - 15 mg (3 ml of solution) and 30 - 50 kg - 25 mg (5 ml of solution).

For children over 6 years old, you can use the following average dosages:

Children 6 – 10 years old – administer 2.5 mg (0.5 ml solution) 1 – 3 times a day;
Children 10 - 14 years old - administer 5 mg (1 ml of solution) 1 - 3 times a day.

Use during pregnancy and breastfeeding

During the first trimester

The drug Cerucal is produced in ampoules and tablets and is used to relieve vomiting in adults and children. When using the medicine, you must strictly follow the instructions.

Cerucal is one of the representatives of the group of antiemetics, which acts as a dopamine receptor blocker. It is used not only to treat adults, but also for children of different ages. Its ability is to quickly stop the urge to vomit. Take Cerucal for children according to the instructions for use.

This type of medication is sold in tablet and liquid form. The solution is poured into ampoules of 2 ml. Tablets are packaged in 10 pieces. Per 1 ml of medication there is 5 mg of metoclopramide hydrochloride. Purified water and sodium chloride were added as additional substances. The solution is used for intramuscular and intravenous administration.

Tasteless and odorless tablets are taken orally. Each contains 10 mg of the active ingredient. Placed in a dark glass bottle.

The instructions for children indicate that the action of the active substance is aimed at blocking the receptors through which impulses pass and irritate the mucous membrane of the digestive tract. As a result, the signals enter the brain and suppress the gag reflex.

The medication also has other effects. It enhances the tone of the smooth muscle structures of the stomach. Thanks to this process, the rate at which food enters the intestinal tract increases. At the same time, the medicine stimulates the protective functions of the esophagus from the ejection of food from the stomach back, as well as the stomach from excessive ingress of bile. Thus, unpleasant symptoms such as heartburn and belching disappear.

In addition to all this, Cerucal has a beneficial effect on intestinal motility, which makes it possible to empty the digestive tract in a timely manner.

Indications for use

Regarding Cerucal, the instructions for use for children indicate that the medicine can be administered intravenously, intramuscularly or taken orally. There are several main indications:

that are associated with the intake of low-quality or stale products, poisoning, diseases of the stomach or pancreas;
nausea and vomiting caused by medication use;
bile duct dyskinesia;
reflux esophagitis;
postoperative gastric hypotension. This condition is accompanied by heaviness, nausea and discomfort in the abdomen;
gastric paresis due to severe diabetes mellitus.

Probing or endoscopic examination may also be indicated.

Contraindications for use

This drug may not be used in all cases. The solution in ampoules has a number of limitations such as:

There are also relative contraindications. That is, the drug can be used, but with caution:

during pregnancy in the second and third trimester;
with arterial hypertension;
for bronchial asthma;
for kidney and liver diseases;
with Parkinson's disease;
with thrombophlebitis.

The instructions for using the tablets for children also highlight several contraindications:

severe sensitivity to the components of the drug;
intestinal obstruction;
epileptic disorder;
children under 3 years of age.

The tablets can be taken with caution in children aged 3 to 14 years. It is not recommended to use the medicine during breastfeeding.

Scheme of medication use

The method of application directly depends on the chosen form of the drug. The instructions for using Tsirukal injections for children say that the solution is administered intravenously or intramuscularly.

The dose depends on the patient's age:

For children from 2 to 6 years old, the amount of the drug administered is calculated based on weight. So, per 1 kg there is 0.5 mg of the active ingredient. This dosage is divided into 2-3 doses.
Children from 6 to 14 years old are given 2 ml of solution, which is equal to one ampoule. Frequency of application - 3 times per day.
Adolescents over 14 years of age are prescribed 2-3 ml at a time. Frequency of use - 3 times.

In extreme cases, a doctor may give an injection to a child as young as 1 year old. The dosage is calculated not only based on the weight, but also the general condition of the baby, as well as the indications.

The tablets should be taken 30 minutes before meals or 1-2 hours after that. In this case, it is necessary to drink the drug with plenty of water.

If Cerucal is prescribed to children for vomiting, the dosage is calculated based on age:

Children from 3 to 6 years old are prescribed ¼ tablet 3 times a day.
Children from 6 to 14 years old are recommended to take ½ tablet up to 3 times a day.
Teenagers are prescribed 1 tablet 3 to 4 times.

The duration of the treatment course depends on the cause. In case of poisoning, it is enough to take the medicine once or twice. For more serious pathologies, the treatment course ranges from 1 to 6 months.

Side effects and overdose

The drug begins to act quickly - 10-20 minutes after use. In some cases, the medicine is well tolerated. But the younger you are, the more likely you are to get side effects.

They appear:

in disorders of the nervous system: dizziness, insomnia, weakness, lethargy, apathy, tremors of the limbs;
in disorders of the cardiovascular system. Characterized by a decrease or increase in pressure, tachycardia;
in disorders of the digestive system in the form of dry mouth, heartburn, belching, a feeling of heaviness in the stomach, constipation, bloating.

If at least one symptom occurs, the patient should stop taking the drug.

If the dose is calculated incorrectly or the doctor’s recommendations are not followed, symptoms of overdose are observed:

confusion;
restlessness, drowsiness, convulsions;
disorientation in space;
a sharp increase or decrease in pressure;
bradycardia.

In severe cases, there is a disturbance in the functionality of the liver and kidneys. In such cases, drug withdrawal, gastric lavage and symptomatic therapy are urgently required.

Cerucal is one of the effective remedies against vomiting and nausea. But you need to be careful when calculating the dosage.

Cerucal is a dopamine receptor blocker that reduces the sensitivity of visceral nerve fibers. They are responsible for transmitting a signal from the pylorus, the pylorus of the stomach, to the vomiting center. The activity of the upper gastrointestinal tract is regulated through the parasympathetic nervous system.

pharmachologic effect

Thanks to its effect on the nervous system, Cerucal suppresses vomiting and hiccups. Other therapeutic effects are only derivatives of the main ones. Penetrating into the bloodstream, and then into the brain and other organs, the drug blocks the sensitivity of receptors in tissues. This stops the functioning of the brain's vomiting center, which leads to a lack of response to irritants of the digestive or respiratory system. Cerucal also eliminates nausea.

Additional effects that the drug has:

Reduced motor and contractile activity of the esophagus, due to which the lumen expands and the passage of food improves.
Accelerates the movement of food from the stomach to the duodenum, relieving the feeling of heaviness and discomfort.
Stabilizes the level of bile secreted as a reaction to food entering the intestines.
Improves the tone of the sphincter connecting the esophagus to the stomach, which reduces the likelihood of gastroesophageal reflux.
Reduces spasm of the sphincter of Oddi, which controls the flow of pancreatic bile into the duodenum. This allows bile to exit normally into the intestines without accumulating in the duct. The contractile activity of the organ is stabilized.

The drug does not regulate the amount of juice, enzymes or bile secreted. The appearance of the pharmacological effects of the drug begins an hour after consuming the tablets, with intramuscular administration after 15 minutes, with intravenous administration after 2-4 minutes. The duration of the Cerucal effect depends on how the drug was introduced into the body:

intramuscular injection – 1.5-2 hours;
tablets taken orally – 6 hours;
intravenous injection – 30 minutes.

Purpose

The medication is used as a complex therapy required to eliminate the following pathologies:

traumatic brain injury;
heartburn;
migraine;
pyloric stenosis;
impaired functioning of the liver or kidneys;
stomach irritation;
nausea, vomiting.

The product is used at the time of diagnosis of the stomach or intestines.

Indications

Cerucal is used in two forms: tablets and injections for intramuscular or intravenous administration. The use of tablets is carried out at home as prescribed by a doctor, and the solution is used in inpatient medical institutions.

Tablets and injections

Prescribe the use of the drug in any form for:

vomiting, nausea or hiccups;
the appearance of digestive system dysfunction or stomach irritation;
diabetic gastroparesis;
development of atony or hypotension.

Injections

In addition to the above, Cerucal, in the form of an injection solution, is used:

to conduct duodenal intubation;
to increase the speed of food passage through the digestive system, in preparation for x-rays of the gastrointestinal tract.

Contraindications

The drug has a number of contraindications:

epilepsy;
glaucoma;
internal bleeding in the digestive system;
intestinal obstruction;
ulcer;
extrapyramidal disorders;
tumor formation leading to increased production of adrenaline;
peritonitis.

Additionally, it is prohibited to use Cerucal for people who are sensitive or intolerant to the components of the drug and for children under 2 years of age. At the same time, take with caution and under the supervision of a doctor if you have:

liver and kidney dysfunction;
hypertension or hypotension;
bronchial asthma.

When prescribing the drug to children, it is necessary to carefully monitor their condition, which is due to the developing organism and possible negative reactions.

Form and composition

The drug is produced in two forms:

pills;
injections.

Each tablet contains 10 mg of the active ingredient - Metoclopramide hydrochloride. The medication in the form of an injection solution is contained in 2 ml ampoules. They contain a similar volume of active substance - 10 mg, where for every 1 ml there is 5 mg. In this case, the effect of the drug is the same in both forms, only the speed of entry and the duration of the effect on the body differ.

When there is an urgent need to relieve the symptoms of digestive dysfunction or when vomiting, when food does not stay in the stomach for more than 20 minutes, injections of the drug are prescribed.

Dosage

Pills

Take the drug in tablet form 30 minutes before meals:

adults: 1 tablet 3-4 times a day;
adolescents over 14 years old: 0.5-1 tablets 3 times a day.

The course of treatment with Cerucal is 4-5 weeks, it can be extended to 6 months for medical reasons.

Ampoules

A solution for intramuscular or intravenous administration is prescribed:

at the age of 3 years - 0.1 mg of medication per 1 kg of child’s weight, per day no more than 0.5 mg per 1 kg of weight;
over 14 years old – 1 ampoule, 3-4 injections per day.

During pregnancy

During the first 3 months of pregnancy, a woman should not use Cerucal in any form. From 4 months, the drug is prescribed only in the presence of serious health problems. It is also prohibited to use the product during lactation.

In children

Use Cerucal to eliminate vomiting in children with extreme caution. This is due to the increased likelihood of dyskinetic syndrome.

Complications

Possible negative consequences from taking Cerucal:

headache or dizziness;
the appearance of tinnitus;
constipation, diarrhea, and dry mouth;
decrease in the level of granulocytes in the blood;
convulsions, fever;
increased heart rate, increased blood pressure, arrhythmia;
allergies, asthma attacks.

Overdose

With self-medication or an incorrectly selected dosage of the drug, an overdose is possible. You need to urgently go to the hospital or call an ambulance. This situation is accompanied by the following symptoms:

confusion;
increased drowsiness;
problems with heart function;
high blood pressure;
convulsions;
cardiopalmus.

When extrapyramidal disorder occurs due to overdose, intravenous administration of biperiden is required, which acts as an antidote. In addition, the person is constantly monitored by doctors in the hospital until the symptoms are eliminated.

Interaction with other drugs

If you need to use Cerucal together with other medications, you need to know what the drug is:

cannot be used when introducing alkaline solutions into the body;
increases the level of absorption of antibiotics;
leads to the destruction of vitamin B1;
enhances existing movement disorders when taken simultaneously with antipsychotics;
increases the chance of developing Parkinson's syndrome when used together with sedatives;
increases the hepatotoxicity of medications taken.

Price, dispensing from pharmacies, storage

Shelf life: 5 years, stored at room temperature, available with prescription.

Prices for drugs from the website apteka.ru.

Cerucal tablets 10 mg 50 pcs. – 118 rub.

Cerucal solution for intravenous use. and intramuscular input. 10 mg 2 ml ampoules 10 pcs. – 235 rub.

Analogs

When there is an allergy or intolerance to the components of the drug, it is possible to use other drugs that have a similar therapeutic effect:

Motilium;
Domperidone;
Metoclopramide.