Metoclopramide
| Evidence Level: L5 | Predicted Indications: 5 |
Table of Contents
Metoclopramide: From Nausea/Vomiting and GI Motility Disorders to Gastric Ulcer
One-Sentence Summary
Metoclopramide is a dopamine D2‑receptor antagonist and prokinetic agent used internationally for nausea, vomiting and gastrointestinal motility disorders (no UK licence record is present in this evidence pack). The TxGNN model’s top-ranked prediction suggests possible efficacy for Gastric Ulcer, but this specific candidate is currently supported by no clinical trials and no literature, so the finding is model-driven only and requires further scrutiny before any development action.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Nausea, vomiting and gastrointestinal motility disorders (general pharmacological knowledge — no UK marketing authorisation data available in this evidence pack) |
| Predicted New Indication | Gastric Ulcer |
| TxGNN Prediction Score | 99.93% |
| Evidence Level | L5 (model prediction only, no supporting trials or literature) |
| UK Market Status | Not marketed (per evidence pack) |
| Number of Marketing Authorisations | 0 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data for this product record is not available in the evidence pack (flagged as a High-severity data gap). Based on general pharmacological knowledge, metoclopramide is a dopamine D2‑receptor antagonist and gastroprokinetic agent: it accelerates gastric emptying and increases lower oesophageal sphincter tone. In theory this could reduce mucosal irritation from bile reflux or delayed gastric emptying, which provides a plausible — but indirect — mechanistic link to gastric ulcer.
However, gastric ulcer pathophysiology is predominantly driven by acid hypersecretion and Helicobacter pylori infection, and standard treatment relies on acid suppression (PPI/H2RA) and eradication therapy rather than motility modulation. The high TxGNN score most likely reflects proximity within the knowledge graph (e.g. shared “gastrointestinal tract” nodes) rather than a genuine, evidence-backed pharmacological effect. No clinical trial or published study in this evidence pack directly examines metoclopramide for gastric ulcer treatment or prevention.
It is worth noting that a lower-ranked prediction in the same evidence pack — gastroduodenitis (rank 2, score 99.90%) — is supported by 20 literature items describing metoclopramide’s effects on antroduodenal motor coordination, reaching evidence level L4. This may represent a more mechanistically coherent research question than the top-ranked gastric ulcer prediction, though it too lacks controlled clinical trial data.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
UK Market Information
No marketing authorisations are recorded for Metoclopramide in this evidence pack. Market status is listed as “Not marketed,” with 0 total licences on file. UK-specific licence, product name, dosage form and approved indication text could not be extracted (TFDA/MHRA label data was flagged as a Blocking-severity data gap in the source evidence pack).
Safety Considerations
Please refer to the SmPC and BNF for safety information. Report suspected adverse reactions via the Yellow Card Scheme.
Conclusion and Next Steps
Decision: Hold
Rationale: The top-ranked prediction (Gastric Ulcer) has no supporting clinical trials or literature and evidence level L5 — this is a pure knowledge-graph association rather than a substantiated repurposing signal, and mechanistically it sits at odds with standard acid-suppression-based ulcer therapy.
To proceed, the following is needed:
- Confirmed mechanism of action (MOA) data from DrugBank or SmPC (currently a data gap)
- UK/TFDA label warnings, contraindications and product licence information (currently a Blocking data gap preventing safety pre-screening)
- Direct clinical or preclinical evidence testing metoclopramide specifically in gastric ulcer, rather than general GI motility studies
- Consider reprioritising evaluation toward gastroduodenitis (rank 2), which has a stronger literature base (20 publications, L4) around metoclopramide’s effect on antroduodenal motor coordination, as a more promising research question
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.