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Domperidone cardiac risk — GPhC CRA MCQ

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HardGastrointestinal TherapeuticsDomperidone cardiac riskGPhC CRA

A prescription requests metoclopramide 10 mg three times daily for 14 days for nausea in a 72-year-old. No exceptional specialist rationale is documented. Which intervention is most appropriate?

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Correct answer: E — Query before supply because the 14-day duration exceeds the five-day restriction

MHRA restricts metoclopramide to short-term use, normally no more than five days, with an adult maximum of 30 mg in 24 hours. This prescription meets the daily dose ceiling but not the duration restriction, and older age increases concern about neurological effects. Dose reduction or prophylactic anticholinergic use does not independently authorise a longer course, and adverse reactions require action rather than consent-based acceptance.

Reference: MHRA: metoclopramide neurological adverse effects. https://www.gov.uk/drug-safety-update/metoclopramide-risk-of-neurological-adverse-effects