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Metoclopramide dystonia — GPhC CRA MCQ

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EasyGastro-intestinal TherapeuticsMetoclopramide dystoniaGPhC CRA

A 19-year-old woman is prescribed metoclopramide 10mg three times daily after migraine-associated vomiting. She returns after two days with neck stiffness, facial spasms and restlessness. What is the most appropriate action?

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Correct answer: C — Refer urgently for suspected extrapyramidal reaction

Metoclopramide can cause acute dystonic and extrapyramidal reactions, particularly in younger patients. Facial spasms and neck stiffness after initiation are concerning. Treatment should be stopped and urgent clinical assessment arranged.

Reference: BNF; MHRA Drug Safety Update