Antiemetics & Prokinetics

Metoclopramide CRI

Antiemetic and prokinetic CRI for dogs and cats. Used for nausea, vomiting, gastric stasis, reflux esophagitis, and prokinetic support in critically ill patients. A higher-dose protocol (1 mg/kg/hr intraoperatively, dropping to 0.083 mg/kg/hr postoperatively for 24 hours) is published for laryngeal paralysis surgery to reduce reflux and aspiration risk. Other antiemetics (ondansetron, maropitant) are preferred in cats.

Stock: 5 mg/mL (5000 µg/mL), 10 mL vial (50 mg)

How this calculator works

Enter the patient's weight and dose. The calculator returns the pump rate to deliver that dose at the chosen bag concentration. The default 40 µg/mL preparation suits most patients on standard antiemetic CRI (0.04–0.09 mg/kg/hr); a 20 µg/mL prep is available for small patients and a more concentrated 1000 µg/mL syringe prep covers the laryngeal-paralysis intraoperative protocol.

After you compute, the result panel shows the laryngeal-paralysis loading-dose protocol alongside the CRI rate. The standard antiemetic CRI doesn't require a loading dose. The laryngeal-paralysis protocol uses a 1 mg/kg IV loading dose before the intraoperative CRI at 1 mg/kg/hr, dropping to 0.083 mg/kg/hr postoperatively.

Metoclopramide is contraindicated in GI obstruction or perforation. It crosses the blood-brain barrier; watch for extrapyramidal signs (restlessness, involuntary movements) at higher doses or with prolonged use. Other antiemetics (ondansetron, maropitant) are preferred in cats.

Species

Dog Cat

Weight

lb kg

Dose (mg/kg/hr)

Typical range: 0.04–0.09 mg/kg/hr (dogs and cats)

Bag preparation

40 µg/mL

10 mg (2 mL stock) into a 250 mL bag of 0.9% NaCl, 5% dextrose, or LRS, or 20 mg (4 mL) into 500 mL

Use a different concentration

All preparations are pharmacologically equivalent. The default (40 µg/mL) fits the most common clinical use case. The alternatives below cover situational needs.

40 µg/mL (default) 10 mg (2 mL stock) into a 250 mL bag of 0.9% NaCl, 5% dextrose, or LRS, or 20 mg (4 mL) into 500 mL Standard preparation for most patients on antiemetic / prokinetic CRI.

20 µg/mL 5 mg (1 mL stock) into a 250 mL bag of 0.9% NaCl, 5% dextrose, or LRS Small patients (<10 kg). Pump rate stays in a reasonable range for syringe-pump or low-flow infusions.

1000 µg/mL 50 mg (10 mL stock) into a 50 mL syringe of 0.9% NaCl Concentrated preparation for the laryngeal-paralysis intraoperative protocol (1 mg/kg/hr).

Awaiting input

Enter a patient weight to see the result.

Reference

How the calculation works

Metoclopramide CRI is dosed in mg/kg/hr. Because the prepared CRI concentration is expressed in µg/mL, the formula needs a × 1000 to convert the mg dose into µg before dividing:

$$\text{mL/hr} = \frac{\text{weight}_{\text{kg}} \times \text{dose}_{mg/kg/hr} \times 1000}{\text{concentration}_{\mu g/mL}}$$

Patient weight (kg) times dose (mg per kg per hour) gives mg per hour. Multiplying by 1,000 converts mg to µg so the units match the bag concentration. Dividing by µg/mL yields mL per hour.

Worked example with current inputs

Enter a patient weight to see the worked example.

Reference

Recommended dilutions

Target concentration	Dilution	When useful
20 µg/mL	5 mg (1 mL stock) into a 250 mL bag of 0.9% NaCl, 5% dextrose, or LRS	Small patients (<10 kg). Pump rate stays in a reasonable range for syringe-pump or low-flow infusions.
40 µg/mL	10 mg (2 mL stock) into a 250 mL bag of 0.9% NaCl, 5% dextrose, or LRS, or 20 mg (4 mL) into 500 mL	Standard preparation for most patients on antiemetic / prokinetic CRI.
1000 µg/mL	50 mg (10 mL stock) into a 50 mL syringe of 0.9% NaCl	Concentrated preparation for the laryngeal-paralysis intraoperative protocol (1 mg/kg/hr).

Metoclopramide stock is 5 mg/mL (10 mL vials, 50 mg per vial). Compatible diluents per Plumb's: 0.9% NaCl, 5% dextrose, LRS, and Ringer's. Avoid co-administration with chloramphenicol, calcium gluconate, or other drugs known to be incompatible (consult Plumb's compatibility tables for the specific drug). Solutions are stable for 24 hours at room temperature in the listed diluents; discard if discoloration occurs.

Dilution helper — Metoclopramide CRI

Work out how many mL of stock drug and diluent to combine for any target concentration. Stock is pre-filled for Metoclopramide CRI; change it if you're using a different vial.

Stock concentration (µg/mL)

Desired concentration (µg/mL)

Suggestions from the reference table above

Final volume (mL)

Draw up

Enter stock, target concentration, and final volume.