Nasal metoclopramide may prove superior to oral tablets in treating diabetic patients with symptomatic gastroparesis. That, according to research presented at the 2003 Annual Meeting of the Society for Clinical Pharmacology and Therapeutics.
Dr. Sian Bigora from GloboMax Service Group in Hanover, Maryland, and associates compared the pharmacokinetics, efficacy, and safety of metoclopramide nasal spray and orally administered metoclopramide tablets in 89 patients with diabetic gastroparesis.
The pharmacokinetics of the 20-mg spray did not differ significantly from that of the 10-mg oral tablet, the results indicate, but the maximum concentration (Cmax) was significantly lower with the 10-mg spray than with the 10-mg oral tablet. There was generally greater variability in the pharmacokinetics of the nasal formulation than that of the oral tablets.
After 6 weeks of treatment, the mean improvements in total symptom scores were significantly better after either 10-mg or 20-mg nasal spray (16.8 and 18.0 points, respectively) than after 10-mg oral tablets (14.3 points).
The investigators concluded, “The results of this open label study suggest that the metoclopramide nasal spray 10 mg and 20 mg may have superior efficacy over the oral 10 mg tablets.”
“Due to the potential bias of this open label study,” the researchers added, “the efficacy results and conclusion need to be reproduced and confirmed by further studies.”