Gastroparesis Medications: What Works and How to Use Them

If your stomach empties too slowly, you’ve probably heard of gastroparesis. The good news is there are medicines that can speed things up and ease nausea. Below we break down the most common drugs, what they do, and how to keep side effects in check.

Common Prescription Options

The first line of treatment usually involves prokinetic agents. These meds stimulate stomach muscles so food moves faster. The go‑to drug is metoclopramide, taken three times a day before meals. It works by boosting the release of a hormone called motilin and blocking dopamine, which relaxes the gut.

If metoclopramide isn’t tolerated, doctors may suggest domperidone. It has a similar effect but stays out of the brain, so it causes fewer movement‑related side effects. The usual dose is 10 mg before each meal, and you need to check your heart rhythm if you have a history of cardiac issues.

Another option is low‑dose erythromycin. Although it’s an antibiotic, at sub‑therapeutic levels it acts like a motilin agonist, giving the stomach a quick “wake‑up” call. It’s taken for short bursts (usually two weeks) to avoid bacterial resistance.

When nausea dominates, antiemetics such as ondansetron or prochlorperazine can be added. They don’t speed digestion but help you tolerate meals. Most patients start with a 4‑8 mg dose of ondansetron before meals and adjust based on how they feel.

Tips for Managing Side Effects

Prokinetics can cause restlessness, drowsiness, or even muscle tremors. To limit these, take the medication at bedtime if it makes you jittery during the day. Eating smaller, more frequent meals also reduces the workload on your stomach.

If you notice any unexplained muscle twitches, dizziness, or mood changes while on metoclopramide, call your doctor right away—these could signal a rare but serious reaction called tardive dyskinesia.

For domperidone users, keep an eye on heart rhythm. A simple ECG once a year can catch early warning signs. And remember, erythromycin may cause mild diarrhea; staying hydrated helps prevent dehydration.

Always inform your pharmacist about every drug you’re taking. Over‑the‑counter meds like antacids or certain supplements can interfere with the absorption of gastroparesis drugs.

Finally, combine medication with lifestyle tweaks: chew food thoroughly, avoid high‑fat meals, and consider a low‑fiber diet for a few weeks to see if symptoms improve. The right mix of drugs and habits often makes the biggest difference.