News Feature | February 4, 2014

Metoclopramide Nasal Spray More Effective Than Oral Tablet

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By Cyndi Root

Evoke Pharma, Inc. announced in a press release that a study has proved that metoclopramide intranasal spray is more effective at symptom relief than an oral tablet. Evoke is a specialty pharmaceutical company that formulates treatments exclusively for gastrointestinal (GI) diseases. The company will publish the results of the study in the Neurogastroenterology & Motility journal, with advance copy available online. Metoclopromide treats diabetic gastroparesis.  


Gastroparesis is a common problem for people with diabetes. The condition is also found in people with previous gastric surgery, minor obstructions, anorexia nervosa, and collagen vascular disorders. Gastroparesis, sometimes called delayed gastric emptying, is a condition whereby food slows or stops on its way from the stomach to the small intestine. Usually, the vagus nerve functions in the stomach to break up food and move it along the gastrointestinal (GI) tract.  Damage to the vagus nerve slows or stops the movement of food. Patients may feel bloated, have abdominal pain, nausea, vomiting, lack of appetite, and weight loss.


Metoclopramide treats gastroesophageal reflux disease (GERD) and gastroparesis. Metoclopramide is a prokinetic agent, a class of drugs that work by strengthening the lower esophageal sphincter (LES), causing the stomach to empty its contents faster. Metoclopramide is commonly given in tablet form, in dissolving tablet form, or in a liquid solution taken orally. Patients usually take it four times daily on an empty stomach. With the current dosing forms of the drug, patients are advised that symptoms may take some time to resolve. Nausea, vomiting, and loss of appetite lessen early on in treatment and continues to improve over the next few weeks. The feeling of fullness may take more time to go away.

The Metoclopromide Nasal Spray Study

The metoclopramide nasal spray offers better symptom relief than other dosage types. The Phase 2b study enrolled 89 people from the U.S. from six different sites. The study was randomized in a parallel design and compared efficacy and safety of the nasal spray compared to oral tablets. Chief Medical Officer of Evoke, Marilyn Carlson, D.M.D., M.D., RAC, said, "It is intuitive that a nasal spray will have more reliable absorption than a tablet in patients with delayed gastric emptying. These data from symptomatic diabetic gastroparesis patients confirm that metoclopramide nasal spray is well-tolerated and can offer better symptom relief than a tablet in this population." Evoke plans to proceed to a Phase 3 clinical trial. Dave Gonyer, CEO of Evoke, noted than the FDA has not approved any gastroparesis drugs since 1980.