Ultramet 10 mg Tablet

Dopamine-blocking antiemetic and prokinetic for (adults, short-term):

• Nausea and vomiting — post-operative, chemotherapy/radiotherapy-induced (delayed), and with acute migraine
• Diabetic gastroparesis (short-term, some countries)
• To speed stomach emptying before procedures (hospital)

Adults: 10 mg up to three times daily (oral, IM or slow IV), maximum 30 mg/day (0.5 mg/kg/day) and maximum 5 days.

• Adults under 60 kg: 5 mg three times daily.
• Kidney impairment (CrCl < 60): reduce dose.

Children 1–18 years: only as second-line for post-operative or chemotherapy nausea: 0.1–0.15 mg/kg up to three times daily (max 0.5 mg/kg/day), for up to 5 days. Contraindicated under 1 year.

• IV doses must be given slowly over at least 3 minutes.

• Gastrointestinal obstruction, perforation or bleeding
• Phaeochromocytoma
• History of tardive dyskinesia or neuroleptic-induced movement disorders
• Epilepsy
• Parkinson's disease
• Use with levodopa or dopamine agonists
• Infants under 1 year
• Breastfeeding (some sources) / methaemoglobinaemia history

Common: drowsiness, tiredness, diarrhoea, low blood pressure.

Movement side effects: acute dystonia (spasms of face, neck, eyes — especially in young women and children), restlessness (akathisia), parkinsonism; tardive dyskinesia with long use (may be permanent).

Rare but serious: neuroleptic malignant syndrome, depression, raised prolactin (breast enlargement, milk discharge), heart rhythm problems with IV use.

• Use for no more than 5 days to minimise neurological effects.
• Young people and elderly: higher risk of movement disorders.
• Stop if involuntary movements occur (treated with an anticholinergic).
• Heart rhythm problems: caution with IV.

Can be used in pregnancy for nausea when needed (large studies reassuring). Passes into milk — short courses generally acceptable; monitor the baby.

• Levodopa, dopamine agonists (opposing effects — contraindicated)
• Antipsychotics (more movement disorders, NMS)
• Alcohol, sedatives (more drowsiness)
• SSRIs (serotonin syndrome, rare)
• Speeds absorption of paracetamol; reduces digoxin absorption

Drowsiness, confusion, severe movement disorders, heart rhythm changes. Seek emergency care.

Store below 30°C, protected from light.