With this dose, it may be necessary to prescribe a pediatric liquid suspension. Higher doses can be given as pills but patients develop tachyphylaxis much more rapidly with higher doses of erythromycin. The other option is metoclopramide 10 mg TID before meals or at bedtime, with an alternative BID dosing. This drug can be given as a pill, liquid suspension, or as subcutaneous injections. The problem with metoclopramide is its unfavorable side-effect profile.
Side effects increase with the dose and duration of metoclopramide.
The last alternative is domperidone, which is not available in the United States but can be obtained in Canada or Mexico. This drug is like metoclopramide but does not cross the blood brain barrier, therefore side-effects are reported to be minimal. Here again, the dose is 10 mg TID before meals and bedtime. Click here to print this page.