Positives

• Metoclopramide remains the only FDA-approved medication for diabetic gastroparesis and has been used off-label for post-viral gastroparesis seen in some Long COVID patients MDPI.
• Patients describe relief from nausea and post-meal fullness, particularly when used short-term NIH StatPearls.

Negatives

• The FDA placed a boxed warning on metoclopramide in 2009 after reports of tardive dyskinesia, and the label specifically advises against use beyond 12 weeks FDA.
• Tardive dyskinesia risk increases with cumulative dose and duration, and the involuntary movements can be irreversible PubMed.

Hurdles & Side Effects

• A patient experienced frequent muscle twitches, particularly in the legs, hands, and neck, which varied from every few seconds on a bad day to being mostly unnoticeable on a good day, raising concerns about metoclopramide as a possible cause Reddit.