Metoclopramide is a procainamide derivative. Its effects are based on at least two mechanisms: on the one hand, it acts on the central nervous system as an antagonist at D2 dopamine receptors, which explains its anti-emetic effect in the area of the chemoreceptor trigger zone and the stimulation of the prolactin release. On the other hand, metoclopramide has an agonistic effect on the cholinergic systems in the stomach and the gut. The result is a general improvement of the gastroduodenal coordination. High doses also have an antagonistic effect at the serotonin 5HT3 receptors.

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