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metoclopramide (Gimoti / EVK 001 / EVK001)

✓ Approved

Evoke Pharma, Inc. · DRD2 · Small Molecule

What is metoclopramide?

metoclopramide is a small molecule developed by Evoke Pharma, Inc.. It is approved for therapeutic indications via inhaled or intranasal or oral (po).

Drug Profile

Brand NamesGimoti, EVK 001, EVK001
CompanyEvoke Pharma, Inc.
Drug ClassSmall Molecule
Molecular TargetDRD2, HTR4, PTGS1, PTGS2
RouteInhaled, Intranasal, Oral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Evoke Pharma, Inc.

Mechanism of Action

Molecular Targets

metoclopramide acts on 4 molecular targets:

DRD2dopamine receptor D2 (D2R, D2DR)
HTR45-hydroxytryptamine receptor 4 (5-HT4R, 5-HT4)
PTGS1prostaglandin-endoperoxide synthase 1 (PHS1, PGHS-1)
PTGS2prostaglandin-endoperoxide synthase 2 (COX2, COX-2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

metoclopramide is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Gastrointestinal disordersGastric atony✓ Approved

Related Research Articles

PubMedAnesthesiology and pain medicine2026-09-20

Effectiveness of Apneic Oxygenation During Induction of General Anesthesia in Children Undergoing Adenotonsillectomy: A Prospective Randomized Controlled Study.

Ragab Safaa Gaber SG, Ali Lotfy Ahmed A, Botros Joseph Makram JM, Hashem Hasnaa Mohsen HM et al.

Children undergoing adenotonsillectomy often have partial airway obstruction due to hypertrophic tonsils and adenoids, increasing their risk of oxygen desaturation during anesthesia induction. This study aimed to evaluate whether apneic oxygenation via nasal cannula prevents oxygen desaturation during tracheal intubation in children aged 3 - 10 years undergoing adenotonsillectomy while assessing its effects on intubation conditions and hemodynamic stability. In this prospective, single-blinded, randomized controlled trial, 140 children scheduled for adenotonsillectomy were allocated to either standard intubation (group A, n = 70) or apneic oxygenation (group B, n = 70; 0.2 L/kg/min via nasal cannula). The primary outcome was the lowest peripheral oxygen saturation (SpO₂) during intubation. Peripheral SpO₂ was significantly lower during intubation in group A (97.40 ± 2.96) than in group B (99.91 ± 0.28) (P < 0.001). Group B also maintained significantly higher SpO₂ immediately after intubation (99.91 ± 0.28%) than group A (97.77 ± 2.24%; P < 0.001). No episodes of desaturation occurred in group B during the procedure (P < 0.001). In group A, 21.43% of patients desaturated to ≤ 95% (P < 0.001). Severe desaturation (SpO₂ < 92%) occurred in 7.14% of controls but was absent in group B (P = 0.023). Intubation time, intubation attempts, and bradycardia rates were comparable between groups (P > 0.05). Apneic oxygenation during intubation in children undergoing adenotonsillectomy effectively prevented desaturation without compromising safety or procedural efficiency.

PMID 42763625
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PubMedOdontology2026-09-20

Effects of clear aligner cleaning agents on Streptococcus mutans biofilms and thermoplastic surface integrity: an in vitro study.

Nalbantoglu Eser Rengin ER, Harzivartyan Sevan S, Topcuoglu Nursen N, Yilmaz Hanife Nuray HN et al.

Clear aligners are increasingly used in paediatric and adolescent orthodontics, but prolonged wear and suboptimal hygiene may promote cariogenic biofilm accumulation. This study aimed to compare the antibacterial efficacy of commonly used commercial and household clear aligner cleaning agents against Streptococcus mutans biofilms and to examine their effects on aligner surface integrity. Biofilms were grown on 48 clear aligner discs; 42 (n = 7 per group across four experimental and two control groups) were used for biofilm quantification, and 6 (n = 1 per group) for SEM analysis. After biofilm formation, discs were treated with Invisalign® Cleaning Crystals, Corega® Proguard and Retainer tablets, Invisalign® Aligner Cleaning Spray, or white vinegar diluted to a final acetic acid concentration of 0.5%. Viable bacteria were quantified as colony-forming units per millilitre (CFU/mL), and surface morphology was assessed by SEM. Data were analysed using the Kruskal-Wallis test followed by Dunn-Holm post hoc comparisons (p < 0.05). Commercial agents significantly reduced CFU counts compared with the negative control, whereas white vinegar did not. Median CFU values were lowest for the commercial agents (1.2-2.5 × 10³ CFU/mL), with no significant difference among them, and Invisalign® Cleaning Crystals and Corega® tablets were more effective than white vinegar (p ≤ 0.04). SEM corroborated the microbiological findings, showing substantial biofilm removal without apparent surface deterioration after commercial treatment. These findings support the use of commercial products in evidence-based clear aligner hygiene protocols because of their greater antibiofilm efficacy and preservation of thermoplastic surface integrity.

PMID 42763375
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PubMedAsian Pacific journal of allergy and immunology2026-09-20

Type 2-interferon imbalance in allergic barrier disease: An asthma-centered, cross-disease perspective.

Rao Shenghong S, Li Shumei S, Shen Haoyue H, Jin Tengchuan T

Allergic diseases are typically regarded as type 2 inflammatory disorders driven by interleukin-4, interleukin-5, and interleukin-13, which mediate immunoglobulin E class switching, eosinophilic inflammation, mucus hypersecretion, pruritus, tissue remodeling, and epithelial barrier dysfunction. However, type 2 cytokine activity alone does not fully account for variations in exacerbation risk, susceptibility to infections, comorbidities, or responses to biologic therapy. This narrative review proposes an asthma-centered type 2-interferon imbalance framework and discusses its cautious, disease-specific extension to atopic dermatitis, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, and food allergy. The model emphasizes that, particularly in asthma, allergic barrier inflammation arises and persists in injured tissues where excessive type 2 inflammation may coexist with impaired interferon-mediated host defense. Evidence is strongest in asthma, where deficiencies in type I and type III interferon responses are linked to rhinovirus susceptibility, delayed viral clearance, and recurrent exacerbations. In other allergic diseases, interferon dysfunction appears more variable, reflecting differences in tissue context, disease stage, and environmental exposure. In asthma, and potentially in selected allergic barrier diseases, persistent inflammation may result from a cycle of epithelial injury, alarmin release, cytokine amplification, impaired antiviral defense, ongoing exposure, and incomplete tissue repair. These mechanisms provide a rationale for tiered intervention, including blockade of upstream epithelial alarmins, inhibition of downstream type 2 effector pathways, and selected investigational approaches aimed at restoring mucosal host defense.

PMID 42763805
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PubMedCureus2026-09-20

Eleven-Year Diagnostic Delay in Episodic Cluster Headache With a Characteristic International Classification of Headache Disorders, 3rd Edition (ICHD-3) Clinical Pattern: A Case of Migraine Misdiagnosis and Otologic Confusion.

Kang Seungyoung S, Adi Amal A, Shetty Padma V PV, Alskaf Asma A

Cluster headache is a primary headache disorder characterized by recurrent attacks of severe unilateral headache accompanied by ipsilateral cranial autonomic symptoms. Despite well-established diagnostic criteria, it remains one of the most frequently misdiagnosed primary headache disorders, resulting in substantial diagnostic delay. We report a diagnostic dilemma involving a 31-year-old man with episodic cluster headache who remained undiagnosed for 11 years despite a clinical presentation highly consistent with the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. Throughout the disease course, he experienced recurrent severe unilateral orbital pain lasting 30-60 minutes, occurring more than three times daily during annual cluster periods and accompanied by ipsilateral lacrimation, nasal congestion, rhinorrhea, and marked restlessness. However, he was repeatedly diagnosed with migraine without aura and later underwent ophthalmologic and otolaryngologic evaluations, further delaying recognition of the characteristic headache pattern. Detailed reassessment of the clinical history ultimately led to a clinical diagnosis of episodic cluster headache, and guideline-recommended therapy was followed by substantial clinical improvement. The principal educational feature of this case is how prominent ipsilateral ear pain and distracting otologic and ophthalmologic findings contributed to delayed recognition of an otherwise characteristic cluster headache presentation. Careful assessment of attack duration, periodicity, cranial autonomic symptoms, and restlessness remains essential for timely recognition of cluster headache, particularly when apparently relevant local findings do not adequately explain the overall headache pattern.

PMID 42763664
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PubMedClinical drug investigation2026-09-20

Symptomatic Interventions for Allergic Rhinitis Without Comorbid Asthma: A Dose-Stratified Network Meta-analysis.

Salimi Sajjad S, Hamidi Arezoo A, Babajani Mohammad Mahdi MM, Mohammadnejad Amirreza A et al.

Allergic rhinitis (AR) is a prevalent chronic condition with a substantial global burden. Although numerous therapeutic interventions exist, their comparative efficacy and safety remain unclear. The objective was to evaluate symptomatic interventions for seasonal and perennial AR without comorbid asthma via a systematic review and dose-stratified network meta-analysis (NMA). We systematically searched Web of Science, Cochrane Library, Scopus, PubMed, and Embase for randomized controlled trials. Studies evaluating immunotherapy, alternative medicine, or primarily enrolling patients with comorbid asthma were excluded. A frequentist random-effects NMA compared interventions at class and dose-specific levels. Primary outcomes were total nasal symptom score (TNSS), total ocular symptom score, quality of life, and adverse events. Treatment rankings were derived using the surface under the cumulative ranking curve (SUCRA), and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation for Network Meta-Analysis for the TNSS outcome. The protocol was registered in PROSPERO (CRD42024507281). Global and local inconsistencies were evaluated. From 36,669 records, 175 randomized controlled trials (RCTs) encompassing over 90,000 participants were included. In the network meta-analysis, treatment rankings varied across outcomes, and no single regimen consistently outperformed others; the observed heterogeneity and significant inconsistency in several networks precluded firm conclusions regarding comparative effectiveness. Intra-class differences in effect sizes were observed across several drug classes. Certain higher-dose intranasal corticosteroid monotherapies appeared among the top-ranked interventions in SUCRA analyses. Still, these rankings should be interpreted cautiously given the substantial heterogeneity and inconsistency in some networks. The certainty of evidence for the TNSS outcome was moderate to very low in most comparisons. Despite sensitivity analyses, significant statistical incoherence persisted in several comparisons, particularly for TNSS in seasonal AR. The analysis was limited to patients without comorbid asthma. Overall, no universally superior regimen could be identified. Given the remaining heterogeneity and inconsistency, the findings should be regarded as exploratory and hypothesis-generating rather than as definitive evidence of comparative effectiveness. These findings raise the possibility that treatment selection may benefit from an individualized approach, although confirmatory studies are needed. PROSPERO CRD42024507281.

PMID 42763361
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PubMedInternational medical case reports journal2026-09-19

Histopathologi⁠cally Confirmed Nasal Rhinosporidiosis in an Adolescent Male Presenting with Long-Standing Right-Si⁠ded Nasal Obstruction and Epistaxis: A Case Report.

Mohamed Fahma Aden FA, Karim Abdishakur Mohamed AM, Tabu Geoffrey G

Rhinosporidiosis is a chronic granulomatous mucosal infection caused by Rhinosporidium seeberi, most commonly affecting the nasal cavity and nasopharynx. It typically presents as a friable polypoidal lesion associated with nasal obstruction and recurrent epistaxis. Histopathological examination is essential for definitive diagnosis. A 17-year-old male presented with a five-year history of progressive right-sided nasal obstruction and recurrent epistaxis. The nasal mass gradually enlarged and eventually protruded through the right nostril. He reported repeated swimming and playing in a nearby pond before symptom onset. Baseline laboratory investigations showed a hemoglobin level of 13.9 g/dL, white blood cell count of 6.63 × 109/L, and platelet count of 345 × 109/L. Mean corpuscular volume was reduced at 76.2 fL. Computed tomography demonstrated a well-defined soft-tissue lesion occupying the right nasal cavity without obvious destructive bony erosion. The lesion was excised through a transnasal approach, followed by cauterization of its base. Histopathological examination demonstrated chronically inflamed subepithelial stroma containing numerous thick-walled sporangia filled with endospores, confirming nasal rhinosporidiosis. Sporangia were present at the resection margin, indicating incomplete histological clearance. Postoperatively, oral dapsone 100 mg once daily was commenced for a planned six-month course after confirmation of normal glucose-6-phosphate dehydrogenase status. At three-month follow-up, repeat computed tomography showed no radiological evidence of recurrence. Nasal rhinosporidiosis should be considered in patients with long-standing unilateral nasal obstruction, recurrent epistaxis, and pond-water exposure. Complete surgical excision with cauterization and continued postoperative surveillance are important, particularly when histological margins are involved.

PMID 42761933
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