Gimoti™ (metoclopramide nasal spray; Evoke) is now available for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis.

Gimoti, a dopamine-2 (D2) antagonist, is a nasal spray formulation of metoclopramide. The novel formulation allows for systemic absorption of metoclopramide regardless of gastric emptying delays and gastroparesis disease flares. According to pharmacokinetic data, the systemic absorption of metoclopramide after nasal administration is lower than that after oral administration given the same dose. Following nasal administration of Gimoti 15mg, the systemic exposure to metoclopramide and the time to reach Cmax were similar to orally administered metoclopramide 10mg.

“Unlike oral medications, Gimoti is administered nasally, bypassing the need for absorption in the GI system, allowing the drug to enter the bloodstream directly and avoiding the problem of unpredictable stomach emptying,” said Henry Parkman, MD, Stanley H. Lorber Research Endowment Fund and Chair, and Director, Gastroenterology Motility Laboratory, School of Medicine at Temple University. “For these patients suffering from debilitating symptoms such as nausea, abdominal pain, bloating, early satiety, and vomiting, Gimoti is an important alternative to the current standard of care to help those that suffer from this disease.”

The most common adverse reactions associated with Gimoti therapy include dysgeusia, headache, and fatigue. The medication also carries a Boxed Warning regarding the risk of tardive dyskinesia, which increases with duration of treatment and total cumulative dosage.

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The product is available in a 10mL amber glass bottle delivering 15mg of metoclopramide with each 70 microliter spray. Each bottle contains 9.8mL which is sufficient for 4 weeks of 4 times a day use. Treatment with metoclopramide (all dosage forms and routes of administration) for longer than 12 weeks should be avoided as there may be an increased risk of developing tardive dyskinesia with longer-term use.

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  1. Evoke and EVERSANA announce commercial launch of Gimoti™. [press release]. Solana Beach, CA and Chicago, IL: Evoke Pharma, Inc and EVERSANA; October 26, 2020. 
  2. Gimoti [package insert]. Solana Beach, CA: Evoke Pharma; 2020.