Drug Database - Reglan

Generic Name: metoclopramide (meht-oh-KLOE-pra-mide)

Brand Names: Reglan®

Classification: Gastrointestinal Stimulant and Anti-Nauseant

Issue Date: 1986

Short term treatment of gastroesophageal reflux disease (GERD) in certain patients who do not respond to other therapy. It is used to treat symptoms of a certain digestive problem in diabetic patients (diabetic gastroparesis). It may also be used for other conditions as determined by your doctor.

Reglan is a gastrointestinal stimulant and anti-nauseant. It works by increasing the movement of the stomach and intestines to help move food and acid out of the stomach more quickly. It also works in certain areas in the brain to decrease nausea.

Some medical conditions may interact with Reglan. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine
• if you are taking any herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have depression
• if you have asthma
• if you have heart failure
• if you have high blood pressure
• if you have diabetes
• if you have Parkinson disease
• if you have blood problems (eg, porphyria)
• if you have kidney problems
• if you have low levels of an enzyme called methemoglobin reductase

Use Reglan as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• take Reglan by mouth 30 minutes before meals unless directed otherwise by your doctor
• it may take several days to weeks for Reglan to work

Do not stop taking Reglan without checking with your doctor. Ask your health care provider any questions you may have about how to use Reglan.

Do NOT use Reglan if:

• you are allergic to any ingredient in Reglan
• you have seizures (eg, epilepsy)
• bleeding, blockage, or perforation in your stomach or intestines
• tumors on your adrenal gland (pheochromocytoma)
• you are taking cabergoline or pergolide
• you are taking medicines, such as phenothiazines (eg, chlorpromazine)

Contact your doctor or health care provider right away if any of these apply to you.

Reglan may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Reglan with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Reglan without first checking with your doctor; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

Diabetes Patients - Reglan may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Reglan. Symptoms may include:

• fever
• stiff muscles
• confusion
• abnormal thinking
• fast or irregular heartbeat
• sweating

Contact your doctor AT ONCE if you have ANY of these symptoms.

Some patients who take Reglan may develop muscle movements that they cannot control. This is more likely to happen in elderly patients, especially women. The chance that this will happen or that it will become permanent is greater in those who take Reglan in higher doses or for a long time. Muscle problems may also occur after short-term treatment with low doses. Tell your doctor at once if you have muscle problems with your arms; legs; or your tongue, face, mouth, or jaw (eg, tongue sticking out, puffing of cheeks, mouth puckering, chewing movements) while taking Reglan.

Lab tests, including liver and kidney function tests, may be performed while you use Reglan. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Reglan should not be used in CHILDREN younger than 15 years old; safety and effectiveness in these children have not been confirmed.

PREGNANCY AND BREAST-FEEDING: - If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Reglan while you are pregnant. Reglan is found in breast milk. If you are or will be breast-feeding while you use Reglan, check with your doctor. Discuss any possible risks to your baby.

If you miss a dose of Reglan, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Side Effects

Seek medical attention right away if any of these SEVERE side effects occur:

• Severe allergic reactions:
• rash
• hives
• itching
• difficulty breathing
• tightness in the chest
• swelling of the mouth, face, lips, or tongue
• unusual hoarseness
• abnormal thinking
• confusion
• dark urine
• decreased coordination
• decreased sexual ability
• fast, slow, or irregular heartbeat
• fever
• hallucinations
• loss of bladder control
• mental or mood changes (eg, depression, anxiety, agitation, jitteriness)
• seizures
• severe or persistent dizziness, headache, or trouble sleeping
• severe or persistent restlessness, including inability to sit still
• shortness of breath
• stiff or rigid muscles
• sudden increased sweating
• sudden unusual weight gain
• suicidal thoughts or actions
• swelling of the arms, legs, or feet
• uncontrolled muscle movements (eg, of the arms, legs, tongue, jaw, cheeks, etc.)
• vision changes
• yellowing of the skin or eyes

Less serious side effects are more likely to occur, such as:

• decreased energy
• diarrhea
• dizziness
• drowsiness
• headache
• nausea
• restlessness
• tiredness
• trouble sleeping

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

Some MEDICINES MAY INTERACT with Reglan. Tell your health care provider if you are taking any other medicines, especially any of the following:

• cisapride or droperidol side effects such as:
• muscle rigidity
• increased heart rate
• altered mental abilities, may occur
• Anticholinergic medicine (eg, hyoscyamine)
• certain antihistamines (eg, diphenhydramine)
• narcotic pain medicines (eg, codeine) they may decrease Reglan's effectiveness
• acetaminophen
• alcohol
• levodopa
• phenothiazines (eg, chlorpromazine)
• sedatives (eg, zolpidem)
• selective serotonin reuptake inhibitors (SSRIs) such as:
• fluoxetine
• succinylcholine
• tetracycline because the risk of their side effects may be increased by Reglan
• monoamine oxidase inhibitors (MOIs)such as:
• phenelzine - the risk of serious side effects might increase
• cabergoline, digoxin, or pergolide - their effectiveness may be decreased by Reglan

There may be other drugs not listed that can affect Reglan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.