Reglan (Metoclopramide) – Oral

What Is Reglan?

Reglan is an oral medication used to treat heartburn and heal ulcers in adults with gastroesophageal reflux disease (GERD) when other treatments have failed. It is also used to treat adults with diabetic gastroparesis—a condition that slows stomach emptying and can cause nausea, vomiting, and a feeling of fullness. Your healthcare provider may prescribe Reglan for other conditions as well.

Reglan belongs to a group of drugs called prokinetics. It works by speeding up the movement of food through the stomach and intestines.

The Food and Drug Administration (FDA) has issued a boxed warning for Reglan. Talk with your healthcare provider about these risks before starting treatment.

What Is Reglan Used For?

Reglan is an oral medication used to treat adults with GERD when other treatment options have failed. It is also used to treat adults with diabetic gastroparesis.

GERD is estimated to affect up to 20% of the U.S. population. It occurs when a muscle at the end of the esophagus (the tube that carries food from your mouth to your stomach) doesn't close properly. This causes stomach contents to flow back into the esophagus and can lead to irritation.

Symptoms of GERD may include heartburn (a burning feeling in your chest or throat), tasting stomach contents in the back of your mouth, a dry cough, and trouble swallowing. Uncontrolled GERD can lead to complications, including esophagitis (inflammation of the esophagus), Barrett's esophagus (a change in cells lining the esophagus), and esophageal cancer.

Medications, such as proton pump inhibitors (PPIs) (e.g., Protonix, Prilosec, Dexilant), are often prescribed to treat GERD. Still, your healthcare provider may consider Reglan if PPIs or other treatments haven't worked.

Gastroparesis is a condition that causes stomach emptying to slow and can lead to symptoms such as nausea, vomiting, bloating and a feeling of fullness. Diabetes is the most common cause of gastroparesis. Suppose dietary changes (such as eating small frequent meals and limiting high-fat and high-fiber foods) don't relieve symptoms. In that case, Reglan is often the first medication healthcare providers will prescribe to treat gastroparesis.

How to Take Reglan

Reglan is an oral medication you take by mouth, typically four times per day, before meals and at bedtime. Reglan may be prescribed less often to control GERD symptoms. If your healthcare provider has told you to take Reglan before meals, be sure to do so at least 30 minutes before eating.

Storage

Store Reglan at room temperature (68 to 77 degrees F). Excursions between 59 and 86 degrees F may be permitted. Do not store your medication in the bathroom. Keep Reglan in its original container and away from light.

Keep Reglan, and all your medications, tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. Visit the FDA website to know where and how to discard all unused and expired drugs. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider about the best ways to dispose of your medications.

If you travel with Reglan, get familiar with your final destination's regulations. Be sure to make a copy of your Reglan prescription. Keep your medication in its original container from your pharmacy with your name printed on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

Off-Label Uses

Healthcare providers may prescribe medicines for conditions not approved by the FDA. This is called off-label use. Healthcare providers may prescribe Reglan off-label to treat:

• Nausea and vomiting due to various causes, including cancer, chemotherapy, radiation, or pregnancy
• Hiccups that won't go away
• Migraines
  

What Are the Side Effects of Reglan?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Reglan may include but are not limited to:

• Restlessness
  
• Drowsiness
• Tiredness
• Lack of energy
  

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Severe side effects of Reglan may include but may not be limited to:

• Tardive dyskinesia, an often irreversible movement disorder
• Uncontrollable spasms in the face, neck, body, arms, or legs
• Symptoms similar to Parkinson's disease, including shaking, body stiffness, trouble moving, or difficulty with balance
• An inability to sit still, as well as feeling jittery, anxious, irritable, unable to sleep, or like you need to move your hands or feet
• Neuroleptic malignant syndrome, a rare but life-threatening condition, requiring immediate medical attention if you develop a high fever, stiff muscles, problems thinking, a very fast or uneven heartbeat, or increased sweating
• Depression and suicidal thoughts or actions
• High blood pressure
• Fluid retention, especially if you have certain liver problems or heart failure, which may appear as sudden weight gain or swelling of your hands, legs, or feet, requiring medical attention
• Too much prolactin hormone (hyperprolactinemia) that can cause menstrual periods to stop, breasts to get larger or make milk, or male impotence (not being able to have an erection or orgasm), requiring medical attention

Long-Term Side Effects

Reglan may cause a potentially irreversible movement disorder called tardive dyskinesia. Tardive dyskinesia causes uncontrollable muscle movements, usually in the face. There is no treatment for tardive dyskinesia, and abnormal movements may continue even after stopping Reglan.

Your risk for developing tardive dyskinesia increases the longer you take Reglan, so it is usually recommended to limit use to less than 12 weeks. Older adults (especially older women) and people with diabetes may also be at increased risk. Let your healthcare provider know right away if you develop any movements you cannot control, such as:

• Lip smacking, chewing, or puckering of your mouth
• Frowning or scowling
• Sticking out your tongue
• Blinking and moving your eyes
• Shaking of your arms or legs
  

Dosage: How Much Reglan Should I Take?

Modifications

The following modifications (changes) should be kept in mind when using Reglan:

Severe allergic reaction: Avoid using Reglan if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: Studies on humans have not found Reglan to be harmful during pregnancy. However, if Reglan is given during delivery, the baby may develop side effects, including abnormal movements and a blood disorder called methemoglobinemia. In animal studies, Reglan did not impact the development of the fetus.

Let your healthcare provider know if you plan to become pregnant or are pregnant, and discuss the benefits and risks of taking Reglan during your pregnancy.

Breastfeeding: Reglan is present in human breast milk and may cause side effects in nursing babies, including abnormal movements and a blood disorder called methemoglobinemia.

Talk with your healthcare provider if you plan to breastfeed and discuss the benefits and risks of taking Reglan while nursing and the different ways to feed your baby.

Adults over 65: Older adults with certain medical conditions, including kidney problems, are at increased risk of developing side effects, including a severe and potentially irreversible movement disorder called tardive dyskinesia. Your healthcare provider may recommend a lower dose of Reglan.

Children: Reglan is not approved to treat children due to the risk of developing abnormal movements, including a severe and potentially irreversible disorder called tardive dyskinesia. Babies are also at an increased risk of developing a blood disorder called methemoglobinemia.

Kidney and liver problems: Individuals with kidney or liver problems may not be able to clear medication from their bodies as easily. This means the medicine stays in the body longer and can have increased side effects.

For this reason, your healthcare provider will likely not prescribe Reglan beyond a certain dosage if you have kidney or liver impairment.

Missed Dose

If you accidentally forget your Reglan dose, take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Find ways to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Reglan might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Reglan?

The symptoms of a suspected Reglan overdose include:

• Drowsiness
• Confusion
• Abnormal movements
• Neuroleptic malignant syndrome, a potentially deadly reaction whose signs include a high fever, stiff muscles, problems thinking, a very fast or uneven heartbeat, or increased sweating

If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

Precautions

What Are Reasons I Shouldn’t Take Reglan?

Do not take Reglan if you:

• Have experienced tardive dyskinesia or other abnormal movement side effects from Reglan in the past
• Have bleeding, a blockage, or a tear in your stomach or intestines
• Have pheochromocytoma or other tumors that can cause high blood pressure
• Have epilepsy (seizures)
• Are allergic to metoclopramide (the active ingredient in Reglan)

What Other Medications Interact With Reglan?

Use caution when taking Reglan with the following medications:

• Other medicines that contain metoclopramide (the active ingredient in Reglan)
• Medicines for Parkinson's disease
• Blood pressure medication
• Medicines for depression, especially monoamine oxidase inhibitors (MAOIs), such as Marplan (isocarboxazid), Nardil (phenelzine), and Parnate (tranylcypromine)
• Antipsychotics used to treat mental illnesses like schizophrenia
• Insulin
• Medicines that make you sleepy, such as antianxiety drugs, sleep medicines, and narcotic pain medications
• Wellbutrin SR, Wellbutrin XL (bupropion)
• Prozac (fluoxetine)
• Paxil (paroxetine)
• Quinidex (quinidine)
• Exelon (rivastigmine)
• Phenergan (promethazine)
  

Many other medications may interact with Reglan. Be sure to let your pharmacist and healthcare provider know about all the medicines you take, or plan to take, including over-the-counter (nonprescription) products, vitamins, herbs, or plant-based medicines.

What Medications Are Similar?

Domperidone is a similar medication. However, domperidone is not readily available in the United States. A prescriber would need to go through the FDA's investigational new drug program to access it.

How Can I Stay Healthy While Taking Reglan?

If you're taking Reglan, chances are the symptoms of gastroparesis or GERD have impacted your quality of life. You may have tried different approaches or treatments. While living with gastroparesis or GERD does have its challenges, there are ways to help improve your quality of life.

You can support your health when taking Reglan by doing the following:

• Take Reglan as recommended by your healthcare provider. Do not take more than is prescribed or take it more often.
• Pay close attention to any side effects. Contact your healthcare provider immediately if you develop abnormal movements that you can't control.
• If you have diabetes, work with your healthcare provider to keep your blood sugar levels as close to the target range as possible. Having good control over your blood sugar can lessen gastroparesis symptoms and help prevent other diabetes complications.
• Consider working with a registered dietitian (RD) or registered dietitian nutritionist (RDN) to help develop an eating plan specific to your condition. Dietary changes may help improve symptoms of GERD and gastroparesis.