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Reglan 10mg Tablet
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Indications & Clinical Uses
- Reglan (metoclopramide hydrochloride) 10 mg tablets are a dopamine (D2) receptor antagonist that increases the tone and contractions of the upper gastrointestinal tract, used in adults for the short-term (4 to 12 weeks) relief of symptomatic, documented gastroesophageal reflux disease that has not responded to other therapy, and for the relief of symptoms from acute and recurrent diabetic gastroparesis (delayed stomach emptying).
- It is taken orally, usually 30 minutes before meals and at bedtime.
- Reglan is not an anaesthesia or anaesthesia-adjunct medicine, despite sometimes being grouped that way on non-clinical sheets; its FDA-approved uses are specifically GERD and diabetic gastroparesis.
- Safety and effectiveness beyond 12 weeks of continuous use have not been established, and metoclopramide is not recommended in children because of an increased risk of movement-disorder side effects.
Side Effects
- Restlessness, drowsiness, fatigue and lassitude are the most common effects, reported in roughly 1 in 10 patients on standard dosing.
- Reglan carries a boxed warning: metoclopramide can cause tardive dyskinesia, a potentially irreversible movement disorder with involuntary, repetitive body movements; the risk increases with the duration of treatment and the total dose taken, which is why treatment beyond 12 weeks should be avoided except in rare cases where the benefit is judged to outweigh this risk.
- Other important effects include acute dystonic reactions (muscle spasms, especially of the face, neck or back), neuroleptic malignant syndrome (fever, muscle rigidity, confusion), and depression, including suicidal ideation.
- Seek urgent medical attention for uncontrollable movements of the face or limbs, muscle stiffness, high fever, or a significant mood change, and report these immediately rather than waiting for a routine visit.
Precautions & Warnings
- Reglan is contraindicated in anyone with a history of tardive dyskinesia or a dystonic reaction to metoclopramide, in epilepsy, in phaeochromocytoma or catecholamine-releasing paraganglioma (risk of hypertensive crisis), and wherever stimulation of gut motility could be harmful, such as gastrointestinal haemorrhage, mechanical obstruction or perforation.
- It is used cautiously in Parkinson's disease, since it can worsen symptoms, and in depression, given the risk of exacerbating mood symptoms.
- Treatment courses are limited to 12 weeks wherever possible, and reassessment is required for anyone needing longer therapy.
- Reglan should be used with care in pregnancy and breastfeeding, and driving or operating machinery should be avoided until you know how the tablets affect you, since drowsiness and dizziness are common.
- Renal impairment requires a lower dose because metoclopramide is cleared through the kidneys.
Avoid Interactions
- Tell your healthcare provider about every medicine you take.
- Combining Reglan with antipsychotics or other dopamine antagonists increases the frequency and severity of tardive dyskinesia and other movement-disorder side effects, so this combination is generally avoided.
- Strong CYP2D6 inhibitors, including quinidine, bupropion, fluoxetine and paroxetine, raise metoclopramide blood levels and its side effects, so a reduced Reglan dose is usually needed.
- Monoamine oxidase inhibitors increase the risk of a hypertensive crisis and should not be combined with Reglan.
- Alcohol and other central nervous system depressants, including opioids, sedatives and benzodiazepines, add to drowsiness and sedation.
- Medicines with opposing dopaminergic effects, such as levodopa, can reduce Reglan's benefit or worsen Parkinson's symptoms.
- Because Reglan speeds gastric emptying, it can change the absorption timing of other oral medicines.
References
- REGLAN (metoclopramide hydrochloride) tablet - ANI Pharmaceuticals, US Prescribing Information, DailyMed
- METOCLOPRAMIDE tablet - US Prescribing Information (consumer view), DailyMed
- Metoclopramide Hydrochloride Tablets - FDA Prescribing Information
- Metoclopramide Tablets/ODT - FDA Prescribing Information
Frequently Asked Questions
Reglan (metoclopramide) treats short-term gastroesophageal reflux disease that has not responded to other treatment, for up to 12 weeks, and relieves symptoms of diabetic gastroparesis, a stomach-emptying problem. It works by increasing muscle contractions in the upper digestive tract. It is not an anaesthesia medicine.
Reglan tablets are swallowed by mouth, usually 30 minutes before meals and at bedtime, up to four times a day. The typical reflux dose is 10 to 15 mg per dose, and the gastroparesis dose is 10 mg. Do not use it longer than your prescriber advises.
Reglan (metoclopramide) carries a boxed warning for tardive dyskinesia, a movement disorder causing uncontrollable, repetitive body movements that can become permanent. Risk rises with longer use and higher doses, so treatment is usually limited to 12 weeks. Tell your prescriber immediately about any new, unusual movements.
Avoid alcohol and other sedating medicines, which add to drowsiness. Do not combine Reglan with antipsychotics, since this raises the risk of tardive dyskinesia, or with MAOI antidepressants, which can cause a hypertensive crisis. Tell your prescriber about all other medicines, especially for depression or Parkinson's disease.
Take the missed dose as soon as you remember, unless it is almost time for your next one; do not double up. Because Reglan is timed around meals, skip a very late dose and resume your normal before-meal schedule at the next meal.
No. Reglan (metoclopramide) is generally limited to 12 weeks of use because longer treatment raises the risk of tardive dyskinesia. It is not recommended for children, who have a higher risk of movement-disorder side effects. Your prescriber will reassess you if longer treatment seems necessary.
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