What is Metoclopramide (Reglan)?
Reglan is a brand name for the generic drug metoclopramide. Both Reglan and generic metoclopramide contain the same active ingredient. It's classified as a prokinetic, enhancing gastrointestinal movement, and an antiemetic, helping to prevent nausea and vomiting.
How does metoclopramide work?
Metoclopramide works by blocking dopamine receptors and increasing acetylcholine in the digestive tract. This action leads to increased gastric emptying, reduced reflux by tightening the lower esophageal sphincter, and relief from nausea and vomiting.
Common uses for metoclopramide
Metoclopramide is used to treat several conditions:
- Diabetic gastroparesis: To improve delayed stomach emptying in individuals with diabetes.
- Gastroesophageal Reflux Disease (GERD): For adults with symptomatic GERD unresponsive to other treatments.
- Chemotherapy-induced nausea and vomiting: To manage severe nausea and vomiting from cancer treatment.
- Postoperative nausea and vomiting: Sometimes used to prevent nausea and vomiting after surgery.
FDA black box warning and serious risks
Metoclopramide has an FDA black box warning for the risk of tardive dyskinesia (TD). TD is a serious, potentially permanent movement disorder with involuntary facial, tongue, and limb movements. The risk of TD increases with treatment duration and total dose, so metoclopramide use is generally limited to 12 weeks.
Other serious side effects can include Neuroleptic Malignant Syndrome (NMS), Extrapyramidal Symptoms (EPS), depression, and suicidal thoughts.
Comparison: Reglan (Metoclopramide) vs. Zofran (Ondansetron)
While both treat nausea, they have different mechanisms and risks.
| Feature | Reglan (Metoclopramide) | Zofran (Ondansetron) |
|---|---|---|
| Drug Class | Prokinetic and Dopamine Antagonist | Serotonin Antagonist (5-HT3) |
| Mechanism of Action | Increases gastric motility and blocks dopamine. | Blocks serotonin receptors. |
| Primary Uses | Gastroparesis, GERD, chemotherapy-induced N/V, postoperative N/V. | Chemotherapy-induced N/V, postoperative N/V. |
| Duration of Therapy | Limited to 12 weeks due to tardive dyskinesia risk. | Not typically limited by duration. |
| Major Risk | Black box warning for tardive dyskinesia. | QT prolongation (heart-related). |
| Side Effect Profile | Drowsiness, restlessness, EPS, depression. | Headache, constipation, dizziness. |
Dosage and administration
Metoclopramide comes in various forms, including tablets, oral solution, and injection. Oral doses are usually taken before meals and at bedtime on an empty stomach. Dosage and duration depend on the condition, but treatment should not exceed 12 weeks.
Conclusion
Reglan is a brand name for metoclopramide, a prescription medication that treats various gastrointestinal issues by acting as a prokinetic and antiemetic. It is associated with a black box warning for tardive dyskinesia, limiting its use to short-term therapy, typically no more than 12 weeks. Patients, especially those who are elderly, have diabetes, or a history of depression or movement disorders, require careful monitoring for adverse effects. Consulting a healthcare professional is essential to determine if metoclopramide is suitable for your condition.
