The generic name for the prescription drug Reglan is metoclopramide. While Reglan is the most well-known brand, metoclopramide is also marketed under various other brand names and in different formulations. Understanding the different names and forms of this medication is important for patients and healthcare providers alike, as it helps in managing treatment and understanding the risks associated with the active ingredient.
What is metoclopramide and how does it work?
Metoclopramide is classified as a prokinetic and an antiemetic drug.
- Prokinetic: It stimulates muscle contractions in the upper gastrointestinal (GI) tract. By increasing the tone and amplitude of gastric contractions, it speeds up the rate at which the stomach empties its contents into the intestines.
- Antiemetic: It prevents and treats nausea and vomiting. It achieves this by blocking dopamine receptors in the chemoreceptor trigger zone (CTZ) of the brain, a region that is responsible for inducing nausea and vomiting.
This dual action makes metoclopramide effective for a variety of conditions where delayed gastric emptying or nausea are problematic. Its effects usually begin within 30 to 60 minutes after taking an oral dose.
Medical uses of metoclopramide
Metoclopramide is primarily used for short-term treatment of specific gastrointestinal issues. Some of its common applications include:
- Diabetic gastroparesis: A condition that causes a delay in the emptying of the stomach in people with diabetes. Metoclopramide helps to relieve associated symptoms such as nausea, vomiting, and feelings of fullness after meals.
- Gastroesophageal reflux disease (GERD): It is used in adults for severe, persistent heartburn that has not responded to other treatments. By increasing the tone of the lower esophageal sphincter, it helps prevent stomach acid from flowing back into the esophagus.
- Chemotherapy-induced nausea and vomiting: It is used to prevent and treat the severe nausea and vomiting caused by certain cancer treatments.
- Postoperative nausea and vomiting: It can be used to prevent nausea and vomiting that occurs after surgery.
- Intestinal intubation: In some medical procedures, it is used to help facilitate the passage of a small bowel tube.
Formulations and availability
Metoclopramide is available in several forms to suit different patient needs and medical situations. These include:
- Oral tablets: Available in both brand-name Reglan and generic versions.
- Orally disintegrating tablets (ODT): Marketed under the brand name Metozolv ODT.
- Oral solution or syrup: A liquid form of the medication.
- Nasal spray: Available under the brand name Gimoti.
- Injection: Given intravenously (IV) or intramuscularly (IM) in a clinical setting.
Important safety information and side effects
Metoclopramide is associated with a black box warning from the FDA concerning the risk of tardive dyskinesia. This serious neurological side effect is characterized by involuntary and repetitive movements of the face, tongue, and limbs. The risk of developing this condition increases with the duration of treatment and total cumulative dosage, which is why metoclopramide is only recommended for short-term use (typically less than 12 weeks).
Common side effects include:
- Drowsiness, fatigue, and lethargy
- Restlessness (akathisia)
- Headache
- Dizziness
- Diarrhea
Serious but less common side effects include:
- Tardive dyskinesia (TD): Involuntary muscle movements.
- Extrapyramidal symptoms (EPS): Such as involuntary limb movements, facial grimacing, and muscle spasms, especially in younger adults and children.
- Neuroleptic Malignant Syndrome (NMS): A rare but potentially fatal condition with symptoms like high fever, muscle stiffness, and confusion.
- Depression: Changes in mood, including suicidal thoughts.
- Increased prolactin levels: Can lead to side effects like galactorrhea (milky nipple discharge) and irregular menstrual cycles.
Comparison of metoclopramide brands
| Feature | Reglan (Brand) | Metoclopramide (Generic) | Gimoti (Brand Nasal Spray) |
|---|---|---|---|
| Active Ingredient | Metoclopramide | Metoclopramide | Metoclopramide |
| Forms | Tablets, injection | Tablets, oral solution, injection | Nasal spray |
| Cost | Typically higher than generic versions | Generally lower cost | Cost may vary |
| FDA Warning | Contains a black box warning for tardive dyskinesia | Contains a black box warning for tardive dyskinesia | Contains a black box warning for tardive dyskinesia |
| Usage Duration | Short-term use (typically ≤ 12 weeks) | Short-term use (typically ≤ 12 weeks) | Short-term use (typically ≤ 12 weeks) |
Considerations for taking metoclopramide
Before taking metoclopramide, patients should discuss their medical history and other medications with their doctor. Certain conditions and medications can interact with metoclopramide, increasing the risk of adverse effects. These include:
- Parkinson's disease: Can worsen symptoms due to the drug's effect on dopamine.
- History of seizures: Increases the risk of seizures.
- Gastrointestinal obstruction, bleeding, or perforation: Stimulating motility can be dangerous.
- Alcohol and sedatives: Can increase the risk of drowsiness and dizziness.
- Antipsychotics: Increases the risk of tardive dyskinesia and extrapyramidal symptoms.
It is also advised to avoid operating heavy machinery or driving until you understand how the medication affects you, as it can cause drowsiness or dizziness. For more detailed pharmacological information, resources like the FDA-approved label for Reglan are highly recommended.
Conclusion
While Reglan is a familiar brand name, the most common alternative name for this medication is its generic form, metoclopramide. It is also available as other brands and in different formulations, such as the nasal spray Gimoti. As a prokinetic and antiemetic, metoclopramide plays a vital role in managing various GI disorders, particularly diabetic gastroparesis and severe GERD. However, its use requires careful consideration due to the risk of serious neurological side effects, especially with long-term use. Patients should always consult with their healthcare provider to determine the appropriate dosage, duration, and formulation for their specific condition, and to understand the potential risks involved.
: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/017862s063lbl.pdf "REGLAN Injection (metoclopramide injection, USP)"
