What is this medication?
Antiemetic; Dopamine Antagonist; Prokinetic; Serotonin 5-HT4 Receptor Agonist
Brand Name US: Reglan
Canadian Equivalent: Metonia
Metoclopramide/Reglan/Metonia is officially indicated for diabetic gastroparesis, chemotherapy induced nausea/vomiting as an alternate agent and in nausea/vomiting in palliative care. It is also commonly prescribed off-label for use for aspiration prophylaxis in patients undergoing anesthetic, refractory dyspepsia, non-diabetic gastroparesis, hiccups, severe migraine, etc. (May also be used for conditions not listed)
“ALERT: US Boxed Warning
Metoclopramide can cause tardive dyskinesia, a serious movement disorder that is often irreversible. There is no known treatment for tardive dyskinesia. The risk of developing tardive dyskinesia increases with duration of treatment and total cumulative dose. Discontinue metoclopramide in patients who develop signs or symptoms of tardive dyskinesia. In some patients, symptoms lessen or resolve after metoclopramide is stopped. Avoid treatment with metoclopramide for longer than 12 weeks because of the increased risk of developing tardive dyskinesia with longer-term use.”
How does this medication work?
Metoclopramide/Reglan/Metonia works in the chemoreceptive trigger zone in the central nervous system by blocking dopamine receptors and serotonin receptors at higher dosages thereby reducing nausea. Works on the upper gastrointestinal tract by enhancing response to acetylcholine. This increases motility and gastric emptying without increasing the production of digestive secretions. It can also increase muscle tone in the lower esophageal sphincter.
How should I take this medication?
Oral: 5-10mg up to four times per day. Avoid using for long periods of time to reduce risk of tardive dyskinesia.
How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day usually before a meal unless otherwise directed, store at room temperature.
You Need to Avoid: Do not operate heavy machinery or drive if sedated from this medication.
What should I watch for while using this medication?
Before starting Metoclopramide/Reglan/Metonia make sure your physician is aware of any allergies, medications you currently take, if you have liver disease, if you have cardiovascular disease (QT prolongation), edematous conditions, Parkinson’s disease, kidney disease, surgical anastomosis, or are pregnant or breastfeeding.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Drowsiness, dystonia (movement disorder), restlessness, galactorrhea, gynecomastia, hyperprolactinemia, nausea, impotence, etc. May rarely cause neuroleptic malignant syndrome.
Note this is not a complete list of side effects, only common ones.
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