Reglan

Reglan (metoclopramide hydrochloride) is a prescription medication designed to accelerate gastric emptying and enhance upper gastrointestinal motility. It is primarily indicated for the short-term treatment of diabetic gastroparesis and symptomatic gastroesophageal reflux disease (GERD) in adults. By increasing muscle contractions in the upper digestive tract, Reglan facilitates the movement of food through the stomach and intestines, providing relief from nausea, vomiting, heartburn, and feelings of prolonged fullness. Its prokinetic and antiemetic properties make it a valuable therapeutic option when standard treatments prove insufficient. Proper usage under medical supervision is essential to maximize benefits and minimize risks.

Features

• Active ingredient: Metoclopramide hydrochloride
• Available in 5 mg and 10 mg oral tablets
• Also supplied as an injectable solution for hospital use
• Works as a dopamine D2 receptor antagonist and serotonin 5-HT4 receptor agonist
• Onset of action: approximately 30–60 minutes orally
• FDA-approved for specific gastrointestinal motility disorders

Benefits

• Accelerates gastric emptying, reducing discomfort from delayed digestion
• Alleviates symptoms of nausea and vomiting associated with gastroparesis
• Decreases episodes of heartburn and regurgitation in GERD
• May improve glycemic control in diabetic patients by optimizing nutrient absorption
• Provides an alternative when first-line antiemetics are ineffective
• Available in multiple formulations for flexible administration

Common use

Reglan is commonly prescribed for the short-term management (4–12 weeks) of diabetic gastroparesis, a condition where the stomach empties too slowly due to nerve damage from diabetes. It is also used for symptomatic GERD when standard acid-suppressing therapies do not adequately control regurgitation or heartburn. In clinical settings, it may be administered intravenously to prevent chemotherapy-induced nausea and vomiting or to facilitate small bowel intubation and radiologic examinations by promoting gastrointestinal motility.

Dosage and direction

For diabetic gastroparesis in adults, the typical oral dosage is 10 mg taken 30 minutes before each meal and at bedtime, not to exceed 40 mg per day. Treatment duration should generally not exceed 12 weeks due to the risk of tardive dyskinesia. For GERD, 10–15 mg up to four times daily may be used, 30 minutes before meals and at bedtime. Injectable forms are dosed based on clinical context, often 10 mg administered slowly intravenously. Dosage adjustments are necessary in patients with renal impairment or CYP2D6 poor metabolizers. Always follow the prescribing physician’s instructions.

Precautions

Use Reglan with caution in patients with a history of depression, Parkinson’s disease, or hypertension. Avoid prolonged use; treatment beyond 12 weeks increases the risk of tardive dyskinesia, which may be irreversible. Monitor for extrapyramidal symptoms, especially in pediatric and young adult populations. Use in elderly patients should be limited to the lowest effective dose for the shortest possible duration. Patients should be advised not to drive or operate machinery until they know how Reglan affects them, as it may cause drowsiness or dizziness.

Contraindications

Reglan is contraindicated in patients with known hypersensitivity to metoclopramide or any component of the formulation. It should not be used in those with gastrointestinal obstruction, perforation, or hemorrhage. Contraindications also include pheochromocytoma, epilepsy, and concurrent use of drugs likely to cause extrapyramidal reactions. It must not be administered to patients with a history of tardive dyskinesia.

Possible side effect

Common side effects include restlessness, drowsiness, fatigue, and diarrhea. Serious adverse reactions may include tardive dyskinesia (involuntary repetitive movements of the face and body), neuroleptic malignant syndrome, depression, and suicidal ideation. Extrapyramidal symptoms such as dystonia, akathisia, and parkinsonism have been reported, particularly in children and young adults. Other potential effects include hyperprolactinemia, galactorrhea, and methemoglobinemia in neonates.

Drug interaction

Reglan may interact with central nervous system depressants (e.g., alcohol, opioids, sedatives), potentiating drowsiness and impairment. Concurrent use with other dopamine antagonists (e.g., antipsychotics) may increase the risk of extrapyramidal symptoms. It can affect the absorption of orally administered drugs by altering gastrointestinal motility. Caution is advised with serotonergic drugs due to the potential for serotonin syndrome. CYP2D6 inhibitors may increase metoclopramide plasma concentrations.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed one. Resume the regular dosing schedule. Consult a healthcare provider if multiple doses are missed or if uncertainty exists regarding administration.

Overdose

Symptoms of overdose may include drowsiness, disorientation, extrapyramidal reactions, and cardiovascular instability. In cases of suspected overdose, seek immediate medical attention. Treatment is supportive and may include administration of anticholinergic or antiparkinsonian agents (e.g., benztropine) for extrapyramidal symptoms. There is no specific antidote for metoclopramide overdose.

Storage

Store Reglan tablets at room temperature (20–25°C or 68–77°F), in a tightly closed container, away from light, moisture, and heat. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly discard any unused medication according to local guidelines.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Reglan is a prescription medication and should be used only under the supervision of a qualified healthcare professional. Always consult with a physician for diagnosis, treatment recommendations, and personalized dosing. Do not initiate, adjust, or discontinue therapy without professional guidance.

Reviews

Clinical studies and patient reports indicate that Reglan can be highly effective for symptom relief in gastroparesis and refractory GERD. Many users note significant improvement in nausea, vomiting, and postprandial fullness. However, concerns regarding neurological side effects, particularly with long-term use, are frequently cited. Most experts recommend it for short-term management with careful monitoring. Individual responses vary, and a thorough risk-benefit assessment with a healthcare provider is essential prior to use.