Doctors' Answers to "Frequently Asked Questions" - Reglan

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 04/30/2000]
Question: I've recently started taking Prilosec for hiatal hernia and reflux problems. My symptoms did not get better, so I added Reglan, a prescription I had from a prior doctor visit. Are these 2 medications compatible?

Thanks

Answer: Yes, Reglan is a very good reflux medication, but occasional patients will develop an irreversible facial tic after taking it for a while. Discuss this with your md as to the pros and cons.

Reglan [posted 1/8/99]
Question: I would like some information on reglan. How long should you take it? What are the side effects? Should it be given to children, and if so, how long? Who is the manufacturer?

Answer: Reglan(metoclopromide) is made by Robins (800-934-5556). This drug is used to improve gi motility and occasionally for severe reflux. Short term side effects place limits on the drug. Extra-pyramidal reactions (involuntary movements, tics, etc. may be permanent), galactorrhea, amenorrhea, gynecomastia, hypertension, and occasional lowering of white cell counts. The usual problem that limits both long term use and short term use is tardive dyskinesia (smacking of the lips, etc.), which is involuntary and may be permanent. This appears to be dosage dependent although individual sensitivity varies a great deal. As to children, risks and benefits need to be discussed. It is the best motility agent and there are few other choices except propulsid.

Reglan Concerns [posted 11/06/98]
Question: My father who is a diabetic also had a bleeding ulcer last year. Reglan was given and lowered his blood sugar too much (working in conjunction with his diabetic medicines). Now my father is off of any diabetic meds but is back on Reglan for undigested food in his stomach (part of his stomach was removed due to the ulcer and the vagal nerve was cut) However, he is retaining fluid, his blood sugar ranges from 99-120 and now he is seeing "floaters" in his eyes. Could this all be from the Reglan which was just started 2 weeks ago? His family doc is on vacation so please help!!

Answer: Not the reglan. Reglan has little effect on glucose metabolism. It can affect absorption of food by changing gi motility.

European Equivalent of Reglan [posted 10/30/98]
Question: I need information on what the names of the European equivalents of Reglan and Prevecid would be. Any information that could point me in that direction would be appreciated.

Answer: You'll need to check with the company, I'm not an expert on Europe, Reglan is Robins 610-685-4400, Prevacid Tap Pharmaceutical 800-621-1020.

Reglan and Infants [posted 8/6/98]
Question: My four-month old son was diagnosed with pyloric stenosis at 19 days old and had surgery at 20 days. However, he continues to vomit (not projectile) quite often with almost all feedings. At his last appointment with the pediatric surgeon, the doctor decided to try Reglan to strengthen the valve at the top of the stomach and move the food through the stomach quicker to help eliminate the vomiting. Is this drug safe for a four-month old? Will it help his situation? Will he now be susceptible to the side effects you list in your information?

Answer: There are no studies ever done on children. Many GI specialists use this drug for reflux and motility disorders. There do not seem to be severe side effects. The long term use is unclear since the drug has only been available a few years.

Reglan
Question: How long should a patient be kept on reglan, 10 milligrams, and should they be monitored closely?

Answer: Reglan(metoclopramide) is an extremely useful drug in treating GI motility disorders. For people with severe reflux, or general slowness of the GI tract resulting in vomiting and malabsorption, this drug can work wonders. It is also useful in diabetic gastroenteropathy of evening out the GI speed. There is no drug as effective as Reglan. However, in some patients it can cause irreversible neurologic side effects. These are usually seen as facial tics and movements. Stopping the drug at the earliest sign and using as little as possible will minimize this problem. However, some patients are very susceptible and can get irreversible facial tics with small doses. There are other drugs which are not used, such as propulsid for GI motility disorders. While they do not work as well, they also do appear to cause the neurologic side effects.



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