Metoclopramide (Reglan)

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Metoclopramide (MET uh CLO prah mide) is the generic name for Reglan®. This medicine is used to treat Gastroesophageal reflux (GERD or reflux) or delayed gastric (stomach) emptying. It also treats or prevents nausea and vomiting. 

How This Medicine Works

The gastrointestinal (GI) system inside the bodyIt improves muscle movement of the food tube (esophagus) and the stomach. It also tightens the muscle between the esophagus and stomach (Picture 1). This decreases the chance of food coming back up. Metoclopramide also helps to strengthen the stomach muscle so food can move into the intestine faster.

  • Metoclopramide tablets and syrup start working 30 to 60 minutes after being taken. The effects last several hours.
  • Depending on your child’s prescription, they will take the medicine 3 or 4 times per day.

Warnings

  • If your child is allergic to metoclopramide, they should not take this medicine.
  • This medicine can cause seizures. Let your child’s health care provider know of any history of seizures.
  • Your child may have a rare side effect called extrapyramidal side effects (EPS). See more details about this side effect below.

Special Note For Female Patients

  • If a patient thinks they may be pregnant, they should tell the doctor before starting this or any medicine.
  • If a patient is breastfeeding their baby, they should tell the doctor before starting this or any medicine. This medicine can pass into breast milk and cause side effects in the baby.

How to Give This Medicine

  • Approved Measuring devices for Medicine Use a pediatric measuring device (available at the pharmacy) or a measuring spoon to measure the exact dose (Picture 2). Do not measure liquid medicines in kitchen spoons.
  • Give the exact dose of medicine that your doctor ordered.
  • Read the label carefully and make sure you are giving your child the right dose. It is easy to confuse the many different dosage forms and strengths.
  • Stay with your child until they have swallowed the dose of medicine.
  • It is very important to give the medicine every day as ordered, even if your child is feeling fine. Do not change doses or stop the medicine without talking to your child’s doctor.

If You Forget to Give a Dose

If you forget to give a dose of this medicine, give it as soon as possible. Then go back to your regular dosing schedule. If you do not remember until it is close to the time for the next dose, skip the missed dose and go back to your regular dosing schedule.

If a Dose is Vomited

  • If your child gags or chokes and spits out the dose before swallowing it, let the child calm down and then give the same amount one more time.
  • Even if the medicine is thrown up (vomited) right after giving it, some of the medicine may still be in the stomach. Do not repeat the dose unless it is in tablet form and you can see the whole tablet was vomited.
  • If the liquid form is vomited right after you give it, do not repeat the dose. Some of the medicine may still be in the stomach.
  • The vomiting might be due to the strong taste of the medicine. For the next scheduled dose, try giving the medicine in applesauce or jelly. If the vomiting continues, call your child’s health care provider.

Possible Side Effects

  • Drowsiness, tiredness
  • Restlessness
  • Rash
  • Seizures
  • Swelling (especially hands and feet)
  • Constipation or diarrhea
  • Extrapyramidal side effects (see box below)

EPS: Extrapyramidal Side Effects

Sometimes metoclopramide will cause side effects called Extrapyramidal Side Effects. These side effects are muscle spasms the child cannot control.

The child may:

  • Turn their eyes upward
  • Appear to have a stiff or locked jaw.
  • Have trouble talking or moving their mouth and tongue.
  • Bend or twist their neck to one side.
  • Arch their back or bend backwards because of muscle spasms in the back.

These side effects can also happen after the medicine has been stopped. This is more likely in patients who take it for a long time (more than 3 months).

The effects may be permanent, and there is no treatment.

If any of these reactions happen, STOP giving the medicine and contact your child’s doctor.

What to do About Side Effects

  • If your child becomes drowsy or sleepy, do not let them ride a bike or operate machinery, like driving a lawnmower or a car, or take part in activities where they must stay alert and awake.
  • Call your child’s health care provider if your child has side effects that continue or are very bothersome.

When to Call 911

Stop giving the medicine and call 911 for emergency help if your child has:

  • Trouble breathing
  • Swelling of the tongue
  • Swelling of hands, feet or ankles
  • Signs of an overdose (severe drowsiness or confusion)
  • Seizures

Drug and Nutrient Interactions

  • This medicine should not be taken in combination with:
  • Antidepressants
  • Antipsychotics
  • Cyclosporine (Neoral®, Sandimmune®)
  • Promethazine (Phenergan®)
  • Tacrolimus (Prograf®, Protropic®)
  • Medicines that prolong the QT interval (a dangerous kind of heartbeat)
  • Your child should not drink alcohol. Taking this medicine with alcohol can cause sleepiness and can be dangerous. Use caution as some cold medicines, cough syrups, and mouthwashes contain alcohol.
  • Your child should not drink large amounts of soft drinks, chocolate drinks, tea, or coffee while taking medicine.
  • Talk to your doctor or pharmacist before your child takes any over-the-counter medicines, herbal products, or supplements.

Medicine Storage

  • Store all medicine out of the reach of children.
  • Always keep medicine in the original bottle from the pharmacy and do not use it after the expiration date printed on the bottle.
  • Keep the bottle tightly closed and store it in a dark, dry place. Do not store it in the bathroom, above the kitchen sink or in the refrigerator.
  • When the medicine is no longer needed, dissolve the leftovers in water or rubbing alcohol. Then, mix the dissolved medicine with an unwanted material, like coffee grounds. Throw the container away in the trash where children and pets cannot reach it.

Other Important Information About This Medicine

  • Get the prescription refilled at least 2 days before the last dose is given.
  • Do not stop giving this medicine or change the amount given without first talking with your child’s health care provider or pharmacist. Stopping the medicine makes symptoms come back. Increasing the dose can be dangerous.
  • Bring all your child’s medicines with you in the original bottles whenever your child sees a doctor or health care provider, goes to an emergency room or is admitted to the hospital. This helps providers who may not know your child. Learn the name, spelling and dose of this medicine. Teach your child if they are old enough. You will need to know this information when you call your health care provider or pharmacist.
  • If your child takes too much of this medicine, or if someone else takes this medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TTY 614-228-2272). They will tell you what to do.
  • This medicine has been prescribed for your child only. Do not give it to anyone else.
  • Tell your child’s teacher, school nurse, coach, babysitter and others your child is taking this medicine and what side effects to watch for.
  • Your child’s school may need a note from you and from the health care provider if the medicine is to be given at school by the school nurse.

Metoclopramide (Reglan®) (PDF)

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