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Side Effects of Metoclopramide (Reglan)


Description: Metoclopramide, available as the brand names of Reglan, Mexalon, and Metozolv, is a prescription medicine used to prevent chemotherapy associated nausea and vomiting. The medication also relieves symptoms of slow stomach emptying in people with diabetes; stops nausea and vomiting that may happen after surgery; and helps make it easier to insert a tube into the small intestine in both adults and children. It is in the class of medications known as Prokinetics.

Serious Side Effects of Reglan

Serious adverse reactions according to the Reglan drug label as reported by the FDA (2009), include:

  • Abnormal muscle (mostly facial) involuntary movements called tardive dyskinesia (TD). Your chances for getting TD increases with the dose and duration of metoclopramide.
  • Uncontrolled spasms of the face, body, arms, and legs (dystonia) and neck muscles; such symptxoms usually occur within the first two days of treatment. Children and adults under age 30 are at high risk of developing these spasms.
  • Depression or self-harm/suicidal thoughts or actions
  • Neuroleptic Malignant Syndrome (NMS) – a very rare but serious condition that may be fatal. Symptoms of NMS include: high fever, stiff muscles, rapid pulse, and increased sweating.
  • Parkinsonism, a neurological condition, has been reported to occur with metoclopramide. Slight shaking, body stiffness, trouble moving or keeping your balance are the common symptoms.
  • Contact your doctor and get medical help immediately if you:

  • Feel depressed or have thoughts about harming or suicide
  • Have high fever, stiff muscles, problems thinking, very fast or uneven heartbeat, and increased sweating
  • Have muscle movements you cannot stop or control
  • Have new or unusual muscle movements
  • Call your doctor right away if you get movements you cannot stop or control, such as: lip smacking, chewing, or puckering up your mouth, blinking and moving your eyes, sticking out your tongue, frowning or scowling or shaking of your arms and legs.

    Common Side Effects of Reglan

    Common side effects according Reglan label include:

  • Restlessness
  • Headache
  • Confusion
  • Trouble sleeping
  • Less Common Side Effects of Reglan

    Rare reactions according to the Reglan Medication Guide as reported by the FDA (2009), include:

  • Hepatotoxicity
  • Rash
  • Bronchospasm
  • Angioneurotic edema
  • Understand Your Risk for Side Effects with Rxight® Genetic Testing

    When treated with metoclopramide, people who lack NADH-cytochrome b5 reductase< enzyme, are more susceptible to develop some side effects (methemoglobinemia and sulfhemoglobinemia) according to the Reglan Guide. Also, individuals with genetic variations in some genes, CYP2D6, KCNH2, and 5-HT4 receptor (HTR4) gene have been reported to experience more adverse reactions.

    How Does Pharmacogenetic Testing Work?

    Pharmacogenetic testing serves to identify patients before treatment with metoclopramide to enhance efficacy and minimize complications. Rxight® is the most comprehensive pharmacogenetic testing technology available screens you for over 200 prescription and OTC medications, analyzing your unique genetically determined metabolism of these drugs, including Reglan. With the Rxight® pharmacogenetic test result, you and your prescriber can be guided in determining a dose of Reglan that is safe for you.

    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry


    Read more about Rxight® pharmacogenetic testing