Reglan (metoclopramide hydrochloride) is a prescription medication specifically formulated to address upper gastrointestinal motility disorders. As a dopamine receptor antagonist and prokinetic agent, it accelerates gastric emptying and enhances coordination between the stomach and duodenum. Clinically proven to alleviate symptoms of diabetic gastroparesis and gastroesophageal reflux disease (GERD), Reglan offers targeted relief for patients suffering from chronic nausea, vomiting, and heartburn. Its mechanism of action not only provides symptomatic improvement but also supports overall digestive function, making it a cornerstone therapy in gastroenterological practice.

Features

• Active ingredient: Metoclopramide hydrochloride
• Available forms: Tablets (5 mg, 10 mg), oral solution (5 mg/5 mL), injectable solution (5 mg/mL)
• Rapid onset of action: Typically within 30–60 minutes orally
• FDA-approved for short-term treatment (4–12 weeks)
• Prescription-only medication requiring medical supervision
• Manufactured under strict pharmaceutical quality standards

Benefits

• Accelerates gastric emptying, reducing feelings of fullness and bloating
• Effectively controls nausea and vomiting associated with delayed gastric emptying
• Decreases symptoms of gastroesophageal reflux, including heartburn and regurgitation
• Improves tolerance to enteral feeding in patients with motility disorders
• Provides rapid symptomatic relief, often within one hour of administration
• Supports better nutritional intake and quality of life for chronic sufferers

Common use

Reglan is primarily indicated for the short-term (4–12 weeks) therapy of diabetic gastroparesis in adults. It is also prescribed for symptomatic treatment of gastroesophageal reflux disease (GERD) that has not responded adequately to conventional therapy. Additionally, Reglan is used postoperatively to prevent nausea and vomiting, and to facilitate small bowel intubation and radiologic examinations of the GI tract. Off-label uses include management of chemotherapy-induced nausea and vomiting, though this application requires careful risk-benefit assessment due to potential neurological side effects.

Dosage and direction

For diabetic gastroparesis: Adults typically receive 10 mg orally 30 minutes before each meal and at bedtime for 2–8 weeks. The maximum recommended duration is 12 weeks due to risk of tardive dyskinesia.

For GERD: 10–15 mg orally up to four times daily 30 minutes before meals and at bedtime. Dosage should be individualized based on symptom severity and response.

For postoperative nausea/vomiting: 10–20 mg IM near end of surgery.

Elderly patients and those with renal impairment require dosage reduction. Tablets should be swallowed whole with water; oral solution should be measured precisely using the provided dosing syringe. Treatment should not exceed 12 weeks due to increased risk of tardive dyskinesia with longer duration.

Precautions

Reglan carries a Black Box Warning regarding the risk of tardive dyskinesia, which may be irreversible. The risk increases with duration of treatment and total cumulative dose. Patients should be periodically reassessed for need for continued treatment. Use with caution in patients with depression, Parkinson’s disease, or hypertension. May cause drowsiness or dizziness—caution when operating machinery. Not recommended during pregnancy unless potential benefits outweigh risks (Pregnancy Category B). Elderly patients are more susceptible to neurological effects and require lower doses. Monitor for signs of neuroleptic malignant syndrome (hyperthermia, muscle rigidity).

Contraindications

Reglan is contraindicated in patients with:

• Known hypersensitivity to metoclopramide or any component of the formulation
• Gastrointestinal obstruction, perforation, or hemorrhage
• Pheochromocytoma
• Epilepsy or seizure disorders (may lower seizure threshold)
• Concomitant use with drugs that may cause extrapyramidal reactions
• History of tardive dyskinesia
• Patients at increased risk of methemoglobinemia

Possible side effect

Common (≥1%): Restlessness, drowsiness, fatigue, headache, insomnia Less common: Dystonic reactions (especially in young patients), Parkinsonian symptoms, galactorrhea, menstrual disorders Serious: Tardive dyskinesia (potentially irreversible), neuroleptic malignant syndrome, depression, suicidal ideation, methemoglobinemia (in neonates) Cardiovascular: Hypertension, hypotension, supraventricular tachycardia Gastrointestinal: Nausea, diarrhea

Drug interaction

Significant interactions occur with:

• CNS depressants (alcohol, benzodiazepines, opioids): Enhanced sedative effects
• Anticholinergic drugs: May antagonize Reglan’s effects
• Dopaminergic agonists (levodopa, bromocriptine): Mutual antagonism
• Serotonergic drugs: Increased risk of serotonin syndrome
• CYP2D6 inhibitors (fluoxetine, quinidine): Increased metoclopramide levels
• Digoxin: May decrease absorption
• Cyclosporine: Increased bioavailability of cyclosporine

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed one. Maintain regular dosing schedule to ensure consistent therapeutic effect. If multiple doses are missed, contact healthcare provider for guidance on resumption of therapy.

Overdose

Symptoms may include drowsiness, confusion, extrapyramidal reactions, seizures, and methemoglobinemia (in neonates). Management includes gastric lavage if recent ingestion, activated charcoal, and supportive care. Extrapyramidal symptoms may be treated with diphenhydramine 25–50 mg IM or benztropine 1–2 mg IM. Severe cases may require benzodiazepines for seizure control. Dialysis is not effective due to high protein binding. Contact poison control center immediately for guidance.

Storage

Store at controlled room temperature (20–25°C/68–77°F). Protect from light and moisture. Keep oral solution in original container—do not transfer to other containers. Keep all medications out of reach of children and pets. Do not use after expiration date printed on packaging. Do not freeze oral solution. Injectable solution should be inspected for particulate matter before administration.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Reglan is a prescription medication that should be used only under supervision of a qualified healthcare professional. Individual response to medication may vary. Always follow your physician’s instructions regarding dosage and administration. Report any adverse effects to your healthcare provider immediately. The full prescribing information including Black Box Warnings should be reviewed before initiation of therapy.

Reviews

“After struggling with diabetic gastroparesis for years, Reglan provided significant relief from my constant nausea and vomiting. The improvement in my quality of life has been remarkable, though I remain vigilant about monitoring for side effects.” - M.B., 54

“As a gastroenterologist, I find Reglan invaluable for short-term management of refractory gastroparesis. While the neurological risks require careful patient selection and monitoring, its efficacy in promoting gastric emptying is unmatched among currently available prokinetic agents.” - Dr. A. Chen, MD

“The rapid onset of action makes Reglan particularly useful for acute episodes of gastroparesis. However, the 12-week treatment limitation necessitates careful long-term management planning for chronic conditions.” - Clinical Pharmacist