Buy Reglan Online

What is Reglan?

Reglan (metoclopramide) increases muscle contractions in the upper digestive tract. This speeds up the rate at which the stomach empties into the intestines.

Reglan is used short-term to treat heartburn caused by gastroesophageal reflux in people who have used other medications without relief of symptoms.

Reglan may also be used for purposes not listed in this medication guide.

Important information about Reglan

NEVER TAKE REGLAN IN LARGER AMOUNTS THAN RECOMMENDED, OR FOR LONGER THAN 12 WEEKS.

High doses or long-term use of Reglan can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs. The longer you take Reglan, the more likely you are to develop a serious movement disorder. The risk of this side effect is higher in women, diabetics, and older adults.

You should not take Reglan if you are allergic to metoclopramide, or if you have bleeding or blockage in your stomach or intestines, epilepsy or other seizure disorder, or an adrenal gland tumor (pheochromocytoma).

Before you take Reglan, tell your doctor if you have kidney or liver disease, congestive heart failure, high blood pressure, diabetes, Parkinson's disease, or a history of depression.

Do not drink alcohol. It can increase some of the side effects of Reglan.

There are many other medicines that can interact with Reglan. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Stop using Reglan and call your doctor at once if you have tremors or uncontrolled muscle movements, fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing, depressed mood, thoughts of suicide or hurting yourself, hallucinations, anxiety, agitation, seizure, or jaundice (yellowing of your skin or eyes).

Before taking Reglan

You should not take Reglan if you are allergic to metoclopramide, or if you have:

  • bleeding or blockage in your stomach or intestines;

  • a perforation (hole) in your stomach or intestines;

  • epilepsy or other seizure disorder; or

  • an adrenal gland tumor (pheochromocytoma).

To make sure you can safely take Reglan, tell your doctor if you have any of these other conditions:

  • kidney disease;
  • liver disease (especially cirrhosis);
  • congestive heart failure, a heart rhythm disorder;

  • high blood pressure;

  • breast cancer;

  • Parkinson's disease;

  • diabetes (your insulin dose may need adjusting); or

  • depression or mental illness.

FDA pregnancy category B. Reglan is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Metoclopramide can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Reglan should not be given to a child.

How should I take Reglan?

Take Reglan exactly as prescribed by your doctor. Reglan is usually taken for only 4 to 12 weeks. Follow the directions on your prescription label.

NEVER TAKE REGLAN IN LARGER AMOUNTS THAN RECOMMENDED, OR FOR LONGER THAN 12 WEEKS.

High doses or long-term use of Reglan can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs. The longer you take Reglan, the more likely you are to develop a serious movement disorder. The risk of this side effect is higher in women, diabetics, and older adults.

Take Reglan 30 minutes before eating. Reglan is usually taken before meals and at bedtime. Your doctor may want you to take the medication as needed only with meals that usually cause heartburn. Follow your doctor's instructions.

Measure the liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not take two different forms of Reglan (such as tablets and oral syrup) at the same time.

Store Reglan at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. After you stop taking Reglan, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include drowsiness, confusion, tremors or uncontrolled muscle movements in your face or neck, or seizure (convulsions).

What should I avoid while taking Reglan?

Avoid drinking alcohol. It can increase some of the side effects of Reglan. Metoclopramide may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Reglan side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Reglan: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking Reglan and call your doctor at once if you have any of these SIGNS OF A SERIOUS MOVEMENT DISORDER, which may occur within the first 2 days of treatment:

  • tremors or shaking in your arms or legs;

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement); or

  • any new or unusual muscle movements you cannot control.

Stop taking Reglan and call your doctor at once if you have any of these other serious side effects:

  • slow or jerky muscle movements, problems with balance or walking;

  • mask-like appearance in your face;

  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;

  • depressed mood, thoughts of suicide or hurting yourself;

  • hallucinations, anxiety, agitation, jittery feeling, trouble staying still;

  • swelling, feeling short of breath, rapid weight gain;

  • jaundice (yellowing of your skin or eyes); or

  • seizure (convulsions).

Less serious Reglan side effects may include:

  • feeling restless, drowsy, tired, or dizzy;

  • headache, sleep problems (insomnia);

  • nausea, vomiting, diarrhea;

  • breast tenderness or swelling;

  • changes in your menstrual periods; or

  • urinating more than usual.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Reglan?

Before using Reglan, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by Reglan.

Tell your doctor about all other medications you use, especially:

  • acetaminophen (Tylenol);

  • cyclosporine (Gengraf, Neoral, Sandimmune);

  • digoxin (digitalis, Lanoxin);

  • glycopyrrolate (Robinul);

  • insulin;

  • levodopa (Larodopa, Atamet, Parcopa, Sinemet);

  • mepenzolate (Cantil);

  • tetracycline (Ala-Tet, Brodspec, Panmycin, Sumycin, Tetracap);

  • atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

  • blood pressure medications;

  • bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);

  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), or propantheline (Pro-Banthine);

  • an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate); or

  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa, Symbyax), prochlorperazine (Compazine), risperidone (Risperdal), thiothixene (Navane), and others.

This list is not complete and there are many other drugs that can interact with Reglan. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

For the Consumer

Applies to metoclopramide: oral solution, oral syrup, oral tablet, oral tablet disintegrating

Along with its needed effects, metoclopramide (the active ingredient contained in Reglan) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking metoclopramide:

Rare
  • Abdominal or stomach pain or tenderness
  • chills
  • clay colored stools
  • convulsions (seizures)
  • dark urine
  • difficulty with breathing
  • difficulty with speaking or swallowing
  • dizziness or fainting
  • fast or irregular heartbeat
  • fever
  • general feeling of tiredness or weakness
  • headache (severe or continuing)
  • inability to move the eyes
  • increase in blood pressure
  • increased sweating
  • itching
  • lip smacking or puckering
  • loss of appetite
  • loss of balance control
  • loss of bladder control
  • mask-like face
  • muscle spasms of the face, neck, and back
  • nausea and vomiting
  • puffing of the cheeks
  • rapid or worm-like movements of the tongue
  • shuffling walk
  • skin rash
  • sore throat
  • stiffness of the arms or legs
  • swelling of the feet or lower legs
  • tic-like or twitching movements
  • trembling and shaking of the hands and fingers
  • twisting movements of the body
  • uncontrolled chewing movements
  • uncontrolled movements of the arms and legs
  • unusually pale skin
  • weakness of the arms and legs
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking metoclopramide:

Symptoms of overdose
  • Confusion
  • drowsiness (severe)

Some side effects of metoclopramide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Diarrhea
  • drowsiness
  • restlessness
Less common or rare
  • Breast tenderness and swelling
  • changes in menstruation
  • constipation
  • decreased interest in sexual intercourse
  • inability to have or keep an erection
  • increased flow of breast milk
  • increased need to urinate
  • loss in sexual ability, desire, drive, or performance
  • mental depression
  • passing urine more often
  • skin rash
  • trouble sleeping
  • unusual dryness of the mouth
  • unusual irritability

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Applies to metoclopramide: injectable solution, oral concentrate, oral syrup, oral tablet, oral tablet disintegrating

Nervous system

Tardive dyskinesia involves involuntary, dyskinetic, repetitive movements and may be more common in elderly women. Tardive dyskinesia may be irreversible and is related to both the duration of therapy and the total amount of drug consumed. Frequent discontinuation and resumption of therapy may predispose patients to the development of tardive dyskinesia.

Dystonias frequently involve tongue protrusions, muscle rigidity, torticollis, and opisthotonos. Dystonias usually resolve after metoclopramide (the active ingredient contained in Reglan) discontinuation, but may require antihistamine and antiparkinsonian therapy if symptoms are severe or if respiration is compromised. Treatment of dystonic reactions and extrapyramidal effects, in addition to general supportive measures, may include judicious use of one or more of the following: benztropine or diphenhydramine.

Hyperthermia, altered consciousness, autonomic dysfunction, and muscle rigidity are the hallmarks of the neuroleptic malignant syndrome. The neuroleptic malignant syndrome is associated with a case fatality rate of about 20%. Immediate discontinuation of metoclopramide therapy, consideration of dantrolene administration, as well as intensive monitoring and supportive care are indicated.

Drug-induced parkinsonian symptoms due to metoclopramide may be misdiagnosed and inappropriately treated with dopaminergic agents. Parkinsonian-like symptoms have occurred, more commonly within the first 6 months from the start of therapy with metoclopramide, but occasionally after longer periods. Caution should be exercised when diagnosing movement disorders in patients currently being treated with metoclopramide. Additionally, metoclopramide should be avoided in patients with confirmed Parkinson's disease.

Patients with AIDS or HIV-positive may be at an increased risk of developing acute dystonia to metoclopramide use. Decreases in dopamine levels have been observed in a study of AIDS patients without clinical neurologic disease. Similarly, HIV-positive patients have shown a decreased response in serum prolactin during intravenous infusion of metoclopramide when compared with controls, interpreted as an indirect evidence of a diminished endogenous dopamine tone.

Nervous system side effects have been commonly reported and included drowsiness, fatigue, restlessness, and lassitude in approximately 10% of patients. Drowsiness may occur in up to 70% of cancer patients treated with high-dose (1 to 2 mg/kg/dose) metoclopramide. Tardive dyskinesia, dystonia, pseudo-parkinsonism, and the neuroleptic malignant syndrome have also been reported. In addition, cases of akathisia have been reported. Seizures and hallucinations have been reported rarely. At least one case of lightheadedness has also been reported.

Endocrine

Endocrine side effects have included galactorrhea, amenorrhea, gynecomastia, and impotence secondary to hyperprolactinemia. In addition, metoclopramide (the active ingredient contained in Reglan) may cause a transient increase in circulating aldosterone levels and subsequently cause edema.

Psychiatric

Depression may occur in patients without prior history of depression or other psychiatric illness and may be severe. Suicidal ideation may be present. Several reports suggest that dose reduction may alleviate depressive symptomatology. In addition, reintroduction of metoclopramide (the active ingredient contained in Reglan) with slow titration of the dose upwards to a therapeutic level has been successful in some patients.

Psychiatric side effects have included depression, anxiety, mania, psychosis, and insomnia.

Cardiovascular

Cardiovascular side effects have included hypertension, hypotension, supraventricular tachycardia, bradycardia, and cardiac arrest. In addition, metoclopramide (the active ingredient contained in Reglan) is associated with hypertensive crisis in patients with pheochromocytoma and has been implicated in a case of congestive heart failure.

It is postulated that metoclopramide may indirectly cause release of catecholamines from tumors in pheochromocytoma patients. Hypertensive crisis may ensue. The use of metoclopramide is considered contraindicated in patients with pheochromocytoma.

Hypertensive crisis has been documented in the absence of pheochromocytoma as well. The manufacturer recommends cautious use of metoclopramide in patients with essential hypertension.

Sinus bradycardia (50 beats per minute) progressing to complete heart block with sinus arrest has been reported in a 54-year-old man after receiving metoclopramide 10 mg IV. Asystole lasted approximately 25 seconds, followed by a spontaneous increase in heart rate to 80 beats per minute in sinus rhythm with a blood pressure of 140/70 mm Hg. Similar effects were observed on rechallenge with a dose of metoclopramide 5 mg given slowly. No changes in ST segment or QRS complexes were observed on electrocardiogram.

Hematologic

Patients with NADH-cytochrome b5 reductase deficiency who need to receive metoclopramide (the active ingredient contained in Reglan) are at increased risk of developing methemoglobinemia and/or sulfhemoglobinemia. The treatment of metoclopramide-induced methemoglobinemia with methylene blue is not recommended in patients with G6PD deficiency.

Hematologic side effects including leukopenia, neutropenia, porphyria, and agranulocytosis have been reported rarely. Methemoglobinemia has also been reported with metoclopramide use in adults, but may be more common in infants who are treated with high doses.

Hepatic

A 22-year-old female, treated with metoclopramide (the active ingredient contained in Reglan) 10 to 15 mg per day for 7 to 8 months for abdominal pain, developed hepatic hemangiomatosis with arteriovenous shunting and cholestasis. Hyperprolactinemia, galactorrhea, amenorrhea, and virilization were also noted on initial presentation. The patient was placed on a waiting list for liver transplantation. However, complete, albeit slow, resolution occurred following discontinuation of metoclopramide.

Hepatic side effects have included rare reports of elevations in liver function tests and jaundice. A case of arteriovenous shunting and cholestasis in conjunction with hepatic hemangiomatosis has been reported.

Genitourinary

Genitourinary side effects have included urinary frequency, incontinence, and urinary retention.

Hypersensitivity

Hypersensitivity side effects have included rash, urticaria, bronchospasm, angioneurotic edema, and glossal or laryngoedemal reactions.

Gastrointestinal

Gastrointestinal side effects have included nausea and diarrhea.

Respiratory

Respiratory side effects have been reported rarely. A case of metoclopramide-induced bronchospasm is reported in the literature.

Other

Other side effects have included porphyria, local pain during intravenous injection, and transient flushing during high-dose infusion. At least one case of generalized weakness has been reported.

Renal

Renal side effects have included urinary frequency and incontinence.

Ocular

Ocular side effects have included visual disturbances. Decrease in pupil diameter and transiently depressed reflex dilation have been reported in patients undergoing lower abdominal surgery under combined epidural/general anesthesia.

Musculoskeletal

Musculoskeletal side effects have included a case of dystonic reaction.

A 28-year-old female experienced dystonic reaction coincident with metoclopramide therapy. She had started taking metoclopramide the day before her presentation to the hospital. Her symptoms resolved six to eight hours after onset.

General

In general, the incidence of side effects correlates with dose and duration of metoclopramide (the active ingredient contained in Reglan) therapy. The elderly may be more susceptible to developing adverse effects due to the changes in organ function, concomitant diseases, and other drug therapies.