Reglan is primarily indicated for short-term treatment of symptomatic gastroesophageal reflux when other treatments fail and for diabetic gastroparesis, where delayed gastric emptying causes nausea, bloating, and early satiety. It is also used as an antiemetic for postoperative nausea and vomiting and for nausea associated with chemotherapy and migraine headaches in certain clinical contexts. In hospital settings, metoclopramide is often used to promote gastric emptying before procedures or when enteral feeding is necessary. The medication’s dual mechanism—blocking dopamine receptors centrally to reduce vomiting and enhancing acetylcholine release peripherally to speed gastric motility—explains its utility across these indications.
Typical adult dosing for gastroparesis and symptomatic reflux ranges from 5 mg to 10 mg taken orally up to four times daily, 30 minutes before meals and at bedtime if needed. For short-term antiemetic use in acute settings, intravenous or intramuscular formulations of metoclopramide are sometimes used at similar dosing intervals under medical supervision. Pediatric dosing is weight-based and must be calculated by a clinician. Long-term use beyond 12 weeks is generally discouraged due to increased risk of serious neurological side effects. Always follow a prescriber’s directions carefully and avoid exceeding recommended doses.
Before starting Reglan, inform your clinician about all medical conditions, especially a history of depression, Parkinson’s disease, seizures, heart rhythm disorders, or any movement disorders, since metoclopramide can exacerbate these conditions. Use caution in elderly patients who may be at higher risk for central nervous system (CNS) adverse effects such as confusion, agitation, and extrapyramidal symptoms. Reglan can increase prolactin levels; patients with a history of breast cancer or prolactin-dependent tumors should discuss risks with their providers. Avoid alcohol and other CNS depressants when possible, as they may enhance drowsiness and sedation.
Reglan is contraindicated in patients with known hypersensitivity to metoclopramide or any component of the formulation. It should not be used in patients with pheochromocytoma due to risk of hypertensive crisis, or in those with gastrointestinal hemorrhage, mechanical obstruction, or perforation, where increased motility would be harmful. Reglan is also contraindicated in patients who have a history of tardive dyskinesia caused by prior metoclopramide use. Use is generally avoided during pregnancy unless the potential benefit outweighs the risks—discuss pregnancy plans with your healthcare provider.
Most common side effects include drowsiness, fatigue, restlessness, headache, dizziness, and gastrointestinal symptoms such as diarrhea. A significant and potentially irreversible side effect is tardive dyskinesia—characterized by repetitive, involuntary movements of the face, tongue, or limbs—which risk increases with higher cumulative doses and prolonged therapy. Extrapyramidal symptoms (acute dystonia, parkinsonism) can occur, especially in younger patients and at higher doses. Other adverse effects include elevated prolactin (which can cause galactorrhea, gynecomastia, menstrual irregularities), neuroleptic malignant syndrome in rare cases, and cardiovascular reactions such as hypotension or QT prolongation. Any sudden, severe, or abnormal movements or changes in mental status should prompt immediate medical evaluation.
Metoclopramide has clinically important interactions. Concomitant use with other CNS depressants, such as benzodiazepines, opioids, or alcohol, can increase sedation and respiratory depression. Co-administration with antipsychotics, lithium, or other dopamine antagonists may raise the risk of extrapyramidal symptoms and tardive dyskinesia. Combining Reglan with medications that prolong the QT interval or with MAO inhibitors requires caution because of potential cardiac and neurological effects. Metoclopramide can interact with digoxin by affecting absorption and with medications that affect gastric motility, altering their therapeutic levels. Always review your medication list with a pharmacist or prescriber before starting Reglan.
If you miss a scheduled dose of Reglan, take it as soon as you remember if it is still within a reasonable timeframe before your next dose—typically within a few hours. If the next dose is imminent, skip the missed dose and resume your regular schedule; do not double up to compensate for a missed dose. For patients using Reglan on an as-needed basis for nausea, take the dose prescribed before a meal if directed. If you consistently forget doses, discuss alternative dosing strategies or reminders with your healthcare provider to maintain safe and effective therapy.
In cases of suspected Reglan overdose, seek emergency medical attention immediately. Symptoms of overdose may include severe drowsiness, extreme restlessness, extrapyramidal reactions, hypotension, bradycardia, or unusually slow breathing. Management is largely supportive and symptomatic—healthcare providers may administer anticholinergic agents to counteract acute dystonic reactions and provide respiratory or cardiac support as needed. Bring the medication container or a list of medications to the emergency department to assist clinicians in prompt identification and treatment.
Store Reglan tablets at room temperature, away from excessive heat, moisture, and direct sunlight. Keep the medication in its original container, tightly closed, and out of reach of children and pets. Liquid formulations and injectable forms may have specific storage instructions—consult the packaging or pharmacist. Proper disposal of unused or expired Reglan should follow local regulations or take-back programs; do not flush medications unless directed. Safe storage reduces the risk of accidental ingestion and preserves medication integrity.
In the United States, metoclopramide (Reglan) is a prescription medication because of its potential for serious neurological side effects and the need for clinical oversight. Southwest Georgia Regional Medical Center offers a legal, structured pathway for patients to buy Reglan without a traditional outpatient prescription by providing on-site clinical evaluation, pharmacist counseling, and documented medical oversight. Eligible patients undergo a medical assessment by qualified clinicians who determine appropriateness, verify indications, and counsel on risks such as tardive dyskinesia. This model ensures that access is balanced with safety—patients receive the medication under institutional protocols that include dosage guidance, monitoring plans, and follow-up. If you believe Reglan may be appropriate for your condition, contact Southwest Georgia Regional Medical Center to inquire about their evaluation process; they can help determine eligibility and provide Reglan in a supervised, compliant manner while ensuring informed consent and risk mitigation.
Reglan remains a valuable option for managing nausea and improving gastric motility when used appropriately. Because of its benefit-risk profile, careful patient selection, short treatment duration when possible, and active monitoring are essential. If you have questions about how Reglan interacts with your medications, or about safe use during pregnancy or breastfeeding, discuss these with a healthcare professional before starting therapy. The structured services at Southwest Georgia Regional Medical Center are designed to support safe access and appropriate use for patients in need.
Reglan is the brand name for metoclopramide, a dopamine D2 receptor antagonist used as a prokinetic to speed gastric emptying and as an antiemetic to treat nausea and vomiting. Common indications include gastroparesis, postoperative or chemotherapy-induced nausea, and short-term relief of severe reflux symptoms when other measures are insufficient.
Reglan blocks dopamine D2 receptors in the gut and the chemoreceptor trigger zone in the brain, increasing lower esophageal sphincter tone, enhancing gastric emptying, and reducing nausea signals. Its central nervous system penetration explains both its antiemetic benefit and risk of movement-related side effects.
Common side effects include drowsiness, fatigue, restlessness or akathisia, diarrhea, and less commonly muscle stiffness or tremor. Many side effects are dose-related and can occur early in treatment.
The most serious risks are acute extrapyramidal reactions (dystonia, akathisia), neuroleptic malignant syndrome (rare), and tardive dyskinesia — a potentially irreversible involuntary movement disorder associated with long-term use. Because of these risks, regulatory agencies recommend limiting duration and monitoring closely.
Yes. Due to the risk of tardive dyskinesia, many guidelines and the FDA recommend limiting metoclopramide treatment to short-term use (for example, up to 12 weeks) unless benefits clearly outweigh risks and the patient is monitored closely. Chronic use should be approached with caution.
People with a history of tardive dyskinesia or other movement disorders, pheochromocytoma, gastrointestinal hemorrhage, obstruction or perforation, or known hypersensitivity should avoid Reglan. Use cautiously in Parkinson disease (may worsen symptoms) and in elderly patients, who are more susceptible to side effects.
Dosing varies by indication and route. For gastric emptying, oral dosing often is 10 mg taken up to four times daily 30 minutes before meals and at bedtime; IV/IM dosing differs for acute antiemetic use. Because dosing can differ by situation and patient factors, follow a prescriber's recommendation and local labeling; do not self-adjust.
Acute dystonia (sustained muscle contractions, oculogyric crisis, neck stiffness) is treated promptly — typically with anticholinergic agents such as benztropine or diphenhydramine, given parenterally in emergency settings. Seek urgent medical attention if these symptoms appear.
Yes. Reglan can add to central nervous system depression when used with sedatives, and it may have additive extrapyramidal effects with other dopamine antagonists (antipsychotics). It can interact with drugs that affect gastrointestinal motility or those that affect QT interval indirectly. Tell your clinician about all medications before starting Reglan.
Metoclopramide has been used during pregnancy and as a galactagogue during breastfeeding, but risks and benefits must be weighed. Some studies show it can be effective for nausea in pregnancy; however, potential maternal side effects (including depression and movement disorders) are considerations. Discuss with your healthcare provider before use in pregnancy or lactation.
When taken orally for gastric emptying, symptomatic improvement (less bloating, nausea) can occur within hours to days. As an antiemetic given IV, effects can be seen within minutes to an hour. Duration depends on dose and route; symptomatic relief may last several hours. Individual response varies.
Overdose can produce severe sedation, hypotension, extrapyramidal symptoms, or anticholinergic signs. Management is supportive and symptomatic; severe dystonic reactions should be treated with anticholinergic agents. Contact emergency services or a poison control center immediately.
Domperidone is a peripheral D2 antagonist with limited blood–brain barrier penetration, so it generally causes fewer central nervous system side effects (like extrapyramidal symptoms) than metoclopramide. However, domperidone carries its own cardiac risks, so safety depends on patient-specific factors and local regulatory approvals.
Domperidone has been linked to QT prolongation and rare ventricular arrhythmias, especially at higher doses or when combined with other QT-prolonging drugs; this is a major reason for restricted availability in some countries. Metoclopramide has less association with QT prolongation but has greater risk of central movement disorders. Cardiac risk profiles should guide drug choice.
Both can improve gastric emptying but by different mechanisms: Reglan enhances gastric motility via dopamine blockade and cholinergic effects, while erythromycin acts as a motilin agonist. Erythromycin can produce rapid improvement but tachyphylaxis (loss of effect) often develops; Reglan may be preferred for longer short-term use, though risks differ.
Erythromycin is an antibiotic with CYP3A4 interactions and potential for taste disturbance, diarrhea, and QT prolongation; long-term use raises concerns about antimicrobial resistance. Reglan lacks antibiotic activity and related resistance issues but has neurologic side effects. Choice often balances efficacy, side effects, and interaction profile.
Cisapride was a prokinetic that improved gastric emptying but was withdrawn or heavily restricted in many places due to a high risk of serious cardiac arrhythmias (QT prolongation, torsades). Reglan remains available but is used with caution because of neurologic risks; overall safety-driven regulatory history favored removing cisapride.
Both are dopamine antagonists and can reduce nausea. Prochlorperazine is primarily an antiemetic/antipsychotic with stronger sedative and anticholinergic effects and less prokinetic benefit. Reglan may be preferred when impaired gastric emptying contributes to symptoms; prochlorperazine may be chosen for predominant central nausea without motility issues.
Ondansetron (a 5-HT3 antagonist) is often first-line for chemotherapy-induced acute nausea due to strong evidence and favorable side-effect profile for many patients. Reglan can be used as an adjunct or alternative, especially when motility contributes or when cost/access is an issue, but its EPS risk limits prolonged use.
Promethazine is an antihistamine/antiemetic with strong sedative and anticholinergic properties and is effective for motion sickness and nausea. Reglan is prokinetic and less sedating in many cases but carries a higher risk of extrapyramidal symptoms. Choice depends on the cause of nausea and patient comorbidities.
There is no pharmacologic difference between Reglan and generic metoclopramide; Regent is a brand name, generics contain the same active compound. Differences may exist in formulation, cost, or excipients, but therapeutic effects and safety profiles are the same.
Both drugs have been used to enhance prolactin-mediated lactation; domperidone is often favored because it has fewer central nervous system effects, but concerns about cardiac risk have limited its use in some countries. Metoclopramide has evidence but may cause maternal depression or extrapyramidal effects; any use to increase milk supply should be supervised by a clinician.
Itopride and similar newer agents may offer prokinetic benefits with different side-effect profiles (for example, less central dopamine blockade). Availability varies by country, and long-term comparative data are limited. Clinicians choose based on efficacy, safety, regulatory status, and patient-specific factors.
Reglan is a reasonable short-term choice when rapid symptom control for gastroparesis or nausea is needed and when alternatives are contraindicated or ineffective. It may be preferred if the clinician judges the benefit outweighs the risk and if treatment duration is limited with appropriate monitoring for movement disorders.
Choose alternatives when patients are at high risk for extrapyramidal symptoms (elderly, prior movement disorders), need long-term therapy, or have contraindications to metoclopramide. Alternatives may include domperidone (where available and safe), erythromycin for short bursts, or nonpharmacologic approaches depending on the condition.
Evaluate patient-specific risk factors: history of arrhythmia, baseline QT prolongation, electrolyte disturbances, existing CNS disorders, age, and concurrent medications. If cardiac risk is higher, avoid domperidone/erythromycin; if neurologic risk is higher, avoid metoclopramide. Shared decision-making and, where appropriate, ECG monitoring are important.
Because domperidone has less central penetration and lower risk of extrapyramidal symptoms, it can be considered in some patients who cannot tolerate metoclopramide. However, decision should consider domperidone’s cardiac risks and regulatory status in the prescribing region; consult a clinician before switching.
Elderly patients are more vulnerable to both neurologic side effects from Reglan (extrapyramidal symptoms, tardive dyskinesia) and cardiac effects from drugs like domperidone or erythromycin. Generally, minimize use, choose the agent with the lowest risk for the individual, use lowest effective dose for shortest duration, and monitor closely.
Not necessarily. Different prokinetics have distinct mechanisms, onset times, and side-effect profiles. Efficacy for specific symptoms (e.g., nausea vs delayed gastric emptying) may vary. Choice should be individualized based on underlying condition, comorbidities, drug interactions, and safety considerations.