Metoclopramide Oral/ IV / IM (Reglan®)
Classification: Antiemetic; Dopamine Antagonist; Serotinin 5-HT4 Receptor Agonist; Prokinetic
About: Metoclopramide Oral/ IV / IM (Reglan®)
Dopamine and serotonin are chemicals in the body that can cause nausea and vomiting by stimulating the chemoreceptor trigger zone in the brain. This medication works by blocking dopamine and serotonin from stimulating this chemoreceptor trigger zone, which helps prevent and treat nausea and vomiting. This medication can also be used to treat gastroesophageal reflux (GERD) and diabetic gastroparesis by helping the gastrointestinal (GI) tract’s motility and by making gastric emptying faster.
How to Take Metoclopramide (Reglan®)
The oral form of metoclopramide may be taken as a scheduled or as-needed medication. If you are taking a scheduled dose, it should be taken 30 minutes before a meal and again at bedtime. The intravenous form of metoclopramide may be given prior to a chemotherapy regimen or as needed as an IV push (depending on the dose) or as a short infusion. This medication can also be given as an intramuscular (IM, into a muscle) injection if your provider feels this is necessary.
This medication can be affected by certain foods and medications, so they should be avoided. These include: acetaminophen, anti-Parkinson agents including apomorphine, bromocriptine, levodopa, pramipexole, and ropinirole, antipsychotics/mood medications including aripiprazole, haloperidol, quetiapine and risperidone, anxiolytics, atovaquone, cabergoline, bupropion, cyclosporine, fluoxetine, hypnotics, monoamine oxidase inhibitors including linezolid and rasagiline, promethazine, rivastigmine, paroxetine, quinidine, opiates, and sedatives, among others. Be sure to tell your healthcare provider about all medications and supplements you take.
This medication can make you dizzy or sleepy. You should not drink alcohol while taking this medication. You should not drive a car or operate heavy machinery until you know how this medication affects you.
Storage and Handling
For oral (by mouth) administration, store this medication in the original container. Tablets should be stored at room temperature. Keep this medication out of reach of children and pets.
Where do I get this medication?
This medication in the oral form is available through retail/mail order pharmacy. Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution. You can work with your provider’s office if this medication needs a prior authorization. The intravenous or intramuscular form would be provided to you in a healthcare setting as ordered by your medical team.
Oral metoclopramide may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources if they are available. Administration of the intravenous or intramuscular form in either the outpatient or inpatient setting would be covered under your medical benefits.
Possible Side effects of Metoclopramide
This medication is given to manage and/or prevent the side effects of your cancer treatment. If you are having side effects from this medication you should talk to your team about if this medication is necessary to your treatment or if there are other options to help manage the side effect this medication is treating. These are some of the most common side effects:
Fatigue & Drowsiness
This medication, depending on your dose and how often you use it, may make you feel sleepy and tired. Please do not drive or operate heavy machinery until you know how this medication affects your ability to do these activities. Additionally, fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your oncology care team for helpful tips on dealing with this side effect.
This medication, depending on your dose and how often you use it, may cause an inability to rest or relax. Talk to your oncology care team if you experience this side effect so they can help you manage it.
In rare cases, this medication can cause tardive dyskinesia. This can lead to abnormal muscle movements, often in the face, including grimacing, sticking out the tongue, and smacking of the lips. Alert your healthcare team immediately if you notice or develop any of these symptoms.
Less common, but important side effects can include:
- Changes in Muscle Control and Movement: Similar to tardive dyskinesia, this medication can cause a number of other side effects that can result in changes to muscle movements. Parkinsonism causes movements such as shaking, body stiffness, and trouble moving or keeping your balance. Akathisia is being unable to sit still or feeling like you need to move your hands, feet, or body. If you are having any changes in muscle movement you should call your provider right away.
- Neuroleptic Malignant Syndrome: This side effect can cause high fever, stiff muscles, problems thinking, fast heart rate, and increased sweating. This side effect is rare but can be serious. Contact your provider if you have any symptoms of neuroleptic malignant syndrome.
- Change in Mood: This medication can cause depression. In rare cases, this medication can cause a person to have thoughts of hurting themselves and to possibly act on those thoughts. If you have any thoughts of suicide you need to call your provider right away.
You should consult with your provider before becoming pregnant or fathering a child while on this medication. You should consult with your healthcare team before breastfeeding while receiving this medication because fetal risk cannot be ruled out in these situations. Risk versus benefits should be weighed and discussed with your healthcare team.