Diabetic gastric stasis and gastroesophageal reflux aren’t much fun. Patients afflicted with these two conditions often experience nausea, vomiting, heartburn, persistent fullness after meals, and anorexia. A prokinetic agent called Reglan (metoclopramide) has been added to the list of suggested short-term therapies for use after conventional therapy fails. Reglan helps by increasing the frequency of gastric contractions and relaxing the pyloric sphincter, a ring of muscle that lets food pass from the stomach to the duodenum (the first section of the small intestine).
While this drug has been shown to provide relief from gastric stasis and gastroesophageal reflux, consumers need to be aware of one of Reglan’s more insidious side effects.
Tardive Dyskinesia, most often linked to the use of antidepressants and antipsychotic drugs, causes the patient’s nerve cells to misfire. This creates involuntary movements such as grimacing, pacing in place, picking at clothes, rocking, and twitching. Long-term or high-level use of Reglan greatly increases the risk of developing this disorder.
The FDA now requires products with metoclopramide in them to add a warning to their labels. ‘The chronic use of metoclopramide therapy should be avoided in all but rare cases where the benefit is believed to outweigh the risk,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research in a February, 2009 press release.
The FDA also states that the movement disorder Tardive Dyskinesia is often irreversible and that the potential increases with duration and accumulation. Women and the elderly are especially at risk, and the warning applies to all forms of Reglan administration, including oral and injected.
With a 20% chance of developing Tardive Dyskinesia from taking Reglan for more than three months, it definitely makes sense to weigh the potential costs with the gastrointestinal benefits. Make sure to communicate with your doctor about the absolute length of administration as well as the amount you need to take.
For more details on Tardive Dyskinesia, click here.