Beasley, Allen, Crow, Methvin, Portis & Miles, P.C.

When Joey* was two months old, he was prescribed Reglan (known generically as metoclopramide) and took the medication for two years. When Joey turned 5, he began blinking his eyes uncontrollably. Less than two years later, he was still blinking uncontrollably but he also began jerking his head. “The doctors at first thought my son had Tourette’s syndrome,” says Joey’s mother on a post on iGuard about Reglan. “But now after knowing the side effects of Reglan they are starting to think he has permanent Tardive Dyskinesia.”

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People who suffer from heartburn, GERD or diabetic gastroparesis are often prescribed metoclopramide, known in the U.S. by the brand name Reglan, to treat their condition. Recent warnings issued by the Food and Drug Administration (FDA), however, may make those individuals consider natural alternatives before turning to pharmaceuticals.

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The elderly are particularly susceptible to drug-induced delirium or dementia and serious side effects from medications, especially painkillers, antidepressants, antihistamines, sleeping pills, urinary incontinence drugs, and the nausea medication often prescribed to diabetics, Reglan (metoclopramide), according to Public Citizen, a nonprofit consumer advocacy group. Among the brand-named drugs most likely to cause delirium or dementia are Benadryl, Ambien, Lunesta, Detrol and Reglan.

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Prokinetic drugs, such as Reglan (metoclopramide) are those that increase the movement of ingested material through the gastrointestingal tract. They are usually prescribed to treat diabetic gastroparesis, heartburn and nausea and vomiting in chemotherapy patients. Unfortunately, some prokinetic drugs may produce a number of serious side effects.

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A Canadian study of pregnant Israeli women who took the heartburn medicine Reglan (metoclopramide) to treat morning sickness has shown the drug does not increase the rate of birth defects in the babies born to those women, compared with babies born to women who did not take the medication.

While researchers are calling this encouraging news to pregnant women, the U.S. Food and Drug Administration (FDA) says more studies must be conducted before the agency will grant approval for the drug to be used in the treatment of morning sickness. After all, the drug carries a black box warning to consumers and health care providers of a serious, debilitating and often irreversible movement disorder called Tardive Dyskinesia. Other problems, it appears, may occur when the medication is taken on a long-term basis, even for pregnant women. 

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An electrical stimulation device to speed up the digestion in overweight patients with type 2 diabetes is showing promising results in the improvement of glycemic control, according to Med Page Today. The device works by discharging electrical current into the gastric antrum. It was originally developed as a nonpharmacologic alternative for treatment of gastroparesis, which is often treated with the medication Reglan (metoclopramide).

Some patients with gastroparesis don’t respond to treatment and some may experience severe adverse events from the medication. For example, Reglan recently fell under a black box warning after reports of a serious movement disorder called Tardive Dyskinesia in some patients who took the medication. Given the risks of medication, alternative therapies like the stimulation device seem more attractive. 

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The Food and Drug Administration (FDA) has approved the safety labeling changes of the heartburn and gastroparesis medication Reglan (metoclopramide) which includes a black box warning of a serious and often irreversible movement disorder called Tardive Dyskinesia. The warning includes Reglan (metoclopramide) tablets, ODT (orally disintegrating tablets), and injection.

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At least one published study reports a prevalence of the disfiguring movement disorder called Tardive Dyskinesia in patients who have taken the acid reflux medication Reglan (metoclopramide) for at least three months to be as high as 20 percent, according to the drug’s updated safety label. Earlier this year, the Food and Drug Administration issued a black box warning on Reglan (metoclopramide) and ordered the drug’s label be updated to include the risk of Tardive Dyskinesia after receiving numerous reports of the condition in patients who had taken the drug.

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Patients with Huntington disease (HD), a rare degenerative disorder of the central nervous system, have often been prescribed Reglan (metoclopramide) for the treatment of gastric problems even though the medication’s label says people with a history of depression, Parkinson’s disease or a movement disorder, and epilepsy or other seizure disorder should not take the drug.

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