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Reglan/Metoclopramide: your experiences?

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Posted 6/8/2014 1:06 AM (GMT 0)
Hi, There!

I am relatively new to GI issues. I began treatment for GERD in April 2013 (first omeprazole 20 mg, now protonix 40 mg).

In March/April of 2014 I developed all sorts of odd and terrifying symptoms which drove me to the ER and were initially diagnosed as esophageal spasms.

A recent esophageal manometry test revealed that my esophagus is only contacting 30 percent of the time when I swallow. (This has been attributed to an autoimmune disease that I suffer from.)

I was referred to a GI doc that specializes in motility issues. She prescribed Reglan (metoclorpramide) to me, and I didn't realize what a powerful and scary medication is was until I got it home and read all of the accompanying literature. I don't think I can/should take this stuff.

If you have experience with this medication and/or esophageal motility issues, would you be so kind as to share your experience with me?

I seem to be stuck between a rock and hard place. I have been on low-fiber liquid/puree diet for over 6 weeks now, as that's all I can tolerate, and I have lost 10 percent of my body weight. I am not looking or feeling good. I am weak, dizzy, and I am experiencing spasms about three times a week that are so severe I almost go to the ER and then think, why bother ...

Any experiences, advice, thoughts, opinions are welcome. This is all new to me!

My best regards,
Nina
Posted 6/8/2014 3:09 AM (GMT 0)
Hi Nina,

My family doctor had me on Reglan (in an effort to mitigate reflux issues, by trying to get the food to move through the digestive tract more quickly.) I took it for 3-4 years without any side effects at all. I do know it has some bad side effects listed, but I can say that I never had a single one of them.

You can always watch for neurological quirks while you're on the drug. That's the way I handled it. If you begin with any of those symptoms, you could stop the medication, and you won't have continued issues. It's a good thing to be aware of the symptoms to watch for, in case you're sensitive to the drug, you'll know it's the culprit.

That said, I took it all those years, without a single issue.
It's your call, but it seems to me it's worth a try, if there's a chance it will help you feel more comfortable.

One of my doctors used to quote Thomas Aquinas when I was struggling over whether or not to try a new drug or procedure:
"If the highest aim of a captain were to preserve his ship, he would keep it in port forever."

Good luck with your decision!
Best wishes,
Denise
Posted 6/8/2014 10:19 AM (GMT 0)
I don't want to cause undue distress or anxiety, but for the sharing of personal experiences... I did not have the best experience with Reglan.

I was prescribed it for gastroparesis, and while it was very effective for symptom relief of GI symptoms, I did not have the best luck with escaping the troublesome side effects. It didn't cause me any issues with tardive dyskinesia, but my mood absolutely fell through the floor while on it. My doctor acknowledged that it can cause emotional upsets and suicidal thoughts, and that's exactly what happened to me. I was a different person while on it; totally depressed and irritable. It wasn't pleasant for myself, and people around and close to me.

But, in regards to tackling the GI symptoms, it was amazing for THAT indication.

Can you get domperidone at all? It's the same as Reglan, but doesn't cross the blood brain barrier so it essentially will aid with GI symptom relief without the potential neurological side effects.

And some people can take it without any significant adverse side effects. If this is your last straw, you could trial it and see how you go. We're all different, and you may have no issues at all taking it.

Good luck!
Posted 6/8/2014 5:45 PM (GMT 0)
I've taken domperidone for over a year without any issues. I think it is a better choice for speeding up the system tbh, less side effects. I have a weak esophagus and food would get stuck on the way down but not since taking that.
Posted 6/8/2014 5:53 PM (GMT 0)
Yeah, I switched to domperidone as well. Fantastic for relief, and no side effects for me at all like Reglan. I think it's not available everywhere though.
Posted 6/9/2014 12:53 AM (GMT 0)
Last time I checked domperidone wasn't available in the US. If it gets FDA approved please let us know!

I took Reglan for 6 months for slow gut. It worked great, but eventually I got facial tics (a type of tardive dyskinesia). If you get that you have to stop Reglan immediately or the side effect can get worse and become permanent. I think the problem was that I was prescribed more than my miserable system can handle. I was on it 4 times a day. I think I would have been fine on a lower dose.

Don't read all the possible side effects and then not take medicines that your doctor prescribes for that reason alone. If you have allergies or intolerances or are prescribed something that is likely to interact with another medicine you are already taking, then bring it up with the doctor. He prescribed it for a good reason!
Posted 6/9/2014 1:11 AM (GMT 0)
That's an excellent point Alcie.

It could definitely be dosage related. I know I took a very small dose when I was on it.

I agree, I don't think the doctor would put a patient on that drug without a very good reason. It is not difficult to watch for side effects, and if they occur, stop the drug. Not everyone gets side effects though. It's not a drug that is used lightly. I know my G.I. docs didn't like it, and would only use it as a last resort.

It's your call, Nina! Good luck with your decision.
Best wishes,
Denise
Posted 6/10/2014 1:29 PM (GMT 0)
Hi folks,

I don't wish to alarm anyone but....... Metaclopramide was in the medical press last year and is thought not to be suitable for long term use. Here's one of the articles about it: -

www.medscape.com/viewarticle/808476

MMM
Posted 6/10/2014 2:59 PM (GMT 0)
Hi MMM,

There is no doubt that Reglan has a reputation for potential neurological issues. There is no argument there. It's just that it's not universal, and is dependent on dose and the person's propensity to neurological problems. It isn't a drug to take without consideration of the risks. I still stand by the fact that it's possible to take a low dose without a negative effect, as I did that. I'm not saying it's for everyone, but it's not universally problematic.

It's great to hear from you!! Thanks for providing the great info.
Hope all is well,
Denise
Posted 6/10/2014 4:27 PM (GMT 0)
For what it is worth, I was taking Reglan three times per day. I don't remember the dose, but it could have been that I was on what's considered a relatively high dose. So, that may have contributed to me experiencing some side effects.

IMO, unless you have a reason to suspect that you could be especially prone to certain side effects, there's no reason to not at least try what your doctor has recommended. In my experience, GI doctors are pretty aware of Reglan's side effects, and they generally don't prescribe it unless they really think it will be more beneficial than detrimental.
Posted 6/10/2014 9:02 PM (GMT 0)
Hi Denise,

Yes I'm sure the benefits often outweigh the risk and of course "forewarned is forearmed"!

Good to hear from you too!

MMM x
Posted 6/16/2014 11:42 PM (GMT 0)
I was on the Reglan a few years ago and it did work well, but I was afraid of it so I stopped taking it. Motilium, (Domperidone) is the same type of drug and from what I have heard the side effects aren't as bad. I think the only way you can get that is from Canada.
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