Reglan is a form of metoclopromide, an agent primarily used to treat nausea and vomiting and regulate gastric emptying. Metoclopromide is produced under the trade name “Reglan” by the Schwarz Farma company, a division of UCB pharmaceutical company. Due to its many adverse effects when used in excess, particularly its link to disorders involving involuntary muscle contractions (Tardive Dyskinesia [TD] and Neuroleptic Malignant Syndrome[ NMS]), the FDA required that Reglan be marked with a “Black box ” warning, the FDA’s strongest warning label.
More than two million Americans use metoclopramide-containing products. When used long-term, there is a 27-29% chance of developing Tardive Dyskinesia.
Reglan is generally prescribed for to treat heartburn, acid reflux, nausea, vomiting, constipation, gastroparesis (delayed gas) and migraine headaches. Reglan is a gastroprokinetic agent, meaning that it works by increasing muscle contractions in the upper digestive track and increasing gastrointestinal motility by making contractions stronger. It works by speeding up the movement of the stomach muscles, increasing the rate at which the stomach empties into the intestines. It is used as a short-term treatment of gastroesophageal reflux (GERD) disease in patients who have not responded to other therapies, and to treat diabetic gastroparesis (slowed emptying of the stomach’s contents into the intestines) Reglan is also a antiemetic, an agent commonly used to treat nausea and motion sickness. It may also be prescribed to treat surgery, radiation therapy and pregnancy. Lastly, Reglan is considered a dopamine antagonist, related to nervous functioning, and is traditionally used to treat schizophrenia and other mental disorders by turning down dopamine activity.
Long term, chronic use has been linked to Neuroleptic Malignant Syndrome (NMS) an often fatal neurological condition and Tardive Dyskinesia (TD), a rare, serious and potentially irreversible neurological disorder characterized by persistent, repetitive, grotesque, involuntary movements of the tongue, mouth, face, lips, and sometimes the arms, trunk or legs, including puckering, pursing or smacking of the lips, uncontrolled facial grimacing, rapid eye blinking, tongue protrusion, involuntary movement of the hands and fingers, difficulty breathing or swallowing.
No known treatment for TD. The development of TD is directly related to the length of treatment time and the number of doses taken. The elderly, especially older women, and people who have been on the drug for a long time are at highest risk for TD.
When used long-term, there is a 27-29% chance of developing tardive dyskinesia. Neuroleptic malignant syndrome is also strongly correlated with the use of Reglan. In terms of diagnosis, signs of twitching, jerking, and involuntary movements when matched with a patient taking reglan for either a long period of time or at a high dosage, generally leads to a higher likelihood that TD or NMS is present. Additionally, patients that are on anti-psychotic or medication for mental disorders are at a higher risk to develop TD or NMS.