Reglan (metoclopramide) is used as a short-term treatment of certain conditions such as Gastroesophageal Reflux Disease (commonly referred to as GERD, acid reflux disease or persistent heartburn) and Gastroparisis (a disorder seen in diabetic patients where the stomach takes too long to empty). Metoclopramide belongs to a class of drugs known as dopamine receptor blockers. Metoclopramide works by increasing stomach emptying and movement in the upper intestines. Over 2 million Americans have been prescribed Reglan.



Metoclopramide is available in several forms including:

?Reglan Tablets

?Reglan Oral Disintegrating Tablets

?Metoclopramide Oral Solution

?Reglan Injection

Reglan acts in the upper end of the digestive system and works by speeding up the movement of the stomach muscles, thus increasing the rate at which the stomach empties into the intestines. It is used as a short-term treatment of gastroesophageal reflux 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). It is recommended that treatment not exceed twelve weeks, however it is estimated that around thirty percent of patients who are prescribed products containing metoclopramide take the medication for a much longer period of time. Chronic, long-term and/or high dose use of metoclopramide has been linked to serious drug induced movement disorders such as tardive dyskinesia.

Tardive dyskinesia (TD) is a drug-induced movement disorder caused by the long-term use of neuroleptic drugs. Tardive means ?delayed? and dyskinesia means ?abnormal movement.? This serious neurological syndrome is often irreversible and may become permanent. Since the 1950's a family of drugs referred to as dopamine receptor blocking drugs (DRB) have been prescribed for certain mental health conditions and are now also commonly prescribed for the treatment of GERD and nausea.

Tardive dyskinesia is a neurological syndrome typically characterized by repetitive, involuntary movements of the face, tongue, lips, mouth, or jaw, and sometimes by involuntary movements of the arms, legs, fingers and trunk. Movements may include facial grimacing, tongue protrusion, lip smacking or puckering, rapid eye movements or uncontrolled blinking, and rapid and involuntary movements of the arms, legs, or fingers. Treatment of tardive dyskinesia includes stopping or reducing the use of Reglan (metoclopramide). However, the symptoms of tardive dyskinesia may continue long after discontinuation of Reglan (metoclopramide) and there is no known treatment. In some patients, symptoms may lessen or disappear after Reglan (metoclopramide) treatment has stopped. The majority of patients who have developed tardive dyskinesia have been treated with Reglan (metoclopramide) for more than three months.

The U.S. Food and Drug Administration (FDA) announced in February 2009 that manufacturers of metoclopramide are required to add a black box warning to their packaging about the risk of tardive dyskinesia associated with its long-term and/or high-dose use. In addition to the black box warning, the FDA is requiring manufacturers to implement a risk evaluation and mitigation strategy so that patients are provided with a medication guide that explains the risk of tardive dyskinesia with chronic metoclopramide treatment.