Reglan (metoclopramide) is a prescription prokinetic and antiemetic used to treat nausea, vomiting, symptomatic gastroesophageal reflux disease (GERD), and gastroparesis, particularly diabetic gastroparesis. By enhancing coordinated motility in the upper gastrointestinal tract, it helps the stomach empty more efficiently and reduces reflux, bloating, and early satiety. Its anti-nausea effect comes from blocking dopamine D2 receptors in the chemoreceptor trigger zone of the brain; at higher doses it also has serotonergic activity (5-HT4 agonism and mild 5-HT3 antagonism), which contributes to its antiemetic and prokinetic actions.
Reglan is typically used short term. For diabetic gastroparesis, it can temporarily relieve symptoms such as nausea, vomiting, heartburn, abdominal fullness, and poor appetite by increasing gastric emptying and raising lower esophageal sphincter tone. In selected patients with refractory reflux, short courses can reduce regurgitation and heartburn when other therapies are inadequate. It is also used off-label in emergency and inpatient settings as an antiemetic and as an adjunct in acute migraine management to reduce nausea and improve absorption of other oral medications.
Clinical onset varies by route. After an oral dose, effects generally begin within 30 to 60 minutes; peak effect occurs within 1 to 2 hours. Intravenous or intramuscular administration produces a faster response. The elimination half-life averages 5 to 6 hours but is prolonged in renal impairment and in older adults. Because metoclopramide crosses the blood–brain barrier, centrally mediated effects such as drowsiness, restlessness, and movement-related adverse effects can occur, especially with prolonged or high-dose use.
Always use Reglan exactly as prescribed by your healthcare provider. Typical adult dosing and administration guidance include the following:
Special populations and dose adjustments:
How to take:
Boxed warning – tardive dyskinesia: Metoclopramide can cause tardive dyskinesia (TD), a potentially irreversible movement disorder characterized by repetitive, involuntary movements of the face, tongue, or extremities. Risk increases with cumulative dose, duration beyond 12 weeks, and in older adults (particularly older women), people with diabetes, and those taking antipsychotics. Discontinue treatment if signs of TD develop. Use the lowest effective dose for the shortest duration.
Neurologic and psychiatric effects: Drowsiness, fatigue, restlessness, agitation, insomnia, and dizziness are relatively common. Acute dystonic reactions (e.g., neck stiffness, oculogyric crisis, jaw spasm), akathisia (inner restlessness), and parkinsonism can occur, sometimes after only a few doses—children and young adults are more susceptible to acute dystonia. Symptoms often respond to anticholinergic agents (e.g., benztropine) or antihistamines (e.g., diphenhydramine), but prevention through conservative dosing is best. Metoclopramide may also exacerbate depression or precipitate suicidal ideation in vulnerable individuals; screen for mood disorders and monitor closely.
Parkinson’s disease: Because it blocks dopamine receptors, metoclopramide can worsen parkinsonian symptoms and antagonize the effects of dopaminergic therapy (e.g., levodopa). Avoid use unless the potential benefit outweighs risk and there are no safer alternatives.
Neuroleptic malignant syndrome (NMS): Rarely, NMS may occur, with features such as fever, rigid muscles, altered mental status, and autonomic instability. This is a medical emergency requiring immediate discontinuation and supportive care.
Endocrine and metabolic effects: Metoclopramide raises prolactin levels, potentially causing galactorrhea, gynecomastia, menstrual irregularities, or sexual dysfunction. Hyponatremia due to SIADH has been reported infrequently.
Cardiovascular and blood pressure: Use caution in patients with a history of hypertension. Avoid in pheochromocytoma (see Contraindications) due to risk of hypertensive crisis.
Gastrointestinal conditions: Do not use in suspected or known mechanical GI obstruction, perforation, or active GI bleeding because increasing motility can worsen these conditions. If abdominal pain, severe cramping, or hematemesis occurs, seek medical evaluation promptly.
Pregnancy and breastfeeding: Metoclopramide has been widely used during pregnancy for refractory nausea and vomiting; many data suggest low teratogenic risk when used at standard doses and durations as clinically indicated. It is excreted in breast milk; most breastfed infants tolerate exposure, but sedation or irritability can occur. Use only if benefits outweigh risks, and consult a healthcare professional for individualized advice. Metoclopramide should not be used solely to increase milk supply unless supervised by a clinician familiar with its risks.
Activities requiring alertness: Drowsiness and dizziness may impair the ability to drive or operate machinery. Avoid hazardous tasks until you know how Reglan affects you.
Alcohol and CNS depressants: Concomitant use can enhance sedation and psychomotor impairment. Limit or avoid alcohol, opioid analgesics, benzodiazepines, and other sedatives.
Do not use Reglan (metoclopramide) if you:
Pediatric use should be limited to situations where the benefit is judged to outweigh the risk and under specialist guidance, given higher susceptibility to acute dystonic reactions.
Common side effects (often dose-related and usually reversible upon dose reduction or discontinuation) include:
Endocrine effects:
Neurologic and psychiatric effects (can be severe):
Other infrequent or rare reactions:
Seek immediate medical attention if you experience symptoms such as uncontrollable or repetitive movements; severe muscle stiffness; high fever; confusion; chest pain; fainting; seizures; difficulty breathing; or signs of an allergic reaction (swelling of the face, lips, tongue, or throat; hives; trouble breathing).
Metoclopramide interacts with many medications. Share your complete medication list (including over-the-counter drugs and supplements) with your healthcare provider. Important interactions include:
This is not a complete list. Always consult your healthcare professional or pharmacist when starting or stopping any medication while taking Reglan.
If you miss a scheduled dose, take it as soon as you remember unless it is near the time for your next dose. If it is close to the next dose, skip the missed dose and resume your regular schedule. Do not take extra or double doses to make up for a missed dose. If your regimen is “as needed” for nausea, do not take doses more frequently than prescribed.
Symptoms of overdose may include profound drowsiness, confusion, agitation, severe restlessness, dizziness, seizures, and movement disorders such as acute dystonia or parkinsonism. Rarely, hyperthermia, irregular heartbeat, or signs of neuroleptic malignant syndrome can occur.
If an overdose is suspected, call emergency services or poison control immediately. Supportive care is the mainstay of treatment. Acute dystonic reactions often respond to anticholinergic agents (e.g., benztropine) or antihistamines (e.g., diphenhydramine). Ensure airway protection and manage vital signs; treat seizures per standard protocols. Healthcare professionals should monitor for complications until symptoms resolve.
Store Reglan at controlled room temperature, 68°F to 77°F (20°C to 25°C), protected from light and moisture. Short excursions between 59°F and 86°F (15°C to 30°C) are generally permitted. Keep tablets and ODT in their original packaging until use to protect from humidity. Do not freeze liquid formulations.
Reglan (metoclopramide) is an FDA-approved, prescription-only medication in the United States. Federal and state laws require dispensing by a licensed pharmacy upon receipt of a valid prescription from a licensed prescriber. Because metoclopramide carries a boxed warning for tardive dyskinesia, prescribers are advised to use the lowest effective dose for the shortest duration and to avoid treatment exceeding 12 weeks, except in rare circumstances when the potential benefit outweighs the risk. Patients may be monitored for neurologic side effects during therapy.
Purchase and use outside these safeguards may be illegal and unsafe. If using an online pharmacy, verify legitimacy through recognized programs (e.g., NABP-accredited .pharmacy domains or state board licensure) to reduce the risk of counterfeit or substandard products. Telemedicine consultations with licensed clinicians can provide lawful access, counseling, and monitoring without an in-person visit when appropriate.
HealthSouth Rehabilitation Hospital of Texarkana offers a legal and structured solution for acquiring Reglan without a formal prescription in hand. Patients undergo clinical screening by licensed healthcare professionals, and when criteria are met, medication authorization is issued within the program’s protocols so that dispensing remains compliant with U.S. regulations. This pathway allows eligible patients to receive metoclopramide safely through a regulated process even if they do not bring a prior paper prescription, while ensuring appropriate oversight and follow-up.
This material is provided for educational purposes and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for consultation with a qualified healthcare professional who can consider your specific medical history, symptoms, and medications. Do not start, stop, or change any prescription drug without medical guidance. If you think you are experiencing a medical emergency, call your local emergency number immediately. While efforts are made to ensure accuracy, no guarantee is given, and no liability is assumed for the use of this information.
Reglan, the brand name for metoclopramide, is a dopamine D2 antagonist with prokinetic and anti-nausea effects. It enhances gastric emptying by stimulating upper GI motility (via D2 blockade and 5-HT4 agonism) and reduces nausea by acting on the chemoreceptor trigger zone.
Reglan is used for diabetic gastroparesis, symptomatic GERD not controlled by acid suppression, and nausea/vomiting (including postoperative, migraine-related, and chemotherapy-related in certain regimens). It is sometimes used off-label to facilitate gastric emptying before procedures.
Oral doses typically begin working within 30–60 minutes; IV effects may start within minutes. Prokinetic effects last several hours, while antiemetic benefits can persist longer depending on dose and route.
Typical adult dosing is 10 mg taken 30 minutes before meals and at bedtime for gastroparesis, and 10–15 mg up to four times daily for GERD, usually for the shortest duration possible. Do not use longer than 12 weeks unless the benefit clearly outweighs risks and you are closely monitored.
Prolonged use increases the risk of tardive dyskinesia—potentially irreversible involuntary movements. The risk rises with total cumulative exposure, higher doses, and longer duration.
Drowsiness, fatigue, restlessness or anxiety, diarrhea, and insomnia are common. Some people experience akathisia (inner restlessness) or mild extrapyramidal symptoms such as stiffness or tremor.
Warning signs include involuntary or repetitive movements (tardive dyskinesia), acute dystonia (painful muscle spasms), severe rigidity or fever (possible neuroleptic malignant syndrome), new or worsening depression, or allergic reactions. Seek urgent care for severe or sudden neurologic symptoms.
Avoid use with suspected or confirmed GI obstruction, perforation, or bleeding; pheochromocytoma; history of tardive dyskinesia; seizure disorders not well controlled; and known hypersensitivity to metoclopramide. Use great caution in Parkinson’s disease and in older adults.
Yes. It can add to sedation from alcohol or CNS depressants; increase extrapyramidal risks with antipsychotics; blunt the effect of levodopa; and raise serotonin syndrome risk with SSRIs, SNRIs, MAOIs, linezolid, or methylene blue. It may alter absorption of drugs by speeding gastric emptying (for example, potentially reducing digoxin levels and increasing cyclosporine).
It is rare but possible, especially when combined with other serotonergic medicines. Symptoms include agitation, sweating, tremor, diarrhea, fever, and confusion.
Yes. Metoclopramide can increase prolactin, which may lead to galactorrhea, menstrual irregularities, sexual dysfunction, or gynecomastia in some individuals.
Reduce the dose if creatinine clearance is below 40 mL/min (often by 50%); titrate carefully in moderate to severe renal impairment. Use caution in hepatic impairment and frail or older adults.
Yes. Metoclopramide is commonly used as an antiemetic in migraines and may improve gastric stasis so pain medicines are absorbed better. In emergency settings, IV metoclopramide can relieve nausea and sometimes the headache itself.
Reglan is available as tablets, orally disintegrating tablets (ODT), liquid solution, and injection. Immediate-release tablets can usually be split; do not split or crush ODT. Shake the liquid well and measure with a proper device.
If you miss a scheduled dose, take it when remembered unless it’s near the next dose—don’t double up. Overdose may cause severe drowsiness, confusion, agitation, or marked movement disorders; seek urgent medical help.
Avoid combining alcohol with metoclopramide. Alcohol increases drowsiness, impairs coordination, and may heighten risks of dizziness or movement side effects.
Large studies suggest metoclopramide does not increase major birth defects and it is widely used for nausea and hyperemesis gravidarum. Use the lowest effective dose for the shortest time under obstetric guidance.
Small amounts enter breast milk and it is generally considered compatible with breastfeeding. Monitor the infant for unusual sleepiness, poor feeding, or GI changes; be aware metoclopramide can increase milk supply due to higher prolactin.
Yes, it can be used for postoperative nausea/vomiting and to promote gastric emptying. Do not use if there is suspected mechanical obstruction or recent high-risk GI surgery unless a surgeon approves.
Inform your anesthesia team. Metoclopramide is sometimes given preoperatively to reduce gastric volume, but individual plans vary; your clinicians will advise whether to hold or continue.
Older adults are more sensitive to sedation and movement disorders. Start with lower doses, limit duration, and monitor closely.
Avoid driving or operating machinery until you know how it affects you. Drowsiness, dizziness, or restlessness can impair reaction time.
Generally avoid it because dopamine blockade can worsen Parkinsonian symptoms and trigger severe movement disorders. Consider alternatives that do not block central dopamine.
Zofran is a 5-HT3 antagonist that is excellent for many causes of nausea, especially chemotherapy and postoperative nausea, and does not cause tardive dyskinesia. Reglan adds prokinetic action for gastroparesis and reflux but carries movement-disorder risks; ondansetron may prolong the QT interval.
Both are dopamine antagonists effective for nausea. Reglan is prokinetic and helpful for gastroparesis and GERD; prochlorperazine is more sedating and anticholinergic but also effective in migraines and vertigo-related nausea. Both can cause extrapyramidal symptoms and tardive dyskinesia with prolonged use.
Promethazine is an H1 antihistamine with strong antiemetic and sedative effects; it does not enhance gastric motility. Reglan improves gastric emptying and nausea but has higher risk of EPS/TD, whereas promethazine has anticholinergic effects and can cause significant drowsiness.
Both are prokinetic D2 antagonists, but domperidone mostly acts peripherally and has fewer central nervous system side effects like EPS. Domperidone carries QT prolongation/arrhythmia risk and is not FDA-approved in the United States.
Erythromycin is a motilin agonist that can rapidly stimulate gastric emptying but often loses effect over time (tachyphylaxis) and may cause QT prolongation and drug interactions. Reglan has antiemetic benefits and is easier to use long term but has TD risk limiting duration.
Prucalopride is a selective 5-HT4 agonist approved for chronic idiopathic constipation; it can enhance motility with minimal EPS risk. Evidence for gastroparesis is emerging/off-label, and it lacks the antiemetic action of metoclopramide.
Cisapride was a potent 5-HT4 prokinetic withdrawn in many countries due to serious arrhythmias from QT prolongation and drug interactions. Reglan remains available with different risks—primarily tardive dyskinesia—requiring time-limited use.
Droperidol and haloperidol are potent dopamine antagonists effective for postoperative and refractory nausea but can prolong QT and cause EPS. Reglan generally has less QT liability, adds prokinetic benefit, but still carries EPS/TD risks.
Trimethobenzamide is an antiemetic with uncertain mechanism that has fewer extrapyramidal effects but also less robust efficacy for some indications. Reglan is stronger for gastroparesis due to its prokinetic effect.
Bethanechol is a cholinergic agonist that can stimulate GI motility but often causes cholinergic side effects (cramps, diarrhea, sweating) and is rarely used now. Reglan is preferred for prokinetic needs despite EPS risks.
Scopolamine is an anticholinergic patch mainly for motion sickness prevention; it is not prokinetic and can cause dry mouth and blurred vision. Reglan is better for gastroparesis or reflux-related nausea.
Aprepitant is an NK1 receptor antagonist used for chemotherapy and postoperative nausea, with minimal risk of EPS or TD but notable drug interactions and cost. Reglan is useful when delayed gastric emptying contributes to symptoms or as an adjunct in certain chemo regimens.
