Reglan 50mg
All dilutions may be stored unprotected from light under normal light conditions up to 24 hours after preparation. Intravenous infusions should be made slowly over a period of not less than 15 minutes, 30 minutes before beginning cancer chemotherapy and repeated every 2 hours for two doses, then every 3 hours for three doses. For the Prevention of Postoperative Nausea and Vomiting: Metoclopramide Injection, USP should be given intramuscularly near the end of surgery.
How to use Reglan See also Warning section. Read the Medication Guide provided by your pharmacist before you start taking metoclopramide and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Take this medication by mouth 30 minutes before meals and at bedtime , usually 4 times daily or exactly as directed by your doctor. Do not use a household spoon because you may not get the correct dose. Parkinsonian-like symptoms have occurred, more commonly within the first 6 months after beginning treatment with metoclopramide, but occasionally after longer periods.
These symptoms generally subside within 2 to 3 months following discontinuance of metoclopramide. The risk of developing tardive dyskinesia increases with the duration of treatment and the total cumulative dose. Treatment with metoclopramide for longer than the recommended 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing TD.
Although the risk of developing TD in the general population may be increased among the elderly, women, and diabetics, it is not possible to predict which patients will develop metoclopramide-induced TD.
Both the risk of developing TD and the likelihood that TD will become irreversible increase with duration of treatment and total cumulative dose. Metoclopramide should be discontinued in patients who develop signs or symptoms of TD. There is no known effective treatment for established cases of TD, although in some patients, TD may remit, partially or completely, within several weeks to months after metoclopramide is withdrawn.
Metoclopramide itself may suppress, or partially suppress, the signs of TD, thereby masking the underlying disease process. The effect of this symptomatic suppression upon the long-term course of TD is unknown. Therefore, metoclopramide should not be used for the symptomatic control of TD. Clinical manifestations of NMS include hyperthermia , muscle rigidity, altered consciousness, and evidence of autonomic instability irregular pulse or blood pressure, tachycardia , diaphoresis and cardiac arrhythmias.
The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases where the clinical presentation includes both serious medical illness e. Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke , malignant hyperthermia , drug fever and primary central nervous system CNS pathology. The management of NMS should include 1 immediate discontinuation of metoclopramide and other drugs not essential to concurrent therapy, 2 intensive symptomatic treatment and medical monitoring, and 3 treatment of any concomitant serious medical problems for which specific treatments are available.
Because metoclopramide produces a transient increase in plasma aldosterone , certain patients, especially those with cirrhosis or congestive heart failure , may be at risk of developing fluid retention and volume overload. If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued. The ambulatory patient should be cautioned accordingly.
Carcinogenesis, Mutagenesis, Impairment Of Fertility A week study was conducted in rats with oral doses up to about 40 times the maximum recommended human daily dose. Metoclopramide elevates prolactin levels and the elevation persists during chronic administration.
Reglan has been prescribed for me. I know it has not been recalled, but I have heard not so good things about it. I have recently had a TIA stroke. Should I take it? Reglan metoclopramide stimulates muscle contractions in the upper gastrointestinal tract, which speeds up the time it takes for the stomach to empty its contents into the intestines.
Reglan is used to treat the symptoms of gastroesophageal reflux disease GERD and delayed stomach emptying. Common side effects of Reglan include feeling restless, sleepy, tired, dizzy, or exhausted; headache; confusion; and trouble sleeping. Because Reglan may affect mental performance or your ability to react, the performance of hazardous tasks such as operating machinery or driving a car should not be undertaken until you are aware of how the drug affects you. Mental depression has occurred in patients with and without a history of depression.
You may not be able to clear this drug from your body well. This may increase the levels of this drug in your body. This can cause more side effects. Your doctor may start you on a lower dose. For people with breast cancer: This drug increases prolactin levels in your body. Prolactin is a hormone that may be responsible for cancerous breast tumors. Tell your doctor if you have a history of breast cancer before starting this drug.
Warnings for other groups For pregnant women: This drug should be used only if the potential benefit justifies the potential risk to the fetus.
For women who are breastfeeding: These usually are seen during the first hours of treatment with metoclopramide, occur more frequently in pediatric patients and adult patients less than 30 years of age and are even more frequent at the higher doses used in prophylaxis of vomiting due to cancer chemotherapy.
These symptoms may include involuntary movements of limbs and facial grimacing, torticollis, oculogyric crisis, rhythmic protrusion of tongue, bulbar type of speech, trismus, or dystonic reactions resembling tetanus.
Rarely, dystonic reactions may present as stridor and dyspnea, possibly due to laryngospasm. Tardive Dyskinesia See Boxed Warnings Treatment with metoclopramide can cause tardive dyskinesia TD , a potentially irreversible and disfiguring disorder characterized by involuntary movements of the face, tongue, or extremities.
The risk of developing tardive dyskinesia increases with the duration of treatment and the total cumulative dose. Treatment with metoclopramide for longer than the recommended 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing TD. Although the risk of developing TD in the general population may be increased among the elderly, women, and diabetics, it is not possible to predict which patients will develop metoclopramide-induced TD.
Both the risk of developing TD and the likelihood that TD will become irreversible increase with duration of treatment and total cumulative dose. Metoclopramide should be discontinued in patients who develop signs or symptoms of TD. There is no known effective treatment for established cases of TD, although in some patients, TD may remit, partially or completely, within several weeks to months after metoclopramide is withdrawn. Metoclopramide itself may suppress, or partially suppress, the signs of TD, thereby masking the underlying disease process.
The effect of this symptomatic suppression upon the long-term course of TD is unknown. Therefore, metoclopramide should not be used for the symptomatic control of TD. Parkinsonian-like Symptoms Parkinsonian-like symptoms, including bradykinesia, tremor, cogwheel rigidity, or mask-like facies, have occurred more commonly within the first 6 months after beginning treatment with metoclopramide, but occasionally after longer periods. These symptoms generally subside within months following discontinuance of metoclopramide.
Depression Mental depression has occurred in patients with and without prior history of depression. Symptoms have ranged from mild to severe and have included suicidal ideation and suicide.
Metoclopramide should be given to patients with a prior history of depression only if the expected benefits outweigh the potential risks.
WARNING: TARDIVE DYSKINESIA
Tell your doctor if your condition persists or worsens. Patients receiving SNRIs and metoclopramide should be monitored for the emergence of reglan syndrome, reglan 50mg, neuroleptic malignant syndrome-like reactions, or other adverse effects. Metoclopramide affects how food moves through your body. Ask the doctor or pharmacist for details. While the manufacturer has provided no guidance regarding the use of gefitinib with CYP2D6 inhibitors, in patients with poor CYP2D6 metabolism, the mean exposure to gefitinib was 2-fold higher when compared to reglan metabolizers; the contribution of drugs that inhibit CYP2D6 on gefitinib exposure has not been evaluated. It should be inspected before use and discarded if either color or particulate is observed. This potentially fatal syndrome is comprised of the symptom complex of hyperthermia, muscular rigidity, altered consciousness, and autonomic instability see WARNINGS. This puts you at risk for a stroke. Use of potent CYP2D6 50mg with metoclopramide is known to increase metoclopramide exposure and the risk of exacerbation of tramadol 50mg vs hydrocodone 5-325 symptoms. Exogenously administered insulin may begin to act before food has left the stomach and lead to hypoglycemia. Precautions General In one study in hypertensive patients, intravenously administered metoclopramide was shown to release catecholamines; hence, caution should be exercised when metoclopramide is used in patients with hypertension. The dosing of antidiabetic agents may require adjustment in patients who receive metoclopramide concomitantly. Metoclopramide should be given to patients with a prior history of 50mg only if the expected benefits outweigh the potential risks. Use the dosing syringe provided, reglan 50mg, or use a medicine dose-measuring device not a kitchen spoon. Although the occurrence is infrequent compared to antipsychotic-induced EPS, the risk of these events may be increased during concurrent use of metoclopramide and tricyclic antidepressants compared to monotherapy with either agent.
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