From the Guidelines
Reglan (metoclopramide) is not typically associated with causing diarrhea, and its mechanism of action is actually intended to help regulate digestive movements and alleviate symptoms like nausea and vomiting. According to the most recent and highest quality study available 1, metoclopramide is a prokinetic drug that stimulates gastric emptying and small intestinal transit, which can be beneficial for patients with conditions like gastroparesis or small intestinal dysmotility. The study highlights that metoclopramide increases the release of acetylcholine from enteric nerves, enhancing muscle contractions in the upper digestive tract and accelerating stomach emptying and intestinal transit.
Some key points to consider when evaluating the potential side effects of Reglan include:
- The medication's primary use is for treating nausea, vomiting, and conditions involving slow stomach emptying, rather than causing diarrhea.
- Common side effects of Reglan include drowsiness, restlessness, fatigue, and sometimes extrapyramidal symptoms (movement disorders), as noted in the study 1.
- If a patient experiences diarrhea while taking Reglan, it is more likely related to their underlying condition or another factor rather than the medication itself.
- Prolonged use of Reglan (more than 12 weeks) can increase the risk of tardive dyskinesia, a serious movement disorder, emphasizing the importance of careful monitoring and consultation with a healthcare provider if unexpected side effects occur.
In the context of managing adult patients with severe chronic small intestinal dysmotility, the study 1 discusses various treatment options, including prokinetic drugs like metoclopramide, and highlights the importance of considering the potential benefits and risks of each medication. Overall, the evidence suggests that Reglan is not typically a cause of diarrhea, and its use should be carefully considered and monitored by a healthcare provider to minimize potential side effects and maximize therapeutic benefits.
From the Research
Reglan and Diarrhoea
- Reglan, also known as metoclopramide, is a prokinetic agent used to treat gastrointestinal motility disorders, including gastroparesis.
- The provided studies do not directly address the question of whether Reglan causes diarrhoea.
- However, one study 2 mentions that the treatment of irritable bowel syndrome (IBS) with diarrhoea-predominant symptoms responds well to loperamide treatment, implying that prokinetic agents like metoclopramide may not be typically associated with causing diarrhoea.
- Another study 3 discusses the use of metoclopramide in the treatment of gastrointestinal motility disorders, but does not mention diarrhoea as a side effect.
- Studies 4, 5, and 6 focus on the safety and efficacy of metoclopramide in treating gastroparesis and gastrointestinal dysmotility disorders, but do not provide information on its potential to cause diarrhoea.
Side Effects of Reglan
- The most frequently reported side effects of prokinetic drugs like metoclopramide include shortness of breath, CNS side effects, and other symptoms 5.
- Tardive dyskinesia is a potential risk associated with long-term use of metoclopramide, particularly in high-risk groups such as elderly females, diabetics, and patients with liver or kidney failure 6.
- However, the risk of tardive dyskinesia due to metoclopramide is considered low, and the influence of known risk factors should be considered when starting a course of metoclopramide for treatment of gastroparesis 6.