From the Guidelines
Reglan (metoclopramide) is not known to directly cause upper gastrointestinal (GI) bleeding. In fact, Reglan is sometimes used in the management of GI bleeding because it increases gastric emptying and can help with symptoms like nausea and vomiting that may accompany GI issues. Reglan works by blocking dopamine receptors and stimulating smooth muscle contractions in the upper digestive tract, which helps move food through the stomach and intestines more quickly. However, Reglan does not have protective effects on the GI mucosa and does not prevent or treat the underlying causes of GI bleeding such as ulcers, gastritis, or varices. If you're experiencing symptoms of upper GI bleeding (such as vomiting blood, passing black or tarry stools, or experiencing abdominal pain), you should seek immediate medical attention regardless of any medications you're taking. The most common medications associated with increased risk of GI bleeding are non-steroidal anti-inflammatory drugs (NSAIDs), anticoagulants, and corticosteroids, not metoclopramide 1. Some studies have shown that proton-pump inhibitors are more effective than H2-receptor antagonists in preventing persistent or recurrent bleeding and surgery in selected patients 1. It's also worth noting that somatostatin and octreotide are not recommended in the routine management of patients with acute nonvariceal upper GI bleeding, according to a meta-analysis of 14 trials 1. Overall, while Reglan may be used to manage symptoms associated with GI bleeding, it is not a cause of upper GI bleeding itself, and other medications such as NSAIDs, anticoagulants, and corticosteroids are more commonly associated with an increased risk of GI bleeding.
From the FDA Drug Label
Metoclopramide should not be used whenever stimulation of gastrointestinal motility might be dangerous, e.g., in the presence of gastrointestinal hemorrhage, mechanical obstruction or perforation. The FDA drug label does not answer the question.
From the Research
Upper G.I. Bleed and Reglan
- There is no direct evidence in the provided studies that links Reglan to upper G.I. bleed 2, 3, 4, 5, 6.
- The studies focus on the management and treatment of upper gastrointestinal bleeding, including the use of proton pump inhibitors and endoscopic therapy 2, 3, 4, 5, 6.
- Reglan, also known as metoclopramide, is not mentioned in the provided studies as a potential cause of upper G.I. bleed.
- However, it is known that certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can increase the risk of upper G.I. bleed 3, 6.
- If you are taking Reglan and experience symptoms of upper G.I. bleed, such as abdominal pain, lightheadedness, or hematemesis, seek medical attention immediately.
Management of Upper G.I. Bleed
- The management of upper G.I. bleed typically involves endoscopic therapy, proton pump inhibitors, and supportive care 2, 3, 4, 5, 6.
- Proton pump inhibitors have been shown to reduce the risk of rebleeding and improve outcomes in patients with upper G.I. bleed 5.
- Endoscopic therapy is often used to diagnose and treat the source of bleeding, and may involve procedures such as cauterization or clipping 3, 4.