What is the dosing frequency for Reglan (metoclopramide) for nausea?

From the Guidelines

Reglan (metoclopramide) for nausea is typically dosed at 5-20 mg tid-qid, with a maximum dose of 20 mg tid-qid, as recommended by the most recent and highest quality study 1. The dosing frequency for Reglan (metoclopramide) can vary depending on the severity of nausea and the patient's response to treatment.

• For acute nausea and vomiting, it may be given every 6-8 hours as needed.
• The medication works by blocking dopamine receptors in the chemoreceptor trigger zone of the brain and increasing upper gastrointestinal motility, which helps relieve nausea and prevent vomiting.
• Treatment duration should generally be limited to no more than 12 weeks due to the risk of developing tardive dyskinesia with prolonged use, as noted in the study 1. Some key points to consider when prescribing Reglan (metoclopramide) include:
• Lower doses (5 mg) may be appropriate for elderly patients or those with renal impairment.
• Patients should be aware that common side effects include drowsiness and restlessness, and they should avoid alcohol while taking this medication as it can increase sedation.
• If symptoms persist beyond a few days of treatment, medical reassessment is recommended, as suggested by the study 1. It's also important to note that Reglan (metoclopramide) is the only FDA-approved medication for gastroparesis, and all other agents are considered off-label use, as stated in the study 1.

From the Research

Dosing Frequency for Reglan (Metoclopramide) for Nausea

The dosing frequency for Reglan (metoclopramide) for nausea is not explicitly stated in the provided studies. However, the following information can be gathered:

• A study published in 2014 2 reported a case where a 25-year-old female musician took metoclopramide 5-10 mg a day for a total per oral dose of 30 mg, which resulted in severe long-lasting adverse effects.
• Another study published in 2018 3 compared the efficacy of metoclopramide, ondansetron, and promethazine in treating hyperemesis gravidarum, but did not provide information on the dosing frequency.
• A study published in 2022 4 compared the effectiveness of metoclopramide and ondansetron in controlling nausea in patients with mild head trauma, and found that metoclopramide was most effective in 15 minutes and ondansetron in 30 minutes after injection.
• A study published in 2014 5 compared the efficacy of ondansetron, metoclopramide, and placebo in treating adult emergency department patients with undifferentiated nausea and vomiting, and found that reductions in nausea severity were similar for all three groups.
• A study published in 2009 6 investigated the use of diphenhydramine as prophylaxis against metoclopramide-induced akathisia in nauseated emergency department patients, and found that routine prophylaxis with diphenhydramine was unwarranted when intravenous metoclopramide was administered over 15 minutes.

Key Findings

• Metoclopramide can be effective in treating nausea, but the dosing frequency is not explicitly stated in the provided studies.
• The efficacy of metoclopramide in treating nausea can vary depending on the population being studied and the comparison group used.
• Metoclopramide can cause adverse effects, such as akathisia, especially when administered in high doses or for extended periods.

Considerations

• The dosing frequency for Reglan (metoclopramide) for nausea should be determined on a case-by-case basis, taking into account the individual patient's needs and medical history.
• Patients should be closely monitored for adverse effects when taking metoclopramide, especially when administered in high doses or for extended periods.
• Alternative treatments for nausea, such as ondansetron or promethazine, may be considered depending on the patient's specific needs and medical history.