Metonia (Metoclopramide) 5mg

Metoclopramide, Reglan/Metonia
Description: Antiemetic; Dopamine Antagonist; Prokinetic; Serotonin 5-HT4 Receptor Agonist

“ALERT: US Boxed Warning

Tardive dyskinesia:

Metoclopramide can cause tardive dyskinesia, a serious movement disorder that is often irreversible. There is no known treatment for tardive dyskinesia. The risk of developing tardive dyskinesia increases with duration of treatment and total cumulative dose. Discontinue metoclopramide in patients who develop signs or symptoms of tardive dyskinesia. In some patients, symptoms lessen or resolve after metoclopramide is stopped. Avoid treatment with metoclopramide for longer than 12 weeks because of the increased risk of developing tardive dyskinesia with longer-term use.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Metoclopramide/Reglan/Metonia works in the chemoreceptive trigger zone in the central nervous system by blocking dopamine receptors and serotonin receptors at higher dosages thereby reducing nausea.  Works on the upper gastrointestinal tract by enhancing response to acetylcholine.  This increases motility and gastric emptying without increasing the production of digestive secretions.  It can also increase muscle tone in the lower esophageal sphincter.  

Metoclopramide/Reglan/Metonia is officially indicated for diabetic gastroparesis, chemotherapy induced nausea/vomiting as an alternate agent and in nausea/vomiting in palliative care.  It is also commonly prescribed off-label for use for aspiration prophylaxis in patients undergoing anesthetic, refractory dyspepsia, non-diabetic gastroparesis, hiccups, severe migraine, etc. (May also be used for conditions not listed)

Before starting Metoclopramide/Reglan/Metonia make sure your physician is aware of any allergies, medications you currently take, if you have liver disease, if you have cardiovascular disease (QT prolongation), edematous conditions, Parkinson’s disease, kidney disease, surgical anastomosis, or are pregnant or breastfeeding.  

5-10mg up to four times per day.  Avoid using for long periods of time to reduce risk of tardive dyskinesia. 

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day usually before a meal unless otherwise directed, store at room temperature.

You Need to Avoid: Do not operate heavy machinery or drive if sedated from this medication.

Drowsiness, dystonia (movement disorder), restlessness, galactorrhea, gynecomastia, hyperprolactinemia, nausea, impotence, etc.  May rarely cause neuroleptic malignant syndrome.

Note this is not a complete list of side effects, only common ones

1. What do I do if my mood worsens on this medication and I feel much worse?
   Contact your physician immediately, it is rare however antidepressant medications can cause suicidal ideation, generally in those under the age of 24.
2. What do I do if side effects are intolerable?
   If the symptoms are causing a lot of distress speak to your physician as soon as possible to discuss how to manage the side effects or to consider therapy modification.
3. What is tardive dyskinesia?
   Tardive dyskinesia is a movement disorder that is sometimes irreversible and involves involuntary movements which can impair daily function.  It generally occurs with long term use of dopamine blocking agents.  This mechanism can be compared to Parkinson’s disease due to both involving reduced dopamine resulting in involuntary movement.
4. What is Neuroleptic Malignant Syndrome?
   NMS is a rare but serious reaction from significant blockade of dopamine which can occur from antipsychotic medications or from being on high dosages of levodopa (dopamine analogue) and stopping suddenly.  Presents initially as muscle cramps, tremors, fever, unstable blood pressure, and sudden changes in mental status.  As it progresses over 8-40 hours it can lead to complications of rhabdomyolysis, hyperkalemia, kidney failure, or seizures.  Seek medical attention immediately if this reaction is suspected.