Metoclopramide prescription: what it does and who needs one
Metoclopramide (often known as Reglan) is a prescription drug used to treat severe nausea, vomiting, and gastroparesis — a condition where the stomach empties too slowly. It helps by speeding up stomach emptying and blocking dopamine signals that trigger nausea. Doctors usually reserve it for cases where other remedies haven’t worked or symptoms are affecting daily life.
Who should get a prescription and how
If you have persistent nausea, frequent vomiting, or confirmed gastroparesis, your doctor may consider metoclopramide. Expect a medical history review, basic exams, and sometimes tests (like gastric emptying studies). Tell your clinician about: movement disorders, Parkinson’s disease, depression, seizure history, kidney problems, other meds you take, pregnancy or breastfeeding plans.
Prescribers often start at the lowest effective dose and limit treatment length. The FDA warns that using metoclopramide longer than 12 weeks raises the chance of tardive dyskinesia — a potentially irreversible movement disorder. If you can, ask your provider about short trials, regular check-ins, and alternative treatments.
Practical dosing, monitoring, and common questions
Typical adult dosing is short-acting 10 mg taken up to four times a day, usually 30 minutes before meals and at bedtime for gastroparesis. For acute nausea, a single dose under medical supervision may be used. Don’t change dose or stop suddenly without talking to your prescriber.
Watch for movement-related side effects: restlessness, involuntary muscle movements, tremors, or facial tics. These can appear within days or weeks. If any new uncontrolled movements or severe mood changes occur, contact your doctor immediately. For older adults or people with kidney disease, doctors usually lower the dose and monitor closely.
Common mild effects include drowsiness, fatigue, diarrhea, and mild anxiety. Avoid driving or heavy machinery until you know how it affects you. Alcohol and other sedatives can increase drowsiness.
Major drug interactions: combining metoclopramide with antipsychotics or other dopamine-blocking drugs raises the risk of movement disorders. Mixing with strong CNS depressants increases sedation. Tell your prescriber about antidepressants, antipsychotics, opioids, and Parkinson’s meds (like levodopa), since dosing and safety decisions depend on those.
Pregnancy and breastfeeding: metoclopramide crosses the placenta and can pass into breast milk. Some doctors still use it for severe pregnancy nausea, but discuss risks and alternatives first.
Final practical tips: keep a symptom diary, schedule follow-ups every few weeks while starting treatment, and ask for the shortest effective course. If you notice twitching, lip smacking, or new stiffness, stop the drug only after consulting your clinician or go to urgent care if severe.
Want help talking to your doctor? Ask for a written plan that states dose, duration, what side effects to watch, and when you’ll re-evaluate treatment. That keeps care safe and focused on getting you better.
