Metoclopramide (Reglan)

Brand Name: Reglan

Available in 5 mg & 10 mg tablets (oral suspension exists but is famous for unpalatable taste to pets)

How This Medication Works

One of the stomach’s most important functions is to grind the food we eat into a fine slurry that passes freely through the intestines. A strong rhythm of contraction is necessary to affect this and this rhythm creates the stomach’s motility.

Motility disorders are common and may be chronic (of long duration) or of sudden onset. When motility is reduced in the stomach, food pools there and creates a sensation of nausea and bloating. In some cases, bile refluxes from the intestine back into the stomach, causing irritation and more nausea. Metoclopramide normalizes stomach contractions so that food and bile can pass in the correct direction.

An additional effect of metoclopramide is helpful in the control of nausea. There is a biochemical barrier separating the brain and central nervous system from the blood stream so that only certain biochemicals can cross over. This partition is called the blood-brain barrier. Metoclopramide is able to cross the blood-brain barrier and act on the brain directly to control the sensation of nausea.

Metoclopramide thus helps the vomiting patient by normalizing stomach motility and acting directly on the brain to reduce the sensation of nausea.

How This Medication Is Used

Signs of nausea in pets include:

* Loss of appetite
* Vomiting
* Drooling
* Loud stomach or intestinal sounds
* Chewing motions

Metoclopramide can be used to control nausea in any situation except in the event of stomach or intestinal obstruction. If a motility problem is suspected (a classical history would include vomiting food many hours after eating), metoclopramide should also be helpful. If a motility disorder extends beyond the stomach (for example, a colon motility disorder might lead to constipation), metoclopramide would not expected to be helpful.


Side Effects

Side effects are rare with metoclopramide but generally stem from the ability to penetrate the blood-brain barrier. Animals predisposed to seizures (i.e., epileptics) may experience seizures, although this should not be a problem for normal animals.

Some animals experience drowsiness and others will experience marked hyperactivity. Hyperactivity can be reversed with a dose of Benedryl (diphenhydramine).

Constipation has been reported as a side effect in some individuals. This is not a common side effect.

If you suspect your pet is having an adverse reaction to metoclopramide, discontinue the medication and inform your veterinarian. There is another motility modifier called cisapride (Propulsid) that may be a good alternative. This medication does not cross the blood-brain barrier and hence does not have the behavioral side effects that metoclopramide can, but it also does not reduce the sensation of nausea by this additional mechanism either.

Interactions With Other Medications

Metoclopramide should not be used with phenothiazine tranquilizers such as acepromazine if there is any potential for seizures in the patient. Both medications serve to lower the threshold to seizures.

Propantheline bromide (Pro-Banthine), which is used to treat some cardiac arrhythmias, will inactivate metoclopramide.

Narcotic analgesics may negate the effects of metoclopramide.

Cautions and Contraindications

In patients with pheochromocytoma (a rare adrenal tumor) the use of metoclopramide can induce dangerously high blood pressure.

If stomach obstruction is suspected in a patient, it is best not to encourage motility and some other anti-nausea drug is preferred.

Metoclopramide crosses the placenta and into milk and is probably best avoided in pregnant or nursing mothers

It is our policy not to give dosing information over the Internet.

SOURCE: The Pet Pharmacy

Date Published: 1/1/2001
Date Reviewed/Revised: 07/23/2007


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