Side Effects Of Long-Term Reglan Treatment

by Steve Fields on August 31st, 2009

It was nearly three decades after the debut of Reglan that the U.S. Food and Drug Administration (FDA) mandated a black box warning for all drugs containing metoclopramide. The impetus was an alarming number of cases in which patients who were taking Reglan began developing severe side effects. Sadly, some of the most distressing symptoms are incurable. In this article, I’ll describe common side effects that can present after prolonged use or high dosage of the drug.

Tardive Dyskinesia

Broadly defined as an involuntary, repetitive movement disorder, tardive dyskinesia manifests through unnatural face grimacing, lip puckering and smacking, and protrusion of the tongue. A number of studies have established a clear link between this condition and patients who have used Reglan for periods exceeding twelve weeks. In fact, the FDA’s recent black box warning specifically mentions tardive dyskinesia as a potential side effect of chronic Reglan use. Unfortunately, because a cure has not yet been developed, treatment seeks to reduce the severity of the symptoms rather than eliminating them.

Cervical Dystonia

This condition is less common than tardive dyskinesia and is accompanied by debilitating muscular spasms in the neck. Over time, these spasms can cause torticollis as the patient’s head begins to tilt to one side. The condition can be treated through physical therapy, medications, and even surgery that seeks to “release” the spasmodic muscles.

Symptoms Similar To Parkinson’s Disease

Prolonged use of Reglan has also been linked to symptoms similar to those found in patients suffering from Parkinson’s disease. For example, many people who have taken drugs containing metoclopramide exhibit stiffness of their musculature, cogwheel rigidity, tremors, and markedly slow movements.

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome (NMS) is perhaps the most serious of Reglan side effects; it is life-threatening. This condition often manifests with high fever, muscular rigidity, and a growing lack of stability in their autonomic nervous system. It is not uncommon for patients to exhibit extreme agitation or delirium.

Ocular Deviation

Frequent high dosage or long-term use of Reglan can also lead to irregular eye movements. In some cases, both eyes will move in unison in the same direction. In other cases, the eyes will move independently of each other. This happens due to the paralysis of the extraocular muscles which directly influences eye movement.

Motor Restlessness (Akathisia)

Patient will often feel a persistent sensation of restlessness and will be unable to sit still. Their need to be in perpetual motion can present as rocking back and forth, mock walking while standing in place, and relentless crossing and uncrossing of their feet. These side effects can result from chronic Reglan use and are usually treated by reducing the dosage or by taking additional medication.

Long-term use of drugs containing metoclopramide has been linked to each of the conditions and side effects described above. Doctors who prescribe Reglan to their patients will normally recommend discontinuing its use after twelve weeks. That said, many people use it for longer periods. If you notice any of these symptoms and suspect Reglan to be the causative agent, a Reglan lawyer can help explain your legal options.