Reglan Rare Side Effects

Reglan is the brand name of the drug metoclopramide. It is most commonly used to treat two conditions. First, it helps alleviate nausea and vomiting. Second, it treats conditions in which the stomach and intestines move food along less actively. This can occur when diseases such as diabetes damage the nerves in the stomach. The drug has several notable, though rare, side effects.

Tardive Dyskinesia

Tardive dyskinesia is a syndrome brought on by use of drugs such as Reglan and antipsychotics that block dopamine in the brain. Symptoms include involuntary movements such as lip smacking, protruding and twisting tongue movements, grimacing, rapid eye movements or movements of the arms and legs. Risk factors for the development of tardive dyskinesia include female gender, diabetes mellitus, increasing age, prolonged drug exposure, presence of abnormal movements before exposure to the drug, and psychiatric disorders. There is no known treatment, but some of the symptoms may be alleviated by discontinuing the drug.

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome is associated with certain drugs including Reglan. It is characterized by a high fever, unstable blood pressures, muscular rigidity, sweating, mental status changes such as confusion or loss of consciousness, and dysfunction of the involuntary nerves that control organs such as the heart. Usually the syndrome occurs within the first few weeks of treatment but can develop at any time. Treatment involves discontinuing the drug, cooling the person down, giving a drug called dantrolene and further care in an intensive care unit.

Acute Extrapyramidal Symptoms

Extrapyramidal symptoms are divided into movement disorders called dyskinesias and disorders of excessive muscle tension called dystonias. Reglan causes either type. Unlike tardive dyskinesia, acute extapyramidal symptoms tend to occur early in the course of drug administration. The movement disorder symptoms resemble Parkinson's disease with stiffness of the arms and legs, trembling and shaking of the hands, difficulty speaking and swallowing, loss of balance, shuffling walk and mask-like face. In addition, the drug can cause weakness in the arms and legs, and muscle spasms in the back, neck and face. Extrapyrimadal effects are usually treated by withdrawing the offending drug and giving an antihistamine such as diphenhydramine, commonly known as Benadryl.