REGLAN and Parkinson's should NEVER mix!

   

    THANK YOU to all of my readers who alerted me to the fact that REGLAN is a dangerous drug and should not ever be given to Parkinson's patients.  I called my family doctor and my neurologist and they both confirmed that REGLAN  should never have been given to me.  I thought it was a wonder drug and I am so glad that I mentioned it on my blog. I am extremely thankful that my loyal readers knew more about the drug than I knew.  My neurologist, in particular, was extremely upset that I was given REGLAN in the ER.  He works in one of the hospitals in that hospital system.  He is the head of neurology. He thinks the drug should be off the market and is dangerous for any patient for any reason. He told me that I should discard the remaining pills that I had left and to take the new meds that he called into my pharmacy.  He told me that he was going to call the ER and have a note put in my chart to never give that drug to me.  I took that drug all day Mon. and Tue. in the hospital and, Wed and Thur at home.  I think I had taken about 15 pills altogether and that now scares me. In the ER, they gave the REGLAN to me through my IV.  I hope I didn't further exacerbate my Parkinson's disease.  Last night, even though I had take my levodopa. I had a lot of difficulty walking, especially in the evening!

        The information below is info I found on the internet. I am so anal, I had to read about REGLAN all day long.

NMS is a very rare but very serious condition that can happen with Reglan. NMS can cause death and must be treated in a hospital. Symptoms of NMS include: high fever, stiff muscles, problems thinking, very fast or uneven heartbeat, and increased sweating. Parkinsonism. drugs that deplete dopamine such as reserpine and tetrabenazine may worsen Parkinson's disease and parkinsonism and should be avoided in most cases.

Contraindications. Metoclopramide is contraindicated in pheochromocytoma. It should be used with caution in Parkinson's disease since, as a dopamine antagonist, it may worsen symptoms. Long-term use should be avoided in people with clinical depression, as it may worsen one's mental state.

Patients may not be aware that some common drugs used for conditions such as headache or gastrointestinal dysmotility may also block dopamine, and concomitantly worsen Parkinson’s disease, or alternatively result in parkinsonism.  These drugs include Prochlorperazine (Compazine), Promethazine (Phenergan), and Metoclopramide (Reglan).  They should be avoided.  Also, drugs that deplete dopamine such as reserpine and tetrabenazine may worsen Parkinson’s disease and parkinsonism and should be avoided in most cases.  Substitute drugs that do not result in worsening of parkinsonism can be utilized, and these include Ondansetron (Zofran) for nausea, and erythromycin for gastrointestinal motility

SIDE EFFECTS

In general, the incidence of adverse reactions correlates with the dose and duration of metoclopramide administration. The following reactions have been reported, although in most instances, data do not permit an estimate of frequency:

CNS Effects

Restlessness, drowsiness, fatigue, and lassitude occur in approximately 10% of patients receiving the most commonly prescribed dosage of 10 mg q.i.d. (see PRECAUTIONS). Insomnia, headache, confusion, dizziness, or mental depression with suicidal ideation (see WARNINGS) occur less frequently. The incidence of drowsiness is greater at higher doses. There are isolated reports of convulsive seizures without clear-cut relationship to metoclopramide. Rarely, hallucinations have been reported.

Extrapyramidal Reactions (EPS)

Acute dystonic reactions, the most common type of EPS associated with metoclopramide, occur in approximately 0.2% of patients (1 in 500) treated with 30 to 40 mg of metoclopramide per day. Symptoms include involuntary movements of limbs, facial grimacing, torticollis, oculogyric crisis, rhythmic protrusion of tongue, bulbar type of speech, trismus, opisthotonus (tetanus-like reactions), and, rarely, stridor and dyspnea possibly due to laryngospasm; ordinarily these symptoms are readily reversed by diphenhydramine (see WARNINGS).

Parkinsonian-like symptoms may include bradykinesia, tremor, cogwheel rigidity, mask-like facies (see WARNINGS).

Tardive dyskinesia most frequently is characterized by involuntary movements of the tongue, face, mouth, or jaw, and sometimes by involuntary movements of the trunk and/or extremities; movements may be choreoathetotic in appearance (see WARNINGS).

Motor restlessness (akathisia) may consist of feelings of anxiety, agitation, jitteriness, and insomnia, as well as inability to sit still, pacing, foot tapping. These symptoms may disappear spontaneously or respond to a reduction in dosage.