Degan

Generic Name

Metoclopramide

About Degan

Degan belongs to a class of drugs known as antiemetics and is one of many generic medications that contain metoclopramide. Metoclopramide is a gastrointestinal agent that helps stimulate stomach contractions and move food from the stomach to the intestines. The drug also blocks the action of a certain chemical in the brain that causes nausea and vomiting.

Disorders treated by Degan and similar brand name drugs include diabetic gastric stasis, gastric reflux disease and heartburn. Degan may also be used pre-operatively to treat nausea caused by anesthesia, and the medication may be given to chemotherapy patients to ease nausea as well. Additionally, Degan may be used as an aid in certain testing procedures used to diagnose stomach or intestinal problems.

While Degan has not been approved for sale in the United States by the Food and Drug Administration (FDA), the medication is available in other countries. Other brand name versions of metoclopramide, such as Reglan, are sold in the U.S.

Degan and Tardive Dyskinesia

In 2004, a study conducted by the FDA and other partners warned that patients using metoclopramide drugs like Degan were at high risk of developing a serious and debilitating movement disorder known as tardive dyskinesia (TD), which is characterized by uncontrollable muscle spasms and body contortions.

Individuals who are stricken with TD suffer involuntary repetitive movements that include facial tics, lip smacking, grimacing, arm and leg spasms and repetitive tongue motions. Older women are particularly susceptible to the disorder as well as patients with pre-existing conditions such as substance abuse, diabetes, psychotic disorders and brain atrophy.

In some cases, TD symptoms cease when treatment with metoclopramide is halted. In other patients, symptoms continue even after metoclopramide has been discontinued. While there is no definitive cure for TD, some treatment options are available to help alleviate the condition.

Metoclopramide Today

While some have pushed for metoclopramide to be taken off the market, the medication continues to remain in use. However, in 2009, the FDA required the manufacturers of all metoclopramide-containing drugs to post black box warnings on the medications, informing consumers and health care professionals that the medications may cause TD, especially when used for extended periods of time. The warning also states that metoclopramide should not be used for more than 12 weeks, except in rare cases where the benefits of continued treatment outweigh the risks associated with long-term use of the medication.

Dosage

Degan dosages may vary among patients. Generally, the drug is taken 30 minutes prior to each meal for up to 12 weeks, though individuals with gastric stasis may be instructed to take Degan at the first sign of a recurrence. Patients usually take Degan is doses of 10 to 15 mg. Tablets are dissolved in liquid or in soft food.

Missed doses should be taken as soon as remembered. However, if it is almost time for the patient's next dose, the missed dose should be skipped. Patients should never take a double dose of Degan to compensate for a missed dose.

Contraindications

Degan should not be used in patients with the following conditions:

Stomach obstructions, bleeding, or injury
Adrenal gland tumor
Epilepsy or seizure disorders

Patients with other pre-existing health conditions should exercise extreme caution when taking the drug and should weigh the medication's risks and benefits before beginning treatment. Pre-existing health conditions that may affect Degan treatment include:

Parkinson’s disease
Depression
Liver or kidney disease
Heart failure
High blood pressure
Asthma
Recent stomach surgery
Diabetes
Certain blood disorders
Cancer

No adequate studies have been conducted to determine the effect of metoclopramide on pregnant women. Therefore, women who are pregnant or may become pregnant should not take Degan. Furthermore, the drug can be excreted in breast milk and consequently should not be used while nursing.

Drug Interactions

Some of the medications that may interact with Degan include:

Insulin
Digoxin
Acetaminophen
Monoamine oxidase (MAO) inhibitors
Tetracycline
Cyclosporine
Levodopa
Cimetidine
Sleeping pills
Narcotic pain relievers (morphine, oxycodone, etc.)

Degan may interact with other medications or substances that are not listed above. In order to avoid potentially hazardous interactions, patients should talk with their doctor about the use of all other medicines, vitamins or supplements before beginning treatment with a new medication.

Side Effects

A number of side effects have been associated with Degan, some of them more serious than others. Patients may be more susceptible to certain side effects of Degan if undergoing long-term treatment with the medication.

Serious side effects of the medication include:

Seizures
Irregular heartbeat
Agitation or anxiety
Jaundice and liver problems
Neuroleptic malignant syndrome (NMS)
Tardive dyskinesia
Endocrine problems

Less serious side effects include:

Nausea
Diarrhea
Headache
Confusion
Drowsiness
Dizziness
Fluid retention
Frequent urination
Menstrual changes

Sources

Mayo Clinic, http://www.mayoclinic.com/health/drug-information/DR600921
Journal of the American Pharmacists Association, http://japha.metapress.com/app/home/contribution.asp?referrer=parent&backto=issue,4,13;journal,36,47;linkingpublicationresults,1:120082,1
U.S. Food and Drug Administration, http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2009/ucm149533.htm
U.S. National Library of Medicine, http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684035.html

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