Reglan

Primperan

Generic Name

Metoclopramide

About Primperan

Primperan is a medication used for several different purposes. The medication is used to treat gastric stasis, persistent heartburn and gastric reflux diseases. As a gastrointestinal motility medication, Primperan stimulates stomach contractions so that food can move more easily from the stomach to the intestines. Primperan can also be used to help tubes pass through the intestines during certain medical procedures or as an aid in x-ray or other imaging tests.

As an antiemetic agent, Primperan is used to treat nausea and vomiting associated with a variety of scenarios. The medication may be given post-operatively to relieve nausea caused by anesthesia, or it may be given to cancer patients experiencing nausea and vomiting because of chemotherapy. Primperan has also been used in conjunction with aspirin or acetaminophen to relieve nausea in patients who suffer from migraines.

Metoclopramide and Tardive Dyskinesia

In 2004, a study conducted by members of the U.S. Food and Drug Administration and the Veterans Administration concluded that long-term use of metoclopramide drugs like Primperan could result in the development of a serious disorder known as tardive dyskinesia (TD). TD is a potentially irreversible condition characterized by repetitive and involuntary movements of various parts of the body. A person with TD may suffer from rapid arm or leg spasms, facial tics, grimacing, lip smacking, tongue protrusion and other similar motions.

Patients who undergo long-term treatment with metoclopramide are at higher risk of developing the condition than others. Older women may be particularly susceptible to the condition. Patients with diabetes, psychosis, dysfunction and those dealing with substance abuse are also at high risk of developing TD. Other users without these conditions are still at risk of developing the disorder, even with short-term use of metoclopramide.

Metoclopramide Today

Although many have called for metoclopramide to be pulled from the market, the drug continues to remain in use. In 2009, the FDA required that all metoclopramide drugs carry a black box warning on their labels, informing consumers and health care professionals about the risk of TD. The warning states the medication should be used with extreme caution and for no longer than 12 weeks, except in rare cases in which the potential benefits of continued treatment outweigh the risks of long-term use.

Dosage

Primperan dosages may vary among patients. When used for the treatment of post-operative nausea or another short term problems, patients may only take one or two doses of the medication.

Other patients may take the medication three or four times a day, approximately 30 minutes before meals. The drug is usually prescribed in pill form, but is also available as a liquid and an injectable drug.

Contraindications

Patients with certain disorders should not take Primperan or any metoclopramide drug. Do not take Primperan if you have any of the following:

  • Stomach obstruction or bleeding
  • Epilepsy or other seizure disorders
  • Adrenal gland tumors

Patients with the following disorders should use Primperan with extreme caution and only after carefully considering the risks and benefits of the medication:

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

Nursing women should not take Primperan, as the medication can pass into breast-milk. In addition, women who are pregnant or may become pregnant should not take Primperan, as no adequate studies have assessed the potential effects of the medication on a developing fetus.

Drug Interactions

There are a number of drugs that can negatively interact with Primperan and cause serious health problems. These include, but are not limited to:

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

Primperan 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

Many serious side effects have been associated with Primperan including:

  • Tardive dyskinesia
  • Irregular heartbeat
  • Agitation or anxiety
  • Jaundice and liver problems
  • Seizures
  • Endocrine problems

Less serious side effects of the medication may include:

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

 

Sources

  1. Mayo Clinic, http://www.mayoclinic.com/health/drug-information/DR600921
  2. 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
  3. U.S. Food and Drug Administration, http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2009/ucm149533.htm
  4. U.S. National Library of Medicine, http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684035.html

In an effort to help patients and their families better understand tardive dyskinesia, Tardivedyskinesia.com is now offering a free informational packet. To receive your packet in the mail, please enter your information below.