Prokinetic agents for gastroesophageal reflux disease (GERD)

Examples

Generic Name	Brand Name
metoclopramide hydrochloride	Reglan

Metoclopramide is taken by mouth (orally) in pill form. It is only available with a prescription from your doctor.

How It Works

Metoclopramide:

• Makes the valve between the esophagus and stomach (lower esophageal sphincter) squeeze shut more tightly. This makes it harder for stomach acid and juices to back up, or reflux, into the esophagus.
• Makes the stomach empty quicker, which reduces the amount of acid in the stomach.

Why It Is Used

Metoclopramide is used to treat heartburn caused by gastroesophageal reflux disease (GERD). Metoclopramide may be used along with H2 blockers (acid reducers) to help clear stomach juices from the esophagus and stomach.

How Well It Works

Metoclopramide can be effective when used with H2 blockers but is not the first choice for treating GERD symptoms, because proton pump inhibitors usually work better and have fewer side effects.

Side Effects

More than 30% of the people taking metoclopramide have side effects.¹ These include:

• Nausea.
• Diarrhea.
• Nervous system side effects, such as jumpiness, confusion, or sleeplessness.

Metoclopramide is known to have interactions with other medicines. If you are taking other medicines, talk to your doctor about taking metoclopramide.

In some people, metoclopramide may cause depression. It can also cause shaking or trembling (symptoms like those of Parkinson's disease) and involuntary movements of the facial muscles and tongue (tardive dyskinesia).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Metoclopramide is not usually used to treat GERD. H2 blockers or proton pump inhibitors are more commonly used.

Some doctors may prefer to use a combination of metoclopramide and an H2 blocker to treat GERD symptoms before using a proton pump inhibitor. But this may cost more than using a proton pump inhibitor alone.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Author:	Monica Rhodes	Last Updated: March 31, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.