Powered By
Continue with Facebook
Continue with Email
If you’ve ever experienced head pain, nausea, or vomiting due to a migraine attack, you know how troubling these symptoms can be. “Started the morning with a migraine attack when I woke up,” one MyMigraineTeam member said. “As the day has progressed, it’s been getting better, but I’m still nauseous.”
To ease these symptoms, your doctor may prescribe metoclopramide (Reglan). This medication can reduce some migraine symptoms, but it usually isn’t taken long term.
Read on for a quick overview of how metoclopramide works and when your doctor might prescribe it.
Metoclopramide is a prescription drug that comes in multiple forms. This includes intravenous (IV) infusions, intramuscular injections, or oral drugs. It’s an antiemetic drug, which means it reduces nausea and vomiting. While it isn’t approved by the U.S. Food and Drug Administration (FDA) for treating migraine, metoclopramide can reduce some of the sickness you feel during a migraine attack.
Inside your body, metoclopramide works by blocking dopamine D2 receptors. It also increases muscle activity in the gastrointestinal (GI) tract. This helps empty the stomach and the digestive system to prevent symptoms like nausea. It also acts as an analgesic by reducing pain signals in your brain.
Metoclopramide isn’t an opioid. In fact, it can act as a safer alternative to opioids for emergency migraine treatment. When used to treat migraine attacks, metoclopramide is often combined with other pain-reducing drugs in an IV infusion. This helps because metoclopramide can increase your absorption of other drugs. This may strengthen the effects of those pain medications.
Metoclopramide can help ease the intense nausea and vomiting that often occur during migraine attacks. This alone can help a migraine attack feel less intense, but it’s not the only way this drug can help.
Researchers believe that metoclopramide can also improve migraine headache symptoms. In one study, metoclopramide was compared to sumatriptan and placebo (an inactive compound) to treat migraine attacks. Metoclopramide significantly reduced headache pain for up to 24 hours with minimal side effects. It was more effective than both sumatriptan and the placebo. More research is needed to confirm this effect.
Together with prochlorperazine, ketorolac, and sumatriptan, metoclopramide remains a preferred treatment for migraine attacks in many emergency departments.
Metoclopramide is only available by prescription. You won’t be able to find it on the shelves at your local drug store. When you take it depends on how it’s prescribed and which form you’re getting.
Injected or IV metoclopramide is usually only prescribed in hospital settings. For instance, you may receive it in an emergency room for acute migraine treatment during an active migraine attack. This is called a rescue medication. You may also receive it at home under a healthcare provider’s supervision. A doctor can monitor you for signs of complications and adverse effects.
Oral forms of metoclopramide include tablets and liquids that you swallow. You won’t need direct supervision for these. But they’re usually only prescribed for short periods of five days or less.
You should follow instructions from your doctor closely when taking this drug orally. Oral metoclopramide is used less often for migraine than IV or intramuscular metoclopramide.
Triptans are another type of drug given for migraine attacks in the emergency room. But metoclopramide is less likely than triptans to cause serious complications. Research shows that 10 milligrams of IV metoclopramide is highly effective for reducing migraine symptoms, with minimal side effects.
Possible side effects of metoclopramide are more likely to occur if you take this drug for a long time or your dose is very high. When side effects occur, they’re typically mild and manageable. The most common side effects include drowsiness, fatigue, dizziness, and restlessness. You may be able to avoid some common side effects if you take metoclopramide under direct doctor supervision.
Metoclopramide can cause akathisia, a feeling of inner restlessness and an urge to move. It’s often described as a physical inability to sit still, rather than emotional anxiety.
Metoclopramide can cause you to feel very tired or have little energy. You might already experience fatigue during a migraine attack. But it’s important to be aware that metoclopramide can affect your energy levels too.
Metoclopramide may affect your mood and how you feel, especially if you already have depression. This medication can make depression symptoms feel more intense. Tell your neurology team right away if you feel anxious, irritable, overly excited, or restless for more than a few days after taking this drug.
Some people might experience a drop in blood pressure after taking metoclopramide. Hypotension (low blood pressure) can make you feel dizzy or faint. Avoid driving and using heavy machinery after taking metoclopramide. In addition, try not to stand up too quickly from sitting or lying down when you’re on this drug.
Your blood pressure will go back to normal once your body adjusts to metoclopramide. If you continue feeling dizzy or faint for more than a few days, get medical advice from your healthcare provider.
Diarrhea is another possible metoclopramide side effect. It can also be a sign of a metoclopramide overdose, so tell your doctor if it’s severe or doesn’t go away. Be sure to stay hydrated, as diarrhea puts you at risk of dehydration.
Tardive dyskinesia is a rare but serious movement disorder. It causes involuntary (uncontrolled) movements, especially of the face, tongue, or body. It can develop after taking certain medications like metoclopramide for a long time or at high doses.
It can be irreversible, meaning it doesn’t go away. That’s why it’s important to only take metoclopramide under your doctor’s guidance.
Signs of tardive dyskinesia can include:
Milder metoclopramide side effects like drowsiness, trouble sleeping, fatigue, and dizziness usually go away on their own without medical attention. Because some adverse effects can be serious or irreversible, it’s important to tell your doctor about them.
You should also tell your neurologist about any signs of a possible allergic reaction to metoclopramide. Contact your doctor immediately if you experience:
If you think you’re experiencing an overdose or allergic reaction, seek emergency medical care right away. Never drive yourself to the emergency room. Call 911 or have someone else drive you.
Your doctor will carefully consider your medical history before prescribing metoclopramide for a migraine attack. They’ll also review all the other medications you take. You may need to be extra cautious while taking metoclopramide if you have certain medical conditions like Parkinson’s disease, seizures, or bowel obstructions.
It’s important to avoid drinking alcohol while taking metoclopramide. Alcohol can increase sleepiness, poor coordination, and dizziness when you’re on this drug. If you’re instructed to take metoclopramide at home, keep it somewhere your kids and pets can’t reach. Once again, only use metoclopramide according to your doctor’s instructions.
Speak with your doctor to learn more about how metoclopramide can help during acute migraine attacks. They can answer your questions and tell you if or when this medication might fit into your migraine management plan.
On MyMigraineTeam, people share their experiences with migraine, get advice, and find support from others who understand.
What was your experience like using metoclopramide for migraine? Let others know in the comments below.
Get updates directly to your inbox.
Continue with Facebook
Continue with Email
Become a member to get even more
Join
This is a member-feature!
Sign up for free to view article comments.
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.