Reglan

Maxolon

Generic Name

Metoclopramide

About Maxolon

Maxolon is a prokinetic drug that is used to treat ailments such as heartburn, gastric reflux disease and gastroparesis. Maxolon works by increasing the rate at which the stomach empties food into the intestines. The medication can also be prescribed in a single dose to facilitate x-rays of the stomach and intestines.

Additionally, Maxolon falls into the category of an antiemetic. As such, it is used to treat patients post-surgery who are experiencing nausea and vomiting. It may also be given to cancer patients who are suffering from these symptoms due to chemotherapy. In some cases, Maxolon and other metoclopramide drugs are prescribed for migraine patients who experience nausea during headache episodes.

While Maxolon is no longer sold in the United States, other versions of metoclopramide are still available.

Metoclopramide and Tardive Dyskinesia

Metoclopramide drugs have been on the market since the 1980s. They were deemed fairly safe until a 2004 study illustrated a definitive link between long-term use of metoclopramide and tardive dyskinesia (TD), a movement disorder characterized by excessive facial tics, lip smacking, grimacing and involuntary, repetitive arm and leg spasms. The study, authored by scientists from the U.S. Food and Drug Administration (FDA) and the Veterans Administration, noted that patients who use the medication for more than three months are at high risk of developing the condition.

Older women may be particularly susceptible to the condition. Other patients that fall into the high risk category include individuals with diabetes, psychosis, dysfunction and those dealing with substance abuse. Other users are still at risk of developing the condition, even with short-term use of metoclopramide.

Metoclopramide Today

While some have called for metoclopramide to be removed from the market, the medication continues to remain in use. In 2009, the FDA demanded that metoclopramide medications carry a stern black box warning, noting the connection between the drugs and the risk of tardive dyskinesia.

Dosage

The prescribed dosage of metoclopramide may vary among each patient. When taken for heartburn or reflux disease, for example, the drug is usually taken three times a day about 30 minutes before each meal. When used to treat nausea and vomiting, the medication may be given only once or when needed.

When a dose of metoclopramide is missed, it 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. Two doses of metoclopramide should never be taken at the same time to compensate for a missed dose.

Contraindications

Patients with certain conditions should not take Maxolon. Do not take the medication if you have any of the following:

  • Bleeding, injury or obstruction in the stomach
  • Epilepsy or other seizure disorders
  • Pheochromocytoma (tumor of the adrenal gland)

Patients with any of the following conditions should use Maxolon with extreme caution and only after carefully weighing 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 mothers should not take Maxolon, as the medication can pass into breast-milk. Women who are pregnant or may become pregnant should also not use Maxolon, as there have been no definitive studies on the effects of the drug on a developing fetus.

Drug Interactions

Many drugs can negatively interact with Maxolon. Those include, but are not limited to:

  • Monoamine oxidase (MAO) inhibitors
  • Digoxin
  • Cyclosporine
  • Tetracycline
  • Insulin
  • Levodopa
  • Narcotic pain relievers such as hydrocodone, morphine, oxycodone and codeine

Users should be aware that Maxolon may increase the effects of certain other medications such as antihistamines, anti-anxiety drugs, sedatives and muscle relaxants. When Maxolon is used alongside these drugs, patients should not drive, operate machinery or engage in other potentially hazardous activities.

Side Effects

As with any drug, Maxolon can cause side effects, some of which may be more serious than others. Patients should contact their doctor or seek immediate medical attention if any of the following are experienced:

  • Involuntary body movements
  • An allergic reaction that includes swelling of the tongue or throat, breathing difficulties or hives
  • Anxiety or agitation
  • Insomnia
  • Jaundice of the skin or eyes
  • Seizures
  • Hallucinations
  • Irregular heartbeat

Less serious side effects may include but are not limited to:

  • Nausea
  • Diarrhea
  • Drowsiness or dizziness
  • Headache
  • Confusion
  • Fluid retention
  • Breast tenderness
  • 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

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