Reglan

Octamide

Generic Name

Metoclopramide

About Octamide

Octamide, like all metoclopramide-containing medications, is an antiemetic agent and a gastrointestinal stimulant used to enhance gastrointestinal motility. It is often prescribed to diabetics who suffer from gastroparesis, a condition in which the stomach muscles do not function at appropriate speed. In addition, Octamide may be prescribed to those who suffer from persistent heartburn and gastric reflux disease. The drug is also given to ease intubations of the lower intestine and to prompt gastric emptying for x-rays and other medical tests.

As an antiemetic medication, Octamide is given post-surgery to patients who suffer from nausea and vomiting due to anesthesia. The drug may also be provided to chemotherapy patients who experience similar symptoms due to chemotherapy. Additionally, Octamide may be prescribed to those who suffer from nausea and vomiting due to migraine headaches.

Metoclopramide and Tardive Dyskinesia

Octamide is just one of a large family of drugs that contain metoclopramide. The medications first emerged on the market approximately 30 years ago.

While all drugs carry side effects, Octamide and other similar medications have come under fire in the last several years due to their connection with a serious movement disorder known as tardive dyskinesia (TD). TD is a potentially irreversible condition characterized by repetitive and involuntary movements of various parts of the body. Common motions performed by patients with the disorder include lip smacking, grimacing, tongue protrusion, rapid movements of the extremities and excessive eye blinking.

In 2004, a study conducted by the U.S. Food and Drug Administration and other partners illustrated a definitive link between the medication and the disorder. The study showed that patients who use metoclopramide for extended periods of time are at particularly high risk of developing the condition.

In some instances, TD symptoms stop when Octamide treatment is discontinued. However, in other cases, the condition continues even after patients stop using the medication.

Metoclopramide Today

In 2009, the FDA required all metoclopramide medications to carry a black box warning informing consumers and health care professionals that the drug places patients at risk of developing TD. The warning states that this risk should be weighed with the potential benefits of the medication before the initiation of treatment. The warning also states that metoclopramide should not be used for more than 12 weeks, except in rare cases where the potential benefits of treatment outweigh the risk of long-term treatment with the drug.

Dosage

Octamide dosages may vary among patients. Generally, patients take three to four doses of the medication per day, approximately 30 minutes before meals. The drug is most often dispensed in pill form but may be available in a liquid as well. The medication may be taken as needed in some patients.

Missed doses should be taken as soon as remembered. However, if it is almost time for a patient's next scheduled dose, the missed dose should be skipped. Two doses of Octamide should never be taken at the same time to compensate for a missed dose.

Contraindications

Octamide should not be used in patients with the following:

  • Adrenal gland tumors
  • Epilepsy or other seizure disorders
  • Bleeding or obstruction in the stomach

Patients with the following conditions should use Octamide 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

Mothers who are nursing should not take Octamide or any other metoclopramide drug. Women who are pregnant or may become pregnant should also not take Octamide, as the potential effects of Octamide on a developing fetus are unknown.

Drug Interactions

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

  • Acetaminophen
  • Narcotic pain relievers
  • Insulin
  • Digoxin
  • Monoamine oxidase (MAO) inhibitors and other anti-depressants
  • Sleeping pills
  • Cyclosporine
  • Tetracycline
  • Levodopa

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

Side Effects

In addition to tardive dyskinesia, Octamide may cause a number of other serious side effects including:

  • Allergic reactions
  • Anxiety
  • Insomnia
  • Irregular heartbeat
  • Seizures
  • Jaundice
  • Hallucinations

Less serious side effects of the medication include:

  • Nausea
  • Diarrhea
  • Headache
  • Confusion
  • Drowsiness
  • Dizziness
  • Fluid retention
  • Breast tenderness
  • 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.