Deciding whether to use Reglan
As most of you know, the FDA just released a new “Black Box Warning” for metaclopramide or Reglan. In my opinion this warning is long overdue! It is essential that parents and patients be informed about the risk of this medication, especially for movement disorders such as Tardive Dyskinesia.
Both of my refluxers have had experience with the use of Reglan in the treatment of their gastroesophgeal reflux disease. My oldest Melina was placed on the medication when her GERD became so severe that they categorized her as failure to thrive. Reglan was one of our last attempts to avoid having to tube feed our sweet baby girl. At the time we were not aware of the side effects nor did we have any major qualms about using the medication. Boy was that about to change!
The first dose of Reglan did not seem to help Melina’s acid reflux at all. Of course, we knew that medicines can take some time to work so we went ahead and continued to give her the medication. It was either the second or third dose she had that made us adamant that she would NEVER take Reglan again. Our sweet girl was out of control. Seriously grouchy, flailing her arms, twitching and screaming uncontrollably. As soon as we discontinued the Reglan she went back to her normal behaviors. It was definitely scary to say the least.
With our second refluxer we were adamant that we did not want to use Reglan again. You know what they say about “never say never”. When Ella aspirated and quit breathing we finally conceded that the benefit to emptying her stomach faster (and hopefully preventing aspirations) far outweighed the risk of using the medication. Even then I was SICK about putting her on it.
Ella did really well on Reglan and I do believe she would have aspirated again with out it. If Ella had done so in her sleep, or when we were not in the room, the consequences of could have been dire. In hindsight I believe we should have had a better plan for weaning her off of the Reglan as soon as her risk for aspiration had been diminished. As it was Ella spent over a year on Reglan.
Ella never showed any signs of Tardive Dyskinesia or movement disorders but had some develop motor issues that her pediatrician felt “might” have been aggravated by the overuse of Reglan. At the very least the Reglan made her seriously groggy which made her unwilling to try a lot of the skills she needed to be working on. She did quite a while of physical therapy in order to be able to walk and she showed much faster progression once she was off of the Reglan.
I would NEVER presume to tell anyone whether to use Reglan or not. That is a decision to weight with your physician. What I will tell you is that this is not a medication that should be taken without doing the research. Make yourself aware of the symptoms of a bad reaction and if you choose to take Reglan ask your doctor what you should do if a bad reaction were to occur.
Last month we were faced with the decision as to whether we should place Ella on Reglan again. I fought hard AGAINST putting her on it. At this time I feel that her current symptoms are not life threatening and thus would not outweigh any possible side effects. The back box warning has left me reassured that my instinct was right and feeling vindicated that I am not an overly dramatic mom! Just a parent who had all of the information needed to make an accurate decision!