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Metoclopramide, commonly known as Reglan, is associated with several serious side effects and risks. It's crucial to understand these potential risks and precautions to ensure safe usage. Here is a summary of the key safety information:

• Tardive Dyskinesia (TD): This medication can cause a severe movement disorder known as tardive dyskinesia, which involves uncontrolled movements of the tongue, face, mouth, lips, hands, arms, legs, and feet. The risk of developing TD increases with prolonged use, especially in older adults, women, and individuals with diabetes. Avoid combining metoclopramide with other medications that may cause TD, like prochlorperazine or haloperidol. If you notice any uncontrollable movements, contact your healthcare provider immediately as these symptoms can become permanent.

• Other Movement Disorders: Metoclopramide may cause other movement-related symptoms such as muscle stiffness, tremors, and restlessness, particularly within the first six months of treatment. These symptoms typically resolve after discontinuation of the medication but may take up to three months to subside completely. Seek medical attention if these occur.

• Neuroleptic Malignant Syndrome (NMS): There is a risk of developing NMS, a rare but life-threatening condition characterized by high fever, muscle stiffness, confusion, rapid or irregular heartbeat, and excessive sweating. Stop the medication and seek emergency medical help if these symptoms appear. The risk is heightened when taken with antipsychotic medications.

• Mental Health Changes: The use of metoclopramide may induce depression or suicidal thoughts, even in those without a prior history of depression. Report any mood changes or suicidal ideations to your healthcare provider immediately.

• High Blood Pressure: This medication can increase blood pressure, particularly if used alongside other medications that have a similar effect, such as MAOIs. Monitor your blood pressure regularly and consult your healthcare provider if any significant changes occur.

• Fluid Retention and Swelling: Metoclopramide can elevate aldosterone levels, leading to fluid retention and swelling in the arms, legs, or abdomen. This is a particular concern for individuals with heart failure or liver issues. Report any unexpected swelling or rapid weight gain to your healthcare provider.

• Elevated Prolactin Levels: The medication can increase prolactin levels, resulting in symptoms like milky discharge from the nipples, enlarged breasts, or irregular menstrual cycles. Discuss any such symptoms with your healthcare provider.

Contraindications: Metoclopramide should not be used in individuals with uncontrolled body movements, stomach bleeding or blockages, tumors that affect blood pressure, or a history of seizures. Always consult your healthcare provider before starting this medication to ensure it is safe for your use.

In case of an overdose, seek immediate medical assistance. These guidelines are essential to prevent adverse effects and ensure the safe use of metoclopramide. Always discuss any concerns or potential interactions with your healthcare provider.

Common side effects:

• Drowsiness
• Dizziness
• Tiredness
• Restlessness
• Headaches
• Flushing
• Diarrhea
• Lack of energy

Less common but important to monitor:

• Trouble sleeping
• Nervousness
• Depression
• Hallucinations
• Changes in blood pressure
• Swelling in arms, legs, or around the belly
• Enlarged breasts
• Leaky nipples
• Irregular menstrual periods
• Changes in heart rate
• Changes in liver function
• Changes in urination
• Changes in blood health

Serious side effects:

• Uncontrolled muscle movements (tardive dyskinesia)
• Neuroleptic malignant syndrome (NMS)
• Suicidal thoughts
• Seizures
• Severe allergic reactions (rash, itching, or swelling)

Interactions with high risk of serious adverse effects and should be avoided:

• Aripiprazole
• Haloperidol
• Amitriptyline
• Citalopram
• Fluoxetine
• Isocarboxazid
• Linezolid
• Selegiline
• Cabergoline
• Ropinirole

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Fosfomycin
• Pramlintide
• Rivastigmine
• Alcohol
• Marijuana (cannabis)
• Antihistamines (such as Cetirizine, diphenhydramine)
• Drugs for sleep or anxiety (such as Alprazolam, Diazepam, Zolpidem)
• Muscle relaxants
• Opioid pain relievers (such as codeine)