Stopping Reglan..Please Help...Pharmacist Steve...Doc Steve...Anyone...

[GJZH]

I started taking reglan about a year ago for gastroparesis...I usually take about ten to fifteen miligrams a day... five in the morning and five at night before bed....I have decided that it is time to try to go off the drug and thought I could just stop this drug....I stopped the drug abruptly yesterday...felt a little jittery yesterday and attributed it to my pain meds...took an extra breakthrough med...but today the jitteriness and aggitation were over the top...I decided to call my pharmacist and she said I could just stop the drug with no side effects...This particular pharmacist has now given me bad advice on three occassions and should be fired. After another hour of feeling terrible I called the doctor that prescribed the pill and he told me I could not just stop the pill, but would have to take five milligrams for five days and then stop....but how is this going to work...It would seem as though I should try to cut the pills in half or something and take two milligrams for five days or something....

I went on the Internet and people are saying they had a very difficult time stopping this pill and some needed help from their pcp. Some had to use other meds to stop this pill...I would rather try to tough it out if possible. I do not want to become addicted to another pill to get off this pill, but does anyone have any suggestions on how best to stop this pill?

It does say to only use this pill for no longer than twelve weeks...I have been on it for a year....I guess this is what happens when you see a PA and not a physician....I think I am going to find a gastroenterologist that actually sees his patients, not one that allows the PA to diagnose and prescribe....

Please if you can suggest anything to avoid the jitters and aggitation...I would appreciate it...I would appreciate it too if you could give me a time table of how long this should last....Thanks for any thing you can share with me...

[BrokenBladder]

I don't have personal experience but my son's best friend went off this med after taking it for 4 years. He was taking 5 mgs every morning and when he came off of it he was very jittery, agitated, and just generally miserable. It was tough to watch him go through it as he had been so calm prior to coming off of Reglan.
I googled Reglan and it does say you shouldn't stop the med without first discussing it with your doctor. Also I couldn't find anything about not being able to cut the pill in half, but I would call a different pharamacist and ask.
In my son's friends case he was completely back to normal in about 2 weeks. If you can hang in there that long then it should be out of your system.
I'm so sorry you're going through this. W/D's can be so horrible and so many doctors and pharmacists don't even believe they exist with some meds.

[Pharmacist.steve]

There is no magic formula or timetable for you... like many things .. it is going to be trial and error ... you can cut the tablets in half without a problem. try half dose of what you were taking for a week or two... then if possible half the dose again for a week or two. At best .. you may only be able to reduce the "withdrawal" down to a minimum and then have to "tough it out"

[Rozia]

I thought they were taking this drug off the market . Or maybe they are thinking about it .

[GJZH]

Roz,

When you look at the side effects ...I think it should be off the market...

[Rozia]

I know , there was talk of taking it off the market. My dr. wanted me to start it and I said no way .

[GJZH]

I just wanted to say that I awoke yesterday and did not have the jitters or anxiety associated with this drug on the other days....so I did not take yesterday's dose ....I again did not feel agitated today so did not take it again....I am hopeful that I am over the withdraw...I hope I do not develop gastroparesis again...If I do they will have to prescribe something else or I will have to just deal with the nausea and vomiting associated with it...but this drug is out for me....

[Kira]

I could not tolerate reglan, it gave me awful side effects while ON it (anxiety, tremors, just crappy mood in general) and I did not even get up to my max prescribed dose, which was supposed to be 10 mg four times/day.

There are not really any good alternatives to it on the market in the US anymore. There used to be cisapride (propulsid) and zelnorm, but those are both off of the market now due to side effects.

There is a drug that works similarly to reglan called domperidone, only it does not cross the blood/brain barrier so it causes fewer side effects. However, it is not FDA approved in the US, even though it is widely used in Canada, Europe, Australia, and much of the rest of the world. It is even over-the-counter in some countries.

My gastroenterologist prescribed domperidone because I have severe gastroparesis and slow GI motility in general with chronic intestinal pseudoobstruction. I have been having a hard time with nausea, vomiting, and being unable to eat normally (plus abdominal pain/distension, severe constipation, etc). For a while we were even talking about doing a GJ-tube, though that is temporarily off the table while we see if the domperidone works. The way I understand it, your doctor can still prescribe it, but there is some paperwork that needs to be filled out for them to be able to do it as an "Investigational New Drug" or something, and then you send your prescription to Canada or England or wherever and get it filled through the mail. They can't legally just prescribe it, though, and you can't get it in the US... there are some hoops to jump through and I still haven't gotten mine yet.

Anyway, I'm not saying to try the domperidone because it sounds like you're doing good with the reglan anyway... just wanted to tell you my experience with reglan. I think that I would try to see a good GI doc before going on any other promotility agents, because they can be nasty drugs.

I was talking to my pain doc about the domperidone/reglan thing today and she was saying how hard it is for some people to tolerate reglan, and how she doesn't like to use it much at all because of all the issues with it. Of course, the internal medicine folks who took care of me during my last hospital stay were all eager to send me home on a pretty high dose of reglan (10 mg four times/day) without even checking with my own PCP first... though I didn't start taking that crap until I talked to my PCP, and then I had to come off of it before I ever got beyond 2.5 mg four times/day. I was going up gradually but I just couldn't take it. I was only on it for a couple of weeks, but I didn't have any problems coming off of it... in fact, I felt better when I stopped taking it.

[GJZH]

Kira,

Maybe the drugs I use masked the side effects of the Reglan, but I never felt any different from it, except that it made eating a lot easier. I did not have the nausea and it aided greatly in digestion...Unfortunately, I also was eating everything...I guess they also prescribe this for anorexia too so it stimulates the appetite...I will have to see what happens now that I am not taking it...so far so good...I think I will just deal with the gastroparesis...I might also find a gastroenterologist that actually sees his patients and not just passes them on to a PA...I have only seen my doc about three or four times in the last three or four years...I think I need to see a doc a little more often...

[debhun]

I was taking Reglan but Doc stoped it.I didn't feel and thing from stopping it. Then Dr put me on phenergan 25mg every 6 hours. it seem to work better for me. My Dr wants me to go to a good gastroenterologist. I am having troubles but no ins so I am trying to hold off as long as I can. I hope you are feeling better.
Deb

[Kira]

I agree that you should get a good gastroenterologist. My other docs were trying to deal with my nausea & vomiting for a while, but then I finally saw a gastroenterologist who specializes in motility disorders, and it was a good decision. He seemed to really know what he was talking about, and so far I have been doing a little better (knock on wood).

I have gastroparesis, too, and it is no fun. For me, it causes a lot of nausea/vomiting... though the rest of my GI tract doesn't work well, either, and my disease itself also makes me vomit when things get out of whack.

GJZH, I am glad that the Reglan worked for you. Just like any med, there are some people that tolerate it well and some people that get bad side effects from it. Unfortunately, I was in the "people that get bad side effects" group.

Deb, I take Phenergan sometimes, too, but I save it for when I am really having a lot of nausea/vomiting because it makes me really sleepy.

I have three GI meds to use... domperidone every day... then, if I am vomiting, I take Zofran (dissolves under your tongue)... then, if that doesn't work, I take Phenergan (either the pill or the suppository). If I am still vomiting after all of that, then I go to the hospital for IV fluids and meds. (I have to go to the hospital if I can't control the vomiting with meds because not eating triggers my mito symptoms, which can be serious.)

My GI doc also had some dietary suggestions to help with gastroparesis.

The most important thing is to eat small, frequent meals. He said to eat 6 small meals instead of 3 big ones. That way, your stomach has less to empty at one time and you don't get that bloated, distended feeling so much.

He also said to avoid high fiber stuff and fatty stuff because fiber and fat both slow down stomach emptying. Since gastroparesis is basically slow stomach emptying, the last thing you need is to eat something that slows it down even more.

He said to try liquids (like Ensure, Boost, etc) when my stomach is really acting up and it is hard to eat, since liquids empty from your stomach faster than solids.

This last one sounds strange, but it does make anatomic sense... He said to try laying down on my right side after eating so that gravity could help empty my stomach. This is because the exit from your stomach into your small intestine is on the right side. It actually does seem to help a bit.

I just thought I'd share those tips because they seem like pretty harmless things that most people could try. (Of course, if you are on a special diet for another medical condition, ask your doctor/nutritionist/etc before changing your diet around).

[GJZH]

Kira,


Thanks for posting the suggestions...Other than prescribing the drugs my doc never has talked to me about the gastroparesis...He did tell me to eat the smaller six meals a day and has a diet posted on the Internet...but that was the extent of it...I see him very infrequently...It is why I think I need to find a new doc...

[Kira]

My PCP did the same thing... didn't really do much at all about it even though I kept asking him what we could do, if I should go to a GI doc, etc... He didn't even want to do the Reglan because he thought it might interact with my antidepressant (though my psychiatrist said it was fine to try it). Then, last time I was in the hospital, the internal medicine doc who took care of me there sent me home with a script for Reglan, which I eventually tried. It didn't work out for me, though. Anyway, I eventually did get a referral to a good GI doc who specializes in motility disorders, but it didn't come from my PCP... it came from my metabolic/genetics doc who was like "we NEED to get this vomiting under control so you can stop having so many hospitalizations for mito," since it was triggering attacks all the time. He freaked me out, though, because he was really pushing for me to get a GJ-tube, which I didn't want to do at all. Luckily, the GI doc doesn't want to try that yet, either.

I think that it would be worth it to try to see a GI doc about the gastroparesis.

[GJZH]

This is a weird drug...I stopped taking the drug on Wednesday...I woke up and felt fine...felt as though I did not need to take any more doses...but woke today feeling agitated again, anxiety...so I am wondering if it dumps out of your system for a few days and then you need to replenish....I think I will just tough it out....I just hope I do not burn a hole in my stomach in the process....