Metloclopramide (Reglan)

[crickit715]

i was wondering approx. how many people are on reglan who have cf?? my daughter has been on it since she was 4 months old. i have been reading several articles citing liver and kidney problems associated with this medication. the pharmacy pamphlet that comes with it states "not for use in children" and "do not use for more than 12 weeks". i have asked her cf doc about this and she does says that sometimes the pros out weigh the cons....but my daughter has been having elevated enzyme tests coming back (with no explanation) and i am getting increasingly uncomfortable with her being on this med. she was originally put on it for GERD, severe vomiting and they diagnosed her with gastroparesis. but she had the nissan procedure and has not had the vomiting or GERD since last april.....just looking for any similar experiences, advice, etc...not sure what to do at this point!

 

[crickit715]

i was wondering approx. how many people are on reglan who have cf?? my daughter has been on it since she was 4 months old. i have been reading several articles citing liver and kidney problems associated with this medication. the pharmacy pamphlet that comes with it states "not for use in children" and "do not use for more than 12 weeks". i have asked her cf doc about this and she does says that sometimes the pros out weigh the cons....but my daughter has been having elevated enzyme tests coming back (with no explanation) and i am getting increasingly uncomfortable with her being on this med. she was originally put on it for GERD, severe vomiting and they diagnosed her with gastroparesis. but she had the nissan procedure and has not had the vomiting or GERD since last april.....just looking for any similar experiences, advice, etc...not sure what to do at this point!

 

[crickit715]

i was wondering approx. how many people are on reglan who have cf?? my daughter has been on it since she was 4 months old. i have been reading several articles citing liver and kidney problems associated with this medication. the pharmacy pamphlet that comes with it states "not for use in children" and "do not use for more than 12 weeks". i have asked her cf doc about this and she does says that sometimes the pros out weigh the cons....but my daughter has been having elevated enzyme tests coming back (with no explanation) and i am getting increasingly uncomfortable with her being on this med. she was originally put on it for GERD, severe vomiting and they diagnosed her with gastroparesis. but she had the nissan procedure and has not had the vomiting or GERD since last april.....just looking for any similar experiences, advice, etc...not sure what to do at this point!

 

[crickit715]

i was wondering approx. how many people are on reglan who have cf?? my daughter has been on it since she was 4 months old. i have been reading several articles citing liver and kidney problems associated with this medication. the pharmacy pamphlet that comes with it states "not for use in children" and "do not use for more than 12 weeks". i have asked her cf doc about this and she does says that sometimes the pros out weigh the cons....but my daughter has been having elevated enzyme tests coming back (with no explanation) and i am getting increasingly uncomfortable with her being on this med. she was originally put on it for GERD, severe vomiting and they diagnosed her with gastroparesis. but she had the nissan procedure and has not had the vomiting or GERD since last april.....just looking for any similar experiences, advice, etc...not sure what to do at this point!

 

[crickit715]

i was wondering approx. how many people are on reglan who have cf?? my daughter has been on it since she was 4 months old. i have been reading several articles citing liver and kidney problems associated with this medication. the pharmacy pamphlet that comes with it states "not for use in children" and "do not use for more than 12 weeks". i have asked her cf doc about this and she does says that sometimes the pros out weigh the cons....but my daughter has been having elevated enzyme tests coming back (with no explanation) and i am getting increasingly uncomfortable with her being on this med. she was originally put on it for GERD, severe vomiting and they diagnosed her with gastroparesis. but she had the nissan procedure and has not had the vomiting or GERD since last april.....just looking for any similar experiences, advice, etc...not sure what to do at this point!

 

[Buckeye]

My son was on Reglan for a short time. After starting it he had some weird muscle movements that looked like seizures, so we decided that he could not continue on the drug since he has a history of seizures anyhow. I had to be able to know when he was really having seizures vs when he was just having weird muscle movements and they looked too similar.Do they think the Reglan is helping your daughter? It is supposed to increase the emptying of the stomach, so if you don't see a benefit to it you should definitely be questioning the doctor.Does she just see the CF doctor or does she also see a GI doctor for this? Personally I prefer to take my son to specialists for anything not Pulmo related even though it may have it's roots in CF. I tend to trust the opinions of the specialists more than the CF team with those other issues - although it makes us not real popular at the CF clinic at times. My son's problems go far beyond just CF related issues though.

 

[Buckeye]

My son was on Reglan for a short time. After starting it he had some weird muscle movements that looked like seizures, so we decided that he could not continue on the drug since he has a history of seizures anyhow. I had to be able to know when he was really having seizures vs when he was just having weird muscle movements and they looked too similar.Do they think the Reglan is helping your daughter? It is supposed to increase the emptying of the stomach, so if you don't see a benefit to it you should definitely be questioning the doctor.Does she just see the CF doctor or does she also see a GI doctor for this? Personally I prefer to take my son to specialists for anything not Pulmo related even though it may have it's roots in CF. I tend to trust the opinions of the specialists more than the CF team with those other issues - although it makes us not real popular at the CF clinic at times. My son's problems go far beyond just CF related issues though.

 

[Buckeye]

My son was on Reglan for a short time. After starting it he had some weird muscle movements that looked like seizures, so we decided that he could not continue on the drug since he has a history of seizures anyhow. I had to be able to know when he was really having seizures vs when he was just having weird muscle movements and they looked too similar.Do they think the Reglan is helping your daughter? It is supposed to increase the emptying of the stomach, so if you don't see a benefit to it you should definitely be questioning the doctor.Does she just see the CF doctor or does she also see a GI doctor for this? Personally I prefer to take my son to specialists for anything not Pulmo related even though it may have it's roots in CF. I tend to trust the opinions of the specialists more than the CF team with those other issues - although it makes us not real popular at the CF clinic at times. My son's problems go far beyond just CF related issues though.

 

[Buckeye]

My son was on Reglan for a short time. After starting it he had some weird muscle movements that looked like seizures, so we decided that he could not continue on the drug since he has a history of seizures anyhow. I had to be able to know when he was really having seizures vs when he was just having weird muscle movements and they looked too similar.Do they think the Reglan is helping your daughter? It is supposed to increase the emptying of the stomach, so if you don't see a benefit to it you should definitely be questioning the doctor.Does she just see the CF doctor or does she also see a GI doctor for this? Personally I prefer to take my son to specialists for anything not Pulmo related even though it may have it's roots in CF. I tend to trust the opinions of the specialists more than the CF team with those other issues - although it makes us not real popular at the CF clinic at times. My son's problems go far beyond just CF related issues though.

 

[Buckeye]

My son was on Reglan for a short time. After starting it he had some weird muscle movements that looked like seizures, so we decided that he could not continue on the drug since he has a history of seizures anyhow. I had to be able to know when he was really having seizures vs when he was just having weird muscle movements and they looked too similar.<p>Do they think the Reglan is helping your daughter? It is supposed to increase the emptying of the stomach, so if you don't see a benefit to it you should definitely be questioning the doctor.<p>Does she just see the CF doctor or does she also see a GI doctor for this? Personally I prefer to take my son to specialists for anything not Pulmo related even though it may have it's roots in CF. I tend to trust the opinions of the specialists more than the CF team with those other issues - although it makes us not real popular at the CF clinic at times. My son's problems go far beyond just CF related issues though.

 

[crickit715]

well, we havent even seen the cf specialist since december...the cf doc is very ill and we have been seeing pediatric pulmonologists only (a different one each time, i might add), and i am not comfortable with the care or lack there of she is getting at this time. we havent seen a gi doc since last april when the feeding tube and nissan proc were completed and i have questioned this and didnt really get a responce, because these new docs havent really taken the time to get to get to know the situation....sorry just venting

 

[crickit715]

well, we havent even seen the cf specialist since december...the cf doc is very ill and we have been seeing pediatric pulmonologists only (a different one each time, i might add), and i am not comfortable with the care or lack there of she is getting at this time. we havent seen a gi doc since last april when the feeding tube and nissan proc were completed and i have questioned this and didnt really get a responce, because these new docs havent really taken the time to get to get to know the situation....sorry just venting

 

[crickit715]

well, we havent even seen the cf specialist since december...the cf doc is very ill and we have been seeing pediatric pulmonologists only (a different one each time, i might add), and i am not comfortable with the care or lack there of she is getting at this time. we havent seen a gi doc since last april when the feeding tube and nissan proc were completed and i have questioned this and didnt really get a responce, because these new docs havent really taken the time to get to get to know the situation....sorry just venting

 

[crickit715]

well, we havent even seen the cf specialist since december...the cf doc is very ill and we have been seeing pediatric pulmonologists only (a different one each time, i might add), and i am not comfortable with the care or lack there of she is getting at this time. we havent seen a gi doc since last april when the feeding tube and nissan proc were completed and i have questioned this and didnt really get a responce, because these new docs havent really taken the time to get to get to know the situation....sorry just venting

 

[crickit715]

well, we havent even seen the cf specialist since december...the cf doc is very ill and we have been seeing pediatric pulmonologists only (a different one each time, i might add), and i am not comfortable with the care or lack there of she is getting at this time. we havent seen a gi doc since last april when the feeding tube and nissan proc were completed and i have questioned this and didnt really get a responce, because these new docs havent really taken the time to get to get to know the situation....sorry just venting

 

[PedsNP2007]

Hi,
Reglan is associated with extrapyramidal symptoms, such as dystonic reactions, muscle spasms, involuntary muscle movements, facial grimacing, etc. These symptoms usually start within 48 hours of starting the drug. You can also have Parkinsonian type symptoms within 6 months of starting the drug.

So, Pam, you are right about the weird movements... it is hard to differentiate between seizures and the adverse reactions of reglan. And some studies have shown that reglan can lower the seizure threshold, making it a bit easier for a child to seize with a history of epilepsy.

In my opinion, Ricki, your daughter should be trialed off of reglan as she has the nissen surgery. If she starts having reflux symptoms again, then either the nissen has loosened and needs to be addressed. The nissen is the treatment of GERD after medical therapy had been used and anti-reflux measures initiated.

I work in the pediatric ICU with sick kids who have poor GI function (related to acute illness). I usually place kids on anti-reflux meds of Zantac, lansoprazole (cheaper than the omeprazole), or pantoprazole (used last since it is more expensive and not more effective unless the other meds have failed or you have pre-existing GI issues). I can count on my hand the number of times I have ordered reglan (besides the one time dosing for NJ tube placements). The side effects are not worth just broadly administering it to all PICU patients. Kids with pre-existing GI issues (significant motility issues with or without Nissen) sometimes are on it when they come in so that is when we continue it. One GI physician said that after a few weeks you develop less response to the drug.

So, I would talk to your CF team and perhaps get a GI consult. I am surprised you don't have a GI physician given your daughter's significant GI issues. Anyone who has a gtube with nissen has a GI physician... As much as your CF team is educated, it is important to have a specialist to deal with the GI issues and the medications that are commonly used with that specialist team.

Do not feel bad in asking for a specialist. You are the consumer and are paying for these services. From what you both are saying, you are not asking for unreasonable things. If your child was just having some minor reflux (without the above mentioned procedures), getting a GI consult would be a bit early. But you both have children with complex GI issues that need follow-up at least 2-3 times per year to make sure your children are thriving from a nutritional and GI aspect.

Good luck!

Jenn
30 yo cf

 

[PedsNP2007]

Hi,
Reglan is associated with extrapyramidal symptoms, such as dystonic reactions, muscle spasms, involuntary muscle movements, facial grimacing, etc. These symptoms usually start within 48 hours of starting the drug. You can also have Parkinsonian type symptoms within 6 months of starting the drug.

So, Pam, you are right about the weird movements... it is hard to differentiate between seizures and the adverse reactions of reglan. And some studies have shown that reglan can lower the seizure threshold, making it a bit easier for a child to seize with a history of epilepsy.

In my opinion, Ricki, your daughter should be trialed off of reglan as she has the nissen surgery. If she starts having reflux symptoms again, then either the nissen has loosened and needs to be addressed. The nissen is the treatment of GERD after medical therapy had been used and anti-reflux measures initiated.

I work in the pediatric ICU with sick kids who have poor GI function (related to acute illness). I usually place kids on anti-reflux meds of Zantac, lansoprazole (cheaper than the omeprazole), or pantoprazole (used last since it is more expensive and not more effective unless the other meds have failed or you have pre-existing GI issues). I can count on my hand the number of times I have ordered reglan (besides the one time dosing for NJ tube placements). The side effects are not worth just broadly administering it to all PICU patients. Kids with pre-existing GI issues (significant motility issues with or without Nissen) sometimes are on it when they come in so that is when we continue it. One GI physician said that after a few weeks you develop less response to the drug.

So, I would talk to your CF team and perhaps get a GI consult. I am surprised you don't have a GI physician given your daughter's significant GI issues. Anyone who has a gtube with nissen has a GI physician... As much as your CF team is educated, it is important to have a specialist to deal with the GI issues and the medications that are commonly used with that specialist team.

Do not feel bad in asking for a specialist. You are the consumer and are paying for these services. From what you both are saying, you are not asking for unreasonable things. If your child was just having some minor reflux (without the above mentioned procedures), getting a GI consult would be a bit early. But you both have children with complex GI issues that need follow-up at least 2-3 times per year to make sure your children are thriving from a nutritional and GI aspect.

Good luck!

Jenn
30 yo cf

 

[PedsNP2007]

Hi,
Reglan is associated with extrapyramidal symptoms, such as dystonic reactions, muscle spasms, involuntary muscle movements, facial grimacing, etc. These symptoms usually start within 48 hours of starting the drug. You can also have Parkinsonian type symptoms within 6 months of starting the drug.

So, Pam, you are right about the weird movements... it is hard to differentiate between seizures and the adverse reactions of reglan. And some studies have shown that reglan can lower the seizure threshold, making it a bit easier for a child to seize with a history of epilepsy.

In my opinion, Ricki, your daughter should be trialed off of reglan as she has the nissen surgery. If she starts having reflux symptoms again, then either the nissen has loosened and needs to be addressed. The nissen is the treatment of GERD after medical therapy had been used and anti-reflux measures initiated.

I work in the pediatric ICU with sick kids who have poor GI function (related to acute illness). I usually place kids on anti-reflux meds of Zantac, lansoprazole (cheaper than the omeprazole), or pantoprazole (used last since it is more expensive and not more effective unless the other meds have failed or you have pre-existing GI issues). I can count on my hand the number of times I have ordered reglan (besides the one time dosing for NJ tube placements). The side effects are not worth just broadly administering it to all PICU patients. Kids with pre-existing GI issues (significant motility issues with or without Nissen) sometimes are on it when they come in so that is when we continue it. One GI physician said that after a few weeks you develop less response to the drug.

So, I would talk to your CF team and perhaps get a GI consult. I am surprised you don't have a GI physician given your daughter's significant GI issues. Anyone who has a gtube with nissen has a GI physician... As much as your CF team is educated, it is important to have a specialist to deal with the GI issues and the medications that are commonly used with that specialist team.

Do not feel bad in asking for a specialist. You are the consumer and are paying for these services. From what you both are saying, you are not asking for unreasonable things. If your child was just having some minor reflux (without the above mentioned procedures), getting a GI consult would be a bit early. But you both have children with complex GI issues that need follow-up at least 2-3 times per year to make sure your children are thriving from a nutritional and GI aspect.

Good luck!

Jenn
30 yo cf

 

[PedsNP2007]

Hi,
Reglan is associated with extrapyramidal symptoms, such as dystonic reactions, muscle spasms, involuntary muscle movements, facial grimacing, etc. These symptoms usually start within 48 hours of starting the drug. You can also have Parkinsonian type symptoms within 6 months of starting the drug.

So, Pam, you are right about the weird movements... it is hard to differentiate between seizures and the adverse reactions of reglan. And some studies have shown that reglan can lower the seizure threshold, making it a bit easier for a child to seize with a history of epilepsy.

In my opinion, Ricki, your daughter should be trialed off of reglan as she has the nissen surgery. If she starts having reflux symptoms again, then either the nissen has loosened and needs to be addressed. The nissen is the treatment of GERD after medical therapy had been used and anti-reflux measures initiated.

I work in the pediatric ICU with sick kids who have poor GI function (related to acute illness). I usually place kids on anti-reflux meds of Zantac, lansoprazole (cheaper than the omeprazole), or pantoprazole (used last since it is more expensive and not more effective unless the other meds have failed or you have pre-existing GI issues). I can count on my hand the number of times I have ordered reglan (besides the one time dosing for NJ tube placements). The side effects are not worth just broadly administering it to all PICU patients. Kids with pre-existing GI issues (significant motility issues with or without Nissen) sometimes are on it when they come in so that is when we continue it. One GI physician said that after a few weeks you develop less response to the drug.

So, I would talk to your CF team and perhaps get a GI consult. I am surprised you don't have a GI physician given your daughter's significant GI issues. Anyone who has a gtube with nissen has a GI physician... As much as your CF team is educated, it is important to have a specialist to deal with the GI issues and the medications that are commonly used with that specialist team.

Do not feel bad in asking for a specialist. You are the consumer and are paying for these services. From what you both are saying, you are not asking for unreasonable things. If your child was just having some minor reflux (without the above mentioned procedures), getting a GI consult would be a bit early. But you both have children with complex GI issues that need follow-up at least 2-3 times per year to make sure your children are thriving from a nutritional and GI aspect.

Good luck!

Jenn
30 yo cf

 

[PedsNP2007]

Hi,
<br />Reglan is associated with extrapyramidal symptoms, such as dystonic reactions, muscle spasms, involuntary muscle movements, facial grimacing, etc. These symptoms usually start within 48 hours of starting the drug. You can also have Parkinsonian type symptoms within 6 months of starting the drug.
<br />
<br />So, Pam, you are right about the weird movements... it is hard to differentiate between seizures and the adverse reactions of reglan. And some studies have shown that reglan can lower the seizure threshold, making it a bit easier for a child to seize with a history of epilepsy.
<br />
<br />In my opinion, Ricki, your daughter should be trialed off of reglan as she has the nissen surgery. If she starts having reflux symptoms again, then either the nissen has loosened and needs to be addressed. The nissen is the treatment of GERD after medical therapy had been used and anti-reflux measures initiated.
<br />
<br />I work in the pediatric ICU with sick kids who have poor GI function (related to acute illness). I usually place kids on anti-reflux meds of Zantac, lansoprazole (cheaper than the omeprazole), or pantoprazole (used last since it is more expensive and not more effective unless the other meds have failed or you have pre-existing GI issues). I can count on my hand the number of times I have ordered reglan (besides the one time dosing for NJ tube placements). The side effects are not worth just broadly administering it to all PICU patients. Kids with pre-existing GI issues (significant motility issues with or without Nissen) sometimes are on it when they come in so that is when we continue it. One GI physician said that after a few weeks you develop less response to the drug.
<br />
<br />So, I would talk to your CF team and perhaps get a GI consult. I am surprised you don't have a GI physician given your daughter's significant GI issues. Anyone who has a gtube with nissen has a GI physician... As much as your CF team is educated, it is important to have a specialist to deal with the GI issues and the medications that are commonly used with that specialist team.
<br />
<br />Do not feel bad in asking for a specialist. You are the consumer and are paying for these services. From what you both are saying, you are not asking for unreasonable things. If your child was just having some minor reflux (without the above mentioned procedures), getting a GI consult would be a bit early. But you both have children with complex GI issues that need follow-up at least 2-3 times per year to make sure your children are thriving from a nutritional and GI aspect.
<br />
<br />Good luck!
<br />
<br />Jenn
<br />30 yo cf