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Primperan

Generic name: Metoclopramide Hydrochloride

Brand names: Reglan,Primperan, Clopra, Maxolon, Metoclopramide

Primperan increases the contractions of the stomach and small intestine, helping the passage of food. It is given to treat the symptoms of diabetic gastroparesis, a condition in which the stomach does not contract. These symptoms include vomiting, nausea, heartburn, feeling of indigestion, persistent fullness after meals, and appetite loss. Primperan is also used, for short periods, to treat heartburn in people with gastroesophageal reflux disorder (backflow of stomach contents into the esophagus). In addition, it is given to prevent nausea and vomiting caused by cancer chemotherapy and surgery

Most important fact about Primperan

Primperan may cause mild to severe depression. If you have suffered from depression in the past, make sure your doctor is aware of it. Primperan may not be the best drug for you.

How should you take Primperan?

Primperan is usually taken 30 minutes before a meal. If you suffer from heartburn that occurs only intermittently or only at certain times of day, your doctor may want you to schedule your Primperan therapy around those times.

You will probably take Primperan for only 4 to 12 weeks. Continuous treatment beyond 12 weeks is not recommended.

If you have diabetic "lazy stomach" (gastric stasis) that tends to recur, your doctor may want you to take Primperan at the first sign of a recurrence.

If you miss a dose of Primperan

Take Primperan as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

Storage instructions for Primperan

Store at room temperature.

What side effects when taking Primperan may occur ?

Side effects cannot be anticipated with Primperan. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Primperan.

More common side effects when taking Primperan may include:

Drowsiness, fatigue, restlessness

Less common or rare side effects when taking Primperan may include:

Breast development in males, confusion, congestive heart failure, continual discharge of milk from the breasts, depression, diarrhea, dizziness, fluid retention, frequent urination, hallucinations, headache, high or low blood pressure, high fever, hives, impotence, inability to hold urine, insomnia, menstrual irregularities, nausea, rapid or slow heartbeat, rash, rigid muscles, slow movement, swollen tongue or throat, tremor, vision problems, wheezing, yellowed eyes and skin
In addition, Primperan may cause symptoms similar to those of Parkinson's disease, such as slow movements, rigidity, tremor, or a mask-like facial appearance.

Especially in older people, Primperan may produce tardive dyskinesia, a syndrome of jerky or writhing involuntary movements, particularly of the tongue, face, mouth, or jaw. In children and adults under 30, Primperan may cause involuntary movements of the arms and legs, and sometimes loud or labored breathing, usually in the first day or two of treatment.

Primperan may cause intense restlessness with associated symptoms such as anxiety, agitation, foot-tapping, pacing, inability to sit still, jitteriness, and insomnia. These symptoms may disappear as your body gets used to Primperan, or if your dosage is reduced.

Why should Primperan not be prescribed ?

Do not take Primperan if you are sensitive to it or have ever had an allergic reaction to Primperan.

You should not take Primperan if you have a condition such as obstruction, perforation, or hemorrhage of the stomach or small bowel that might be aggravated by increased stomach and small-bowel movement.

If you have pheochromocytoma (a nonmalignant tumor that causes hypertension), do not take Primperan; it could trigger a dangerous jump in blood pressure.

Do not take Primperan if you have epilepsy; it could increase the frequency and severity of seizures.

If you are taking a drug that is likely to cause side effects such as tremors, jerks, grimaces, or writhing movements, do not take Primperan; it could make such symptoms more severe.

Primperan is not recommended for patients under 18 years of age.

Special warnings about Primperan

If you have Parkinson's disease, you should be given Primperan cautiously or not at all, since the drug may make your Parkinson's symptoms worse.

Because Primperan may make you drowsy and impair your coordination, you should not drive, climb, or perform hazardous tasks until you know how the medication affects you.

Use Primperan with caution if you have high blood pressure. Be careful, too, if you have cirrhosis or congestive heart failure. Under these conditions, Primperan may cause fluid retention and heart problems. If this happens during the first few weeks of Primperan therapy, you'll have to stop taking Primperan.

Possible food and drug interactions when taking Primperan

If Primperan is taken with certain other drugs, the effects of either could be increased, decreased, or altered.

It is especially important to check with your doctor before combining Primperan with the following:

Acetaminophen (Tylenol)
Alcoholic beverages
Antispasmodic drugs such as Bentyl and Pro-Banthine
Cimetidine (Tagamet)
Cyclosporine (Sandimmune)
Digoxin (Lanoxin)
Insulin
MAO inhibitor antidepressants such as Nardil and Parnate
Levodopa (Sinemet)
Narcotic painkillers such as Percocet and Demerol
Sleeping pills such as Dalmane, Halcion, and Restoril
Tetracycline (Sumycin, others)
Tranquilizers such as Valium and Xanax

If you take insulin for diabetes, your insulin dosage or dosing schedule may have to be adjusted while you are taking Primperan.

Special information if you are pregnant or breastfeeding

The effects of Primperan during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Primperan should be used during pregnancy only if it is clearly needed. Primperan appears in breast milk. Your doctor may recommend that you discontinue Primperan while you are breastfeeding your baby.

Recommended dosages for Primperan

ADULTS

Symptoms of Gastroesophageal Reflux
The usual dose is 10 milligrams to 15 milligrams of Primperan, up to 4 times a day, 30 minutes before each meal and at bedtime, depending upon the symptoms being treated and the effectiveness of the dose. Treatment usually lasts no longer than 12 weeks.

If symptoms occur only intermittently or at specific times of the day, your doctor may give you a single dose of up to 20 milligrams as a preventive measure.

Symptoms Associated with Diabetic Gastroparesis or Gastric Stasis

The usual dose is 10 milligrams 30 minutes before each meal and at bedtime for 2 to 8 weeks.

OLDER ADULTS

Relief of Symptomatic Gastroesophageal Reflux
Older adults may need only 5 milligrams per dose.

Overdosage with Primperan

Any medication taken in excess can have serious consequences. If you suspect an overdose of Primperan, seek medical attention immediately.

Symptoms of Primperan overdose may include:

Disorientation, drowsiness, involuntary movements