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Reglan®, also sold under its generic name metoclopramide hydrochloride, is used as a treatment for diabetic gastroparesis or diabetic gastric stasis as well as to prevent nausea and vomiting in patients undergoing chemotherapy treatments. The drug is also used to aid in radiological examinations when delayed gastric emptying may interfere and in small bowel intubations when the tube is unable to pass the pylorus. Dosage requirements depend on the condition this drug is treating. Patients with diminished kidney function may need adjustments to their Reglan® dosage due to differences in the speed at which they metabolize and excrete the drug and its metabolites.
Patients who are receiving Reglan® for the prevention of nausea and vomiting associated with chemotherapy should be given the drug intravenously half an hour before their treatment and over a period of no less than 15 minutes. An additional course may given if needed two hours, four hours, seven hours, 10 hours and 13 hours thereafter. When highly nauseating drugs like decarbazine or cisplatin are employed, the Reglan® dosage for the first two doses should be 2 mg per 2.2 lbs (1 kg) of body weight. For use with less nauseating drugs, a dose of 1 mg per 2.2 lbs (1 kg) may be sufficient. If the patient exhibits an acute dystonic reaction to the drug, the intramuscular injection of 50 mg of diphenhydramine hydrochloride should control the symptoms.
When using the medication to prevent nausea and vomiting upon recovery from anesthesia, it should be administered by intramuscular injection toward the end of the surgical procedure. The adult Reglan® dosage for post-surgical nausea is 10 mg. Some patients may benefit from doses as high as 20 mg though.
Reglan® can be used to facilitate some lower intestinal procedures. If delayed gastric evacuation is preventing a radiological examination, the administration of the drug by intravenous drip over two minutes may suffice. Adult patients should receive a 10 mg Reglan® dosage, while patients between the ages of six and 14 should receive between 2.5 and 5 mg doses. The recommended Reglan® dosage for patients under six years of age is 0.1 mg per 2.2 lbs (1 kg) of body weight. The same approach may be used to facilitate conventional small bowel intubation if the tube has not passed the pylorus within 10 minutes.
These dosage guidelines may need to be revised in patients with severe impairment of kidney function. This is defined as having a creatine clearance (CrCl) of less than 40 ml per minute. Adjustments to Reglan® dosage are not believed to be required for patients with diminished liver function.
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