Reglan long term

[Mommyof2]

I was wondering what is the recommended length of long term use of Reglan? Are there any significant risk to taking it long term? Should you tapper down to wean off Reglan? I plan on breastfeeding for about two more months and I have Ben on Reglan for about 1/2 month. Thank you for your help.

[admin]

Mommyof2:

Reglan (metoclopramide) has some rather nasty side effects in adults and I would not recommend its use past 3 months for sure. I'd suggest you get your milk supply working, breastfeed following by pumping to build your supply then start tapering the dose after the first month to 6 weeks. I would not recommend its use much past this as the risk of depression, extrapyramidal jerking, etc, starts to appear after 1-3 months.

If your milk supply decreases as you come off the Reglan, your only safe choice is Domperidone. Check the internet for sources for this drug. Do not use if you have any cardiac rhythm abnormalities, and only use 10-20 mg three times daily. I'd consult your physician and tell him/her that domperidone has a remote risk of prolonged QT interval, like about 120 other drugs on the US market. It has not CNS side effects which is wonderful.

But hopefully, you can transition off the Reglan and not need anything.

Tom Hale Ph.d.

[Mommyof2]

Thank you so much for your response Dr. Hale. i greatly appreciate your time and advice. I have taken your advice and have tapered off Reglan and I am now off of it completely. I have already noticed a significant drop in my milk. Would it be safe to do another taper up then taper down two week course like I just finished after taking a break from Reglan? If so, how long would it be safe to wait? I have started back Fenugreek and Blessed Thistle. I have also been pumping whenever I can. I talked to my doctor about the Domperidone before I took Reglan and they will not write me a prescription for it. I took Domperidone for about three months with my first child and did fine on it. If I can make it two more months I will make to my baby's first birthday which is my goal. Thank you again Dr. Hale for your advice!

[admin]

Mommyof2:

I assume you could go back on Reglan for a while, but I imagine if you taper you will have the same experience, a reduced milk supply. This happens with many women and there's nothing one can do except take more Reglan or Domperidone.

I would not however, exceed 3 months of Reglan therapy as the risk of Tardive Dyskinesia rises after 3 months.

Tom Hale Ph.D.