meginreglan

Meginreglan is a brand name used in some regions for metoclopramide, a medication that acts as both an antiemetic and a prokinetic agent. The active ingredient metoclopramide is a dopamine D2 receptor antagonist with additional activity on serotonin receptors, which underpins its therapeutic effects and side-effect profile.

Indications for metoclopramide include prevention of nausea and vomiting associated with surgery or chemotherapy, as well as treatment of gastroesophageal reflux disease and symptoms related to diabetic or idiopathic gastroparesis. It is sometimes used to accelerate gastric emptying in patients with delayed stomach emptying.

Mechanism of action involves central and peripheral effects. By antagonizing D2 receptors in the chemoreceptor trigger zone, it reduces nausea. Peripherally, metoclopramide enhances upper gastrointestinal motility by stimulating acetylcholine release through serotonin 5-HT4 receptor activity, which increases gastric emptying and boosts lower esophageal sphincter tone.

Common routes of administration include oral tablets, orally disintegrating tablets, oral solutions, and parenteral forms (intravenous or intramuscular). The drug is primarily metabolized in the liver and has a typical duration compatible with multiple dosing regimens; the half-life is generally in the range of several hours, with renal excretion playing a role in elimination.

Adverse effects range from drowsiness and fatigue to extrapyramidal symptoms such as dystonia or akathisia, particularly with higher doses or prolonged use. Rare but serious risks include tardive dyskinesia, neuroleptic malignant syndrome, and QT interval prolongation. Metoclopramide is contraindicated in cases of mechanical GI obstruction, perforation, or hemorrhage, and in patients with known hypersensitivity or certain seizure disorders. Use in pregnancy or lactation requires medical assessment of benefits versus risks.