Does taking metoclopramide in pregnancy increase the chance of other pregnancy related problems?
Metoclopramide
This sheet is about exposure to metoclopramide in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is metoclopramide?
Metoclopramide is a medication that has been used to treat gastrointestinal (stomach / bowel) motility issues, for nausea and vomiting caused by surgical operations, chemotherapy, or pregnancy, and to help with lactation. This medication has been sold under band names such as Reglan®, Maxolon® or Metozolv ODT®.
Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
If you are experiencing nausea and vomiting or gastrointestinal problems that are affecting your ability to function, speak with your healthcare provider about which treatment(s) would be best for you during pregnancy. For more information on nausea and vomiting of pregnancy, please see the MotherToBaby fact sheet on Nausea and Vomiting in Pregnancy at https://mothertobaby.org/fact-sheets/nausea-vomiting-pregnancy-nvp/.
I take metoclopramide. Can it make it harder for me to get pregnant?
Studies have not suggested that metoclopramide would affect fertility (a person’s ability to get pregnant).
There have been some reports of menstrual problems and galactorrhea (milk production that is not related to breastfeeding) among people who have taken metoclopramide. Those who have these side effects might have a harder time becoming pregnant.
Does taking metoclopramide increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. A small number of studies did not find an increased chance for miscarriage among people taking metoclopramide.
Does taking metoclopramide increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the studies reviewed, an increased chance for birth defects is not expected when metoclopramide is used in pregnancy.
Does taking metoclopramide in pregnancy increase the chance of other pregnancy related problems?
Based on the studies reviewed, it is not known if metoclopramide can cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). One study showed no increased risk of stillbirth in pregnancies exposed to metoclopramide.
There are case reports of people who developed severe side effects while taking metoclopramide during pregnancy which required them to be admitted to a hospital for treatment. In these reports, two people developed movement disorders (known as tardive dyskinesia) and two other people developed intermittent porphyria (a condition that affects the body’s ability to make red blood cells) which led to psychiatric conditions. All reports showed that these people got well with treatment and went on to have healthy newborns.
Another report describes a person with high blood pressure who was pregnant and taking metoclopramide. It was suggested that the use of metoclopramide was related to headache, fast heart rate (tachycardia) and severe high blood pressure in this person.
These reports do not tell us how often these side effects may occur during pregnancy. If you are taking metoclopramide tell your healthcare provider about any changes in your mood, changes in movement such as lip smacking, jerky eye movements, or jerky limb movements, headache, fast heart rate, or high blood pressure.
Does taking metoclopramide in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if metoclopramide can cause behavior or learning issues for the child.
Breastfeeding while taking metoclopramide:
There is limited information on the use of metoclopramide during breastfeeding. Metoclopramide can cross into the breast milk. Most reports have not listed any side effects in nursing infants. If you suspect the baby has any symptoms (such as stomach discomfort and gas), contact the child’s healthcare provider.
Metoclopramide use while breastfeeding might increase your chance for post-partum depression. Any changes in your mood should be reported to your healthcare provider. Be sure to talk to your healthcare provider about all of your breastfeeding questions.
Metoclopramide is sometimes used to try and increase milk supply (galactagogue). Studies looking at whether metoclopramide increases or causes milk production are limited, and results of these studies have been mixed. If you are having trouble with milk production, talk with your healthcare provider or a lactation consultant.
If a male takes metoclopramide, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?
Studies have not been done to see if metoclopramide could affect male fertility or increase the chance of birth defects. There is no evidence that suggests that a male’s use of metoclopramide would cause any problems during a pregnancy. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
Please click here to view references.
OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
Metoclopramide
Taking metoclopramide may cause you to develop a muscle problem called tardive dyskinesia. If you develop tardive dyskinesia, you will move your muscles, especially the muscles in your face in unusual ways. You will not be able to control or stop these movements. Tardive dyskinesia may not go away even after you stop taking metoclopramide. The longer you take metoclopramide, the greater the risk that you will develop tardive dyskinesia. Therefore, your doctor will probably tell you not to take metoclopramide for longer than 12 weeks. The risk that you will develop tardive dyskinesia is also greater if you are taking medications for mental illness, if you have diabetes, or if you are elderly, especially if you are a woman. Call your doctor immediately if you develop any uncontrollable body movements, especially lip smacking, mouth puckering, chewing, frowning, scowling, sticking out your tongue, blinking, eye movements, or shaking arms or legs.
Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with metoclopramide and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.
Talk to your doctor about the risks of taking metoclopramide.
Why is this medication prescribed?
Metoclopramide is used to relieve heartburn and speed the healing of ulcers and sores in the esophagus (tube that connects the mouth to the stomach) in people who have gastroesophageal reflux disease (GERD; condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus) that did not get better with other treatments. Metoclopramide is also used to relieve symptoms caused by slow stomach emptying in people who have diabetes. These symptoms include nausea, vomiting, heartburn, loss of appetite, and feeling of fullness that lasts long after meals. Metoclopramide is in a class of medications called prokinetic agents. It works by speeding the movement of food through the stomach and intestines.
How should this medicine be used?
Metoclopramide comes as a tablet, an orally disintegrating (dissolving) tablet, and a solution (liquid) to take by mouth. It is usually taken 4 times a day on an empty stomach, 30 minutes before each meal and at bedtime. When metoclopramide is used to treat symptoms of GERD, it may be taken less frequently, especially if symptoms only occur at certain times of day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take metoclopramide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking the orally disintegrating tablet, use dry hands to remove the tablet from the package just before you take your dose. If the tablet breaks or crumbles, dispose of it and remove a new tablet from the package. Gently remove the tablet and immediately place it on the top of your tongue. The tablet will usually dissolve in about one minute and can be swallowed with saliva.
If you are taking metoclopramide to treat the symptoms of slow stomach emptying caused by diabetes, you should know that your symptoms will not improve all at once. You may notice that your nausea improves early in your treatment and continues to improve over the next 3 weeks. Your vomiting and loss of appetite may also improve early in your treatment, but it may take longer for your feeling of fullness to go away.
Continue to take metoclopramide even if you feel well. Do not stop taking metoclopramide without talking to your doctor. You may experience withdrawal symptoms such as dizziness, nervousness, and headaches when you stop taking metoclopramide.
Other uses for this medicine
Metoclopramide is also sometimes used to treat the symptoms of slowed stomach emptying in people who are recovering from certain types of surgery, and to prevent nausea and vomiting in people who are being treated with chemotherapy for cancer. Ask your doctor about the risks of using this medication to treat your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking metoclopramide,
- tell your doctor and pharmacist if you are allergic to metoclopramide, any other medications, or any of the ingredients in metoclopramide tablets or solution. Ask your doctor or pharmacist or check the Medication Guide for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take while taking metoclopramide. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
- tell your doctor if you have or have ever had blockage, bleeding, or a tear in your stomach or intestines; pheochromocytoma (tumor on a small gland near the kidneys); or seizures. Your doctor will probably tell you not to take metoclopramide.
- tell your doctor if you have or have ever had Parkinson’s disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance); high blood pressure; depression; breast cancer; asthma;glucose-6-phosphate dehydrogenase (G-6PD) deficiency (an inherited blood disorder); NADH cytochrome B5 reductase deficiency (an inherited blood disorder); or heart, liver, or kidney disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking metoclopramide, call your doctor.
- talk to your doctor about the risks and benefits of taking metoclopramide if you are 65 years of age or older. Older adults should not usually take metoclopramide, unless it is used to treat slow stomach emptying, because it is not as safe or effective as other medications that can be used to treat those conditions.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking metoclopramide.
- you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- ask your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects of metoclopramide worse.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your regular diet.
