New metoclopramide nasal spray (Gimoti) can worsen Parkinson's: Tips on treating GI issues
Picture from contractpharma.com
What is metoclopramide (Reglan)?
Metoclopramide (Reglan) is a medication used to treat gastroparesis. But a caution: It is absolutely not recommended in Parkinson’s disease. It can cause worsening of symptoms of Parkinson’s disease and cause dystonia (involuntary muscle contraction that can cause twisting or pulling) and other movement disorders.
Why do these drugs worsen Parkinson’s?
Anti-nausea agents that block dopamine, such as metoclopramide or promethazine, can significantly worsen Parkinson’s symptoms (meaning they are contraindicated). Agents such as
ondansetron (5HT3 antagonists), trimethobenzamide, or domperidone have all been used successfully with Parkinson’s disease.
Why is domperidone a better option for
gastrointestinal issues in Parkinson’s?
Domperidone, despite being anti-dopamine, works only in the peripheral blood and not in the brain. Thus, domperidone does not have a significant effect at the level of the brain cells and will not worsen Parkinson’s disease symptoms. This is an excellent choice for treatment of gastrointestinal symptoms of Parkinson’s.
What other common drugs could worsen Parkinson’s?
Metoclopramide, Phenergan, and Compazine are all common drugs administered for other medical reasons (commonly for headache); however, these drugs will make Parkinson’s disease symptoms worse.
What is Gimoti® (metoclopramide) nasal spray?
Gimoti is a new FDA approved nasal spray formulation of metoclopramide. We do not recommend this for use in Parkinson’s or movement disorders. This medication formulation has been associated with movement disorders similar to the pill form. The company also states that there are potential effects such as “other changes in muscle control and movement, such as, uncontrolled spasms of your face and neck muscles, or muscles of your body, arms, and legs (dystonia), parkinsonism – slight shaking, body stiffness, and trouble moving or keeping your balance, being unable to sit still or feeling that you need to move your hands, feet, or body (akathisia), Neuroleptic Malignant Syndrome (NMS) – a very rare but very serious condition. NMS can lead to death and must be treated in a hospital, and depression, thoughts about suicide, and suicide.”
To read more books and articles by Michael S. Okun MD check on Twitter @MichaelOkun and these websites with blogs and information on his books and http://parkinsonsecrets.com/ #Livingwith Parkinson’s #EndingPD #Parkinsonsecrets #LessonsFromTheBedside
He also serves as the Medical Advisor for the Parkinson’s Foundation.
To see more on Dr. Indu Subramanian she does live interviews of experts in Parkinson’s for the PMD Alliance.
The blog artist is Jonny Acheson.