Hospital Website says Reglan “safe” for Infants: that’s news to us…

February 18th, 2010. By AbiK

Use of Reglan for babies with GERD issues—particularly premature babies—as well as using Reglan to stimulate milk production for breastfeeding are hot topics on mommy message boards all over the internet. Boards about colic, GERD, low milk production, premature births, and even morning sickness debate the pro’s and con’s of using Reglan to provide relief—or help things get moving properly.

But it’s also a well-known fact that Reglan can only be prescribed off label for the above uses, and that no studies have been done on the effects of Reglan on infants. All we know is that Reglan carries a black box warning for Tardive Dyskinesia and that there’s a mixed bag of anecdotal experiences on all the mommy message boards and forums out there.

So why is this what’s written about Reglan use in infants with regurgitation, reflux or GER on the California Pacific Medical Center’s website?…

Medications
When basic measures fail to control symptoms, medication may be indicated. Usually, two types of medication are used. Acid-blocking medications (famotidine/Pepcid, ranitidine/Zantac, cimetidine/Tagamet, omeprazole/Prilosec and lansoprazole/ Prevacid) suppress stomach acid and prevent it from doing damage to the esophagus and lungs. Pro-motility agents (bethanechol, metoclopramide/Reglan, cisapride/ Propulsid) help to strengthen the tone of the lower sphincter and increase gastric emptying. For children these medications are by prescription only.

All of these medications are safe in infants and children [my bolding] and have only minor side effects. If your child experiences side effects, we will adjust the dose or change medication.

No qualifying statements or footnotes. No references to use of Reglan in this capacity being off-label. No mentions of the info you’ll see on rxlist.com (run by webmd.com) for Reglan use in children, which reflects Reglan’s monograph:

Pediatric Use

Safety and effectiveness in pediatric patients have not been established (see OVERDOSAGE).

Care should be exercised in administering metoclopramide to neonates since prolonged clearance may produce excessive serum concentrations (see CLINICAL PHARMACOLOGY – Pharmacokinetics). In addition, neonates have reduced levels of NADH-cytochrome b5 reductase which, in combination with the aforementioned pharmacokinetic factors, make neonates more susceptible to methemoglobinemia (see OVERDOSAGE).

The safety profile of metoclopramide in adults cannot be extrapolated to pediatric patients. Dystonias and other extrapyramidal reactions associated with metoclopramide are more common in the pediatric population than in adults. (See WARNINGS and ADVERSE REACTIONS – Extrapyramidal Reactions.)

 What gives California Pacific Medical Center?

Tags: Breastfeeding, GERD, Reglan

This was posted on Thursday, February 18th, 2010 at 1:48 pm and is filed under Drugs/Medical . Feel free to respond, or trackback. Read our comments policy.