Users of this drug should be aware of its side effects.
Plasil is the international brand name for the drug based on the generic compound metoclopramide .
The drug is intended for patients with diabetes who have problems with their digestive activities and people with heartburn caused by gastroesophageal reflux disease .
Therapeutic uses
Plasil is an antiemetic drug and for gastrointestinal disorders.
Composition of plasil
- Each tablet contains: Metoclopramide Hydrochloride Anhydrous 10 mg.
Metoclopramide tablets are indicated as short-term therapy (4 to 12 weeks) for adults with documented symptomatic gastroesophageal reflux who do not respond to conventional therapy.
Metoclopramide tablets are indicated for the relief of symptoms associated with acute and recurrent diabetic gastric stasis.
The usual manifestations of delayed gastric emptying (eg, nausea, vomiting, heartburn, persistent fullness after meals, and anorexia) appear to respond to metoclopramide tablets at different time intervals.
Significant relief from nausea occurs early and continues to improve over a three-week period. Relief from vomiting and anorexia may precede relief from abdominal fullness by a week or more.
Contraindications
- History of tardive dyskinesia (TD) or a dystonic reaction to metoclopramide.
- When stimulation of GI motility can be dangerous (for example, obstruction, perforation or bleeding).
- Pheochromocytoma or other catecholamine-releasing paragangliomas.
- Epilepsy.
- Late dyskinesia.
Warnings and cautions
- Increased risk of TD with long-term use; avoid treatment> 12 weeks.
- Diabetes mellitus is discontinued if signs / symptoms of TD, extrapyramidal symptoms (EPS), parkinsonian symptoms, motor restlessness, or neuroleptic malignant syndrome (NMS) appear.
- Avoid in Parkinson’s disease, depression , hypertension.
- Cirrhosis. CHF Kidney or liver failure. NADH-cytochrome b 5 reductase deficiency. G6PD deficiency. CYP2D6 poor metabolisers.
Interactions
Avoid concomitant medications that may cause or may affect TD, EPS, or NMS (eg, antipsychotics).
Potentiated by strong CYP2D6 inhibitors (eg quinidine, bupropion, fluoxetine, paroxetine); reduce the dose.
Increased risk of hypertension with MAOIs; avoid.
Increased risk of CNS depression with alcohol, sedatives, hypnotics, opiates, anxiolytics. Antagonized by drugs that alter GI motility (eg, antidiarrheals, anticholinergics, opiates).
Avoid concomitant dopamine drugs (eg, apomorphine, bromocriptine, levodopa, ropinirole). Can enhance succinylcholine, mivacurium, sirolimus, tacrolimus, cyclosporine; control and adjust the dose.
Can antagonize digoxin (adjust dose), atovaquone, posaconazole (oral suspension), fosfomycin; display. Concomitant insulin: monitor and adjust the dose.
Side effects
Drowsiness and fatigue
A commonly reported side effect of plasil is drowsiness and fatigue.
Symptoms of drowsiness and fatigue vary in severity. Mild cases are not considered a serious side effect of plasil use, but extreme drowsiness or fatigue can be a sign of an overdose.
Diarrhea
diarrhea is a common but not serious side effect of taking plasil.
As the drug is designed in part to aid digestive processes, this side effect may initially be considered a natural part of the treatment.
If the diarrhea does not go away over time, it is recommended to see a doctor, especially if there is a history of intestinal irritation or a bowel disorder to consider.
Addiction
The main ingredient in Plasil, metoclopramide, has been found to be addictive. Drugs.com notes that it can be difficult to stop taking the drug due to the potential for withdrawal effects.
Patients who feel they are addicted to medication should consult their doctors for treatment.
Late dyskinesia
Metoclopramide treatment can lead to tardive dyskinesia, a potentially irreversible disorder manifested by involuntary movements of the tongue, face, mouth, or jaw and sometimes involuntary movements of the trunk and / or limbs.
The movements can have a choreoatotic appearance.
Although the risk of tardive dyskinesia with metoclopramide has not been widely studied, the syndrome has been reported in approximately 20% of patients who received the drug for at least 12 weeks.
Treatment with metoclopramide for more than 12 weeks should be avoided in all but rare cases, where the therapeutic benefit is thought to outweigh the risk of developing tardive dyskinesia.
Although the risk of developing tardive dyskinesia in the general population may increase in geriatric patients, women and patients with diabetes mellitus.
The risk of developing tardive dyskinesia and the likelihood of it becoming irreversible increases with increasing duration of treatment and total cumulative dose.
Metoclopramide should be discontinued in patients with signs or symptoms of tardive dyskinesia.
There is no known effective treatment for established cases of tardive dyskinesia, although the syndrome may resolve, either partially or completely, in some patients within several weeks or months after metoclopramide is stopped.
Metoclopramide itself can suppress or partially suppress the manifestations of tardive dyskinesia, masking the underlying disease process. It is unknown whether this symptomatic suppression affects the long-term course of tardive dyskinesia.
Therefore, metoclopramide should not be used for the symptomatic control of tardive dyskinesia.
Other side effects
- Restlessness.
- Fatigue.
- Fatigue.
- TD.
- EPS.
- Parkinsonismo.
- Akathisia.
- Seizures
- Hallucinations
- SMN.
- Hypertension (discontinue if occurs).
- Fluid retention (discontinue if occurs).
- hyperprolactinemia.
- Hypersensitivity reactions.
