UPDATE: FDA Requires Boxed Warning For Metoclopramide Drugs
February 26 2009 - 4:15PM
Dow Jones News
The U.S. Food and Drug Administration said Thursday it was
requiring manufacturers of metoclopramide, a drug used to treat
gastrointestinal disorders, to add a boxed warning to their drug
labels about the risk of developing a neurological disorder.
The agency said metoclopramide has been linked to tardive
dyskinesia, a neurological disorder that can be a side effect of
some types of drugs. The condition is marked by involuntary and
repetitive movements of the body, even after the drugs are no
longer taken. Current drug labels for metoclopramide already warn
of the risk of developing tardive dyskinesia. But requirement of a
boxed warning, which appears at the top of drug labels, means the
agency is strengthening the warning.
The FDA said development of tardive dyskinsia "is directly
related to the length of time a patient is taking metoclopramide
and the number of doses taken." The FDA said the elderly and people
who have been on the drug for a long time are at highest risk.
Metoclopramide, a generic drug, is used by more than two million
Americans and is made by several drug makers including Baxter
Healthcare Corp. (BAX), according to the FDA. The products are
available in a variety of formulations including tablets, syrups
and injections and are sold under brand names including Reglan
Tablets, Reglan Oral Disintegrating Tablets, Metoclopramide Oral
Solution and Reglan Injection.
"The chronic use of metoclopramide therapy should be avoided in
all but rare cases where the benefit is believed to outweigh the
risk," said Janet Woodcock, the director of FDA's Center for Drug
Evaluation and Research.
Erin Gardiner, a Baxter spokeswoman, which makes an injectable
form of metoclopramide, said the product has been safely and
effectively used for more than 30 years and that tardive dyskinsia
is a "rare" side effect. However, she said, Baxter would add the
boxed warning to Reglan's label and provide patients with a
medication guide that outlines the risks and benefits of the
drug.
Metoclopramide works by speeding up the movement of the stomach
muscles and increases the rate at which the stomach empties into
the intestines. It is used as a short-term treatment of
gastroesophageal reflux disease in patients who have not responded
to other therapies, and to treat diabetic gastroparesis, the FDA
said. It's recommended that treatment not exceed three months.
-By Jennifer Corbett Dooren, Dow Jones Newswires; 202-862-9294;
jennifer.corbett@dowjones.com