Use this tool to determine which anti-nausea medication might be best for your condition based on key factors.
Reglan (generic name Metoclopramide) is a dopamine‑receptor antagonist used to treat nausea, vomiting, and delayed stomach emptying. It comes in tablets, oral syrup, and injectable form.
Reglan is often prescribed when other anti‑nausea drugs haven’t helped, but it carries a unique side‑effect profile that makes many patients look for alternatives.
If you’ve been warned about tremors, drowsiness, or the rare risk of tardive dyskinesia, you’re not alone. Those concerns push doctors and patients toward drugs that work the same way without the same nervous‑system warnings. Below we break down the most common substitutes, what they do, and when they shine.
| Drug | Primary Mechanism | Typical Uses | Common Dose | Key Side Effects | Prescription Status |
|---|---|---|---|---|---|
| Reglan (Metoclopramide) | Dopamine D2 receptor antagonist (central & peripheral) | Nausea, vomiting, gastroparesis, migraine headache | 10‑15mg orally 3‑4times daily | Tremor, drowsiness, ↑ prolactin, tardive dyskinesia (rare) | Prescription only |
| Domperidone | Peripheral dopamine D2 antagonist (no CNS penetration) | Gastroparesis, reflux, nausea | 10‑20mg orally before meals | Headache, dry mouth, QT prolongation (high doses) | Prescription (OTC in some EU countries) |
| Ondansetron | 5‑HT3 serotonin receptor antagonist | Chemo‑induced nausea, post‑op nausea, hyperemesis gravidarum | 4‑8mg orally or IV once daily | Constipation, headache, rare QT prolongation | Prescription |
| Prochlorperazine | Phenothiazine dopamine antagonist | Severe nausea, vertigo, psychosis (off‑label) | 5‑10mg orally 3‑4times daily | Sedation, extrapyramidal symptoms, low blood pressure | Prescription |
| Promethazine | H1 antihistamine with anti‑serotonin activity | Motion sickness, nausea, allergic reactions, sedation | 12.5‑25mg orally 2‑3times daily | Severe drowsiness, anticholinergic effects, respiratory depression (children) | Prescription (OTC in limited strengths) |
| Erythromycin (low‑dose) | Motilin receptor agonist (pro‑kinetic effect) | Gastroparesis, functional dyspepsia | 250mg orally 4times daily | Abdominal cramps, diarrhea, antibiotic resistance risk | Prescription (sometimes compounded) |
| Cisapride | Serotonin‑4 (5‑HT4) agonist | Severe refractory gastroparesis | 5‑10mg orally 3times daily | QT prolongation, arrhythmia (why it was withdrawn) | Restricted/compassionate‑use only |
Here’s a quick decision‑tree you can run through with your doctor:
Always discuss these points with a healthcare professional. The best choice balances how well the drug works for you against the side‑effect risk you’re willing to accept.
Seek medical advice if you experience any of the following while on these drugs:
Early intervention can prevent complications and allow a switch to a safer alternative.
Yes, many clinicians start with domperidone because it stays out of the brain, lowering the chance of tremors or tardive dyskinesia. However, it may need ECG monitoring for QT prolongation, especially at higher doses.
Ondansetron is classified as Category B in the UK, meaning animal studies show no risk and limited human data are reassuring. It’s often the go‑to drug for severe morning sickness when other options fail.
Stop the medication immediately and contact your doctor. A short taper may be recommended, and the clinician might switch you to domperidone or a serotonin‑based anti‑emetic.
Cisapride was linked to serious heart rhythm disturbances (QT prolongation) that could trigger fatal arrhythmias. It remains available only through special compassionate‑use programs for patients who have no other options.
Both drugs cause sedation, so mixing them can lead to excessive drowsiness or respiratory depression, especially in the elderly. It’s best to avoid the combo unless a doctor explicitly advises it.
