GERD: Any substitute for Propulsid in treating GERD


Topic: Irritable Bowel Syndrome (IBS), June 2000

Dr. Lee:
Since Propulsid is no longer available, what do you use as a prokinetic agent in treating GERD?

Dr. Marks:
The only prokinetic agent available to use is Reglan (or metoclopramide). And it is an effective medication in treating acid reflux. It works in two ways. First, it tightens the muscle at the lower end of the esophagus which prevents acid from refluxing. Second, it causes the stomach to empty faster and, therefore, there is less acid in the stomach to reflux.

Despite its effectiveness in treating reflux, Reglan in not as effective as medications that suppress acid, in particular Prilosec and other proton pump inhibitors. Reglan is rarely used alone in treating reflux. Instead, it is added to other acid-suppressing medications, like Prilosec.

Despite the fact that Reglan is added to other medications, it has not been shown that adding Reglan to these other medications improves the effectiveness of treatment.

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