Sancuso vs. Reglan for Nausea: Important Differences and Potential Risks.

Key takeaways

Sancuso (granisetron) and Reglan (metoclopramide) are both used to manage nausea and vomiting, but they work differently and are used for different conditions. Sancuso (granisetron) is a patch that blocks serotonin to prevent nausea and vomiting caused by chemotherapy. It is applied to the skin and can be worn for up to 7 days. Reglan (metoclopramide), on the other hand, is an oral medication that blocks dopamine to treat gastroesophageal reflux disease (GERD) and diabetic gastroparesis. It is taken multiple times a day and has a black box warning for a serious side effect called tardive dyskinesia, which involves uncontrolled muscle movements. Sancuso is generally well-tolerated with few side effects, while Reglan can cause drowsiness, restlessness, and some serious side effects including seizures. Additionally, generic Reglan is available in various forms, including tablets and nasal spray, whereas Sancuso is a brand-name patch that can be very expensive.

Sancuso

(granisetron)

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Metoclopramide

(Reglan)

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Summary for Sancuso

Prescription only

Sancuso, the brand name for the granisetron patch, is used to prevent nausea and vomiting caused by chemotherapy. This antiemetic medication is approved for adults only. You typically apply a patch to the skin on the upper outer arm 1 to 2 days before chemotherapy. The patch slowly releases your dose over several days. The most common side effect of Sancuso (granisetron) is constipation.

Indications for Sancuso

Prevention of nausea and vomiting caused by cancer medications (chemotherapy)

Pros and Cons for Sancuso

Pros

Good option for people who don't like to take pills
Each patch prevents nausea and vomiting around the clock for up to 7 days
A convenient option for those on multi-day chemotherapy regimens
Usually well-tolerated with few side effects

Cons

Only approved for adults
Can only wear each patch for up to 7 days, even if you still have nausea
Need to apply to nearly hairless skin
Must place on the upper outer arm, so it might be visible to others

Common Side Effects for Sancuso

Constipation (5%)

Warnings for Sancuso

Digestion problems
Serotonin syndrome
Skin reactions
Possible side effects with heat and sun exposure to the patch

Summary for Reglan

Prescription only

Metoclopramide (Reglan) is FDA-approved to treat gastroesophageal reflux disease (GERD), as well as gastroparesis in people with diabetes. Providers might also prescribe it off-label for morning sickness during pregnancy and nausea and vomiting caused by chemotherapy. But metoclopramide (Reglan) isn’t a first-choice medication for these conditions because it has a black box warning for a serious side effect called tardive dyskinesia. Metoclopramide (Reglan) can interact with some commonly prescribed medications, such as risperidone (Risperdal) and quetiapine (Seroquel).

Indications for Reglan

Delayed stomach-emptying caused by diabetes (diabetic gastroparesis)
Severe acid reflux (gastroesophageal reflux disease or GERD) when other medications haven’t worked

Pros and Cons for Reglan

Pros

Available as a lower-cost generic medication
Available in many forms including tablet, fast-melting tablet, liquid, nasal spray, and injection
Typically starts to work in 30 minutes to 1 hour
A possible option during pregnancy

Cons

Shouldn’t be used in children or for more than 12 weeks because of a higher risk of serious side effects
Needs to be taken multiple times a day
Interacts with a lot of medications such as antipsychotics, antidepressants, and opioids
Can't be used if you have Parkinson's disease, seizures, or stomach blockages or bleeds

Common Side Effects for Reglan

Restlessness (10%)
Drowsiness (10%)
Lack of energy (10%)
Tiredness (10%)

Warnings for Reglan

Difficulty controlling muscle movements (tardive dyskinesia)
Other conditions with uncontrolled muscle movements (dystonia, Parkinsonian symptoms, and restlessness)
Neuroleptic malignant syndrome (NMS)
Depression and suicidal thoughts and behavior
High blood pressure
Swelling in arms, legs, or around the belly
High prolactin levels