Monday Pharmaceutical Mystery: April 27

Gunda Siska, PharmD

Gunda Siska, PharmD, has worked in various fields within the pharmaceutical industry as a licensed pharmacist for more than 20 years. She is currently a staff hospital pharmacist assisting nurses and doctors with drug prescribing, administration, and dispensing, as well as independently monitoring and dosing highly toxic and dangerous drugs. For 2 years, she was concurrently a consultant pharmacist for skilled nursing facilities and nursing homes. Dr. Siska is a member of the New Mexico Society of Health-System Pharmacists and the American Academy of Anti-Aging Medicine. Follow her on Twitter @GundaSiska

Why was a patient prescribed something normally used for stomach problems to help her produce breastmilk?

A lady with a newborn baby comes into the pharmacy. She asks to speak to the pharmacist. You approach the counter, hands you a bottle of medication and says it’s not working.

She took this medication for 2 days and nothing happened. Then she looked up the medication on the internet and found out it is for stomach problems. She was expecting her doctor to give her something to help her produce breastmilk to feed her newborn baby.

You look at the bottle of medication, and it is for metoclopramide (Reglan) 10 mg tid. #90.

Mystery: Why did her doctor prescribe something that is normally used for stomach problems when she needs something to help her produce breastmilk for her newborn?

Solution: Metoclopramide is a galactagogue. It is used for initiating or augmenting maternal milk production. She has only been taking it for 2 days, and prolactin levels slowly go up with time. It is possible that her milk production will start after several more days, or possibly weeks of taking the drug.

REFERENCE

Drugs and Lactation Database (LactMed) [online]. Bethesda, MD: National Library of Medicine (US); 2006-. Metoclopramide. https://www.ncbi.nlm.nih.gov/books/NBK501352/ Updated October 31, 2018. Accessed April 25, 2020.