Alternatives to Reglan: What Works When Reglan Isn't Right

When Reglan, a dopamine antagonist used to treat nausea and delayed stomach emptying. Also known as metoclopramide, it stops working—or causes side effects like tremors, fatigue, or restless legs—people need options. Reglan isn’t the only drug that helps with nausea, acid reflux, or gastroparesis. Many patients switch because the risks outweigh the benefits, especially with long-term use. The good news? There are several proven alternatives that work just as well, sometimes better, and with fewer neurological side effects.

One major category of alternatives includes other dopamine antagonists, medications that block dopamine receptors to reduce nausea and speed up stomach emptying. Drugs like prochlorperazine and promethazine are older but still used, especially for acute vomiting. Then there’s domperidone, which works similarly to Reglan but doesn’t cross the blood-brain barrier as easily, meaning fewer brain-related side effects. It’s not FDA-approved in the U.S., but many doctors prescribe it off-label or patients get it through trusted international pharmacies. For those with gastroparesis, erythromycin—a common antibiotic—can act as a motilin receptor agonist, triggering stomach contractions naturally. It’s not a long-term fix due to tolerance, but it’s effective for short bursts.

For people whose main issue is acid reflux or heartburn rather than slow digestion, proton pump inhibitors, medications that reduce stomach acid production like omeprazole or pantoprazole often help more than Reglan. They don’t fix stomach emptying, but they reduce the burning sensation that makes people feel sick. If nausea comes from migraines or inner ear problems, anti-seizure drugs like topiramate or even low-dose antidepressants like amitriptyline can be surprisingly effective. And for those who want to avoid pills altogether, non-drug options like acupuncture, ginger supplements, or even acupressure wristbands have real evidence behind them—especially for pregnancy-related nausea or chemo-induced vomiting.

What’s missing from most lists is the importance of matching the cause to the treatment. Reglan is often prescribed as a one-size-fits-all fix for nausea, but nausea isn’t one condition. It can come from gastroparesis, migraines, chemotherapy, pregnancy, or even anxiety. The best alternative depends on why you’re feeling sick in the first place. That’s why the posts below dive into real comparisons—like how domperidone stacks up against metoclopramide, why erythromycin works for some but not others, and what over-the-counter options actually have clinical backing. You’ll find detailed breakdowns of side effects, costs, and real patient experiences—not just drug names. No fluff. No marketing. Just what works, what doesn’t, and what to ask your doctor next.