Side effects associated with<unk>  include dry mouth, abdominal cramps, diarrhea, nausea, rash, itching, hives, and hyperprolactinemia (the symptoms of which may include breast enlargement, galactorrhea, breast pain/tenderness, gynecomastia, hypogonadism, and menstrual irregularities). Due to blockade of D2 receptors in the central nervous system, D2 receptor antagonists like metoclopramide can also produce a variety of additional side effects including drowsiness, akathisia, restlessness, insomnia, lassitude, fatigue, extrapyramidal symptoms, dystonia, Parkinsonian symptoms, tardive dyskinesia, and depression. However, this is not the case with<unk> , because, unlike other D2 receptor antagonists, it minimally crosses the blood–brain barrier, and for this reason, is rarely associated with such side effects. Elevated prolactin levels Due to D2 receptor blockade,<unk>  causes hyperprolactinemia. Hyperprolactinemia can suppress the secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus, in turn suppressing the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and resulting in hypogonadism and low levels of the sex hormones estradiol and testosterone. Accordingly, 10 to 15% of females have been reported to experience mammoplasia (breast enlargement), mastodynia (breast pain/tenderness), galactorrhea (inappropriate or excessive milk production/secretion), and amenorrhea (cessation of menstrual cycles) with<unk>  therapy. Males may experience low libido, erectile dysfunction, and impaired spermatogenesis, as well as galactorrhea and gynecomastia. D2 receptor antagonists like antipsychotics and<unk>  may also increase the risk of prolactinomas, but more research is needed to confirm this. Rare reactions Cardiac complications<unk>  use is associated with an increased risk of sudden cardiac death (by 70%) most likely through its prolonging effect of the cardiac QT interval and ventricular arrhythmias. The cause is thought to be blockade of hERG voltage-gated potassium channels. The risks are dose-dependent, and appear to be greatest with high/very high doses via intravenous administration and in the elderly, as well as with drugs that interact with<unk>  and increase its circulating concentrations (namely CYP3A4 inhibitors). Conflicting reports exist, however. In neonates and infants, QT prolongation is controversial and uncertain. UK drug regulatory authorities (MHRA) have issued the following restriction on<unk>  in 2014 due to increased risk of adverse cardiac effects: However, a 2015 Australian review concluded the following: Possible central toxicity in infants In Britain a legal case involved the death of two children of a mother whose three children had all had hypernatraemia. She was charged with poisoning the children with salt. One of the children, who was born at 28 weeks gestation with respiratory complications and had a fundoplication for gastroesophageal reflux and failure to thrive was prescribed<unk> . An advocate for the mother suggested the child may have suffered neuroleptic malignant syndrome as a side effect of<unk>  due to the drug crossing the child's immature blood–brain barrier.
Domperidone
Primidone
Chlortalidone
Thioridazine
Cinolazepam
Fluparoxan
Mepiprazole
Ziprasidone