Metoclopramide Hydrochloride interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

  4 sources

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Metoclopramide Hydrochloride needs care, as documented in this source.

• Depressive Disorder

  Major

  Metoclopramide has been reported to cause mental depression in patients with and without a prior history of depression. Symptoms have ranged from mild to severe and have included suicidal ideation and suicide. Therapy with metoclopramide in patients with a history of mental depression, especially suicidal tendencies, should be administered cautiously, and only if benefits are anticipated to outweigh the potential risks. Some patients who experience depression with metoclopramide have improved following temporary discontinuation of the drug and reinstitution at a lower dosage with gradual titration.

  5 sources

  1. Adams CD "Metoclopramide and depression." Ann Intern Med 103 (1985): 960
  2. Bottner RK, Tullio CJ "Metoclopramide and depression." Ann Intern Med 103 (1985): 482
  3. Feder R "Metoclopramide and depression." J Clin Psychiatry 48 (1987): 38
  4. Weddington WW, Jr Banner A "Organic affective syndrome associated with metoclopramide: case report." J Clin Psychiatry 47 (1986): 208-9
  5. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):

• Gastrointestinal Diseases

  Major

  The use of metoclopramide is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage.

  1 source

  1. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):

• Neuroleptic Malignant Syndrome

  Major

  Although not a neuroleptic agent, metoclopramide has antidopaminergic effects and may rarely precipitate or aggravate a potentially fatal symptom complex known as Neuroleptic Malignant Syndrome (NMS). Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, involuntary movements, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Metoclopramide therapy should not be initiated in patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of metoclopramide or other antidopaminergic therapy should be carefully considered, since NMS may recur.

  11 sources

  1. Henderson A, Longdon P "Fulminant metoclopramide induced neuroleptic malignant syndrome rapidly responsive to intravenous dantrolene." Aust N Z J Med 21 (1991): 742-3
  2. Friedman LS, Weinrauch LA, D'Elia JA "Metoclopramide-induced neuroleptic malignant syndrome." Arch Intern Med 147 (1987): 1495-7
  3. Cassidy T, Bansal SK "Neuroleptic malignant syndrome associated with metoclopramide." Br Med J (Clin Res Ed) 296 (1988): 214
  4. Patterson JF "Neuroleptic malignant syndrome associated with metoclopramide." South Med J 81 (1988): 674-5
  5. Donnet A, Harle JR, Dumont JC, Alif Cherif A "Neuroleptic malignant syndrome induced by metoclopramide." Biomed Pharmacother 45 (1991): 461-2
  6. Bakri YN, Khan R, Subhi J, Kawi Z "Neuroleptic malignant syndrome associated with metoclopramide antiemetic therapy." Gynecol Oncol 44 (1992): 189-90
  7. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):
  8. Shintani S, Shiigai T, Tsuchiya K, Kikuchi M "Hyperventilation alternating with apnea in neuroleptic malignant syndrome associated with metoclopramide and cisapride." J Neurol Sci 128 (1995): 232-3

  Show all 11 sourcesShow fewer sources

  9. Brower RD, Dreyer CF, Kent TA "Neuroleptic malignant syndrome in a child treated with metoclopramide for chemotherapy-related nausea." J Child Neurol 4 (1989): 230-2
  10. Patel P, Bristow G "Postoperative neuroleptic malignant syndrome. A case report." Can J Anaesth 34 (1987): 515-8
  11. Nonino F "Neuroleptic malignant syndrome associated with metoclopramide." Ann Pharmacother 33 (1999): 644-5

• Pheochromocytoma

  Major

  The use of metoclopramide is contraindicated in patients with pheochromocytoma. In a study involving patients with essential hypertension, intravenously administered metoclopramide was shown to induce the release of catecholamines. Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.

  5 sources

  1. Abe M, Orita Y, Nakashima Y, Nakamura M "Hypertensive crisis induced by metoclopramide in patient with pheochromocytoma." Angiology 35 (1984): 122-8
  2. Filibeck DJ, Grimm D, Forman WB, Leidner BA "Metoclopramide-induced hypertensive crisis." Clin Pharm 3 (1984): 548-9
  3. Agabiti-Rosei E, Aliccandri CL, Corea L "Hyperstensive crisis in patients with phaeochromocytoma given metoclopramide." Lancet 1 (1977): 600
  4. Plouin PF, Menard J, Corval P "Hypertensive crisis in patient with phaeochromocytoma given metoclopramide." Lancet 2 (1976): 1357-8
  5. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):

• Seizures

  Major

  The use of metoclopramide is contraindicated in patients with seizure disorders. Metoclopramide may increase the frequency and severity of seizures.

  2 sources

  1. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):
  2. Desmond PV, Watson KJ "Metoclopramide--a review." Med J Aust 144 (1986): 366-9

• Tardive Dyskinesia

  Major

  Metoclopramide may precipitate symptoms of tardive dyskinesia (TD) following chronic administration. Elderly patients, particularly women, are most susceptible. Both the risk of developing TD and the likelihood that it will become irreversible increase with the duration and total cumulative dose of metoclopramide or other antidopaminergic therapy administered. Metoclopramide therapy should be discontinued in patients who develop signs or symptoms of tardive dyskinesia. There is no known treatment for tardive dyskinesia. In some patients, symptoms may lessen or resolve after metoclopramide treatment is stopped. Treatment with metoclopramide for longer than 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing tardive dyskinesia. In patients with preexisting drug-induced TD, initiating or increasing the dosage of metoclopramide therapy may temporarily mask the symptoms of TD but may eventually worsen the condition.

  10 sources

  1. Miller LG, Jankovic J "Metoclopramide-induced movement disorders. Clinical findings with a review of the literature." Arch Intern Med 149 (1989): 2486-92
  2. Ganzini L, Casey DE, Hoffman WF, McCall AL "The prevalence of metoclopramide-induced tardive dyskinesia and acute extrapyramidal movement disorders." Arch Intern Med 153 (1993): 1469-75
  3. Pall HS, Williams AC "Extrapyramidal disturbances caused by inappropriate prescribing." Br Med J (Clin Res Ed) 295 (1987): 30-1
  4. Grimes JD "Parkinsonism and tardive dyskinesia associated with long-term metoclopramide therapy." N Engl J Med 305 (1981): 1417
  5. Lavy S, Melamed E, Penchas S "Tardive dyskinesia associated with metoclopramide." Br Med J 1 (1978): 77-8
  6. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):
  7. Sewell DD, Kodsi AB, Caligiuri MP, Jeste DV "Metoclopramide and tardive dyskinesia." Biol Psychiatry 36 (1994): 630-2
  8. Bateman DN, Rawlins MD, Simpson JM "Extrapyramidal reactions with metoclopramide." Br Med J (Clin Res Ed) 291 (1985): 930-2

  Show all 10 sourcesShow fewer sources

  9. Putnam PE, Orenstein SR, Wessel HB, Stowe RM "Tardive dyskinesia associated with use of metoclopramide in a child." J Pediatr 121 (1992): 983-5
  10. JimenezJimenez FJ, GarciaRuiz PJ, Molina JA "Drug-induced movement disorders." Drug Saf 16 (1997): 180-204

• Hypertension

  Moderate

  In a study involving patients with essential hypertension, intravenously administered metoclopramide was shown to induce the release of catecholamines. Therapy with metoclopramide should be administered cautiously in patients with hypertension because of potential increases in blood pressure.

  2 sources

  1. Filibeck DJ, Grimm D, Forman WB, Leidner BA "Metoclopramide-induced hypertensive crisis." Clin Pharm 3 (1984): 548-9
  2. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):

• Kidney Diseases

  Moderate

  Renal function affects the clearance of metoclopramide. In patients with varying degrees of renal impairment, a reduction in creatinine clearance was correlated with a reduction in plasma clearance, renal clearance, and non-renal clearance, and increase in elimination half-life of metoclopramide. Therapy with metoclopramide should be administered cautiously in patients with impaired renal function. A dosage reduction may be appropriate to avoid drug accumulation.

  5 sources

  1. Lehmann CR, Heironimus JD, Collins CB, O'Neil TJ, Pierson WP, Crowe JT, Melikian AP, Wright GJ "Metoclopramide kinetics in patients with impaired renal function and clearance by hemodialysis." Clin Pharmacol Ther 37 (1985): 284-9
  2. Lloveras J, Masramon J, Aubia J, Llorach M "Amiodarone, metoclopramide, and renal failure." Lancet 1 (1979): 981-2
  3. Caralps A "Metoclopramide and renal failure." Lancet 1 (1979): 554
  4. Bateman DN, Gokal R, Dodd TR, Blain PG "The pharmacokinetics of single doses of metoclopramide in renal failure." Eur J Clin Pharmacol 19 (1981): 437-41
  5. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):

• Parkinsonian Disorders

  Moderate

  Metoclopramide has antidopaminergic effects and may cause parkinsonian-like symptoms such as akinesia, bradykinesia, tremors, pill-rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually within the first six months following initiation of therapy but occasionally after longer periods. Symptoms generally subside within 2 to 3 months after drug discontinuation. Therapy with metoclopramide should be administered cautiously, if at all, in patients with Parkinson's disease or parkinsonian symptoms.

  7 sources

  1. Sirota RA, Kimmel PL, Trichtinger MD, Diamond BF, Stein HD, Yudis M "Metoclopramide-induced parkinsonism in hemodialysis patients. Report of two cases." Arch Intern Med 146 (1986): 2070-1
  2. Miller LG, Jankovic J "Metoclopramide-induced movement disorders. Clinical findings with a review of the literature." Arch Intern Med 149 (1989): 2486-92
  3. Ganzini L, Casey DE, Hoffman WF, McCall AL "The prevalence of metoclopramide-induced tardive dyskinesia and acute extrapyramidal movement disorders." Arch Intern Med 153 (1993): 1469-75
  4. Grimes JD "Parkinsonism and tardive dyskinesia associated with long-term metoclopramide therapy." N Engl J Med 305 (1981): 1417
  5. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):
  6. Bateman DN, Rawlins MD, Simpson JM "Extrapyramidal reactions with metoclopramide." Br Med J (Clin Res Ed) 291 (1985): 930-2
  7. JimenezJimenez FJ, GarciaRuiz PJ, Molina JA "Drug-induced movement disorders." Drug Saf 16 (1997): 180-204

• Water-Electrolyte Imbalance

  Moderate

  Metoclopramide produces a transient increase in plasma aldosterone and may cause fluid retention and volume overload in susceptible patients. Therapy with metoclopramide should be administered cautiously in patients with or at risk for fluid overload (e.g., cirrhosis, congestive heart failure). If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued.

  2 sources

  1. Ahmad S "Metoclopramide-induced acute congestive heart failure." South Med J 84 (1991): 283-4
  2. "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories (2001):

Therapeutic duplication

Drug classes that overlap with Metoclopramide Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• antidopaminergic-like antiemetic

  The recommended maximum number of medicines in the 'antidopaminergic-like antiemetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidopaminergic-like antiemetics' category.

  Example product in the source data (US market): Promethazine dm

• antidopaminergic-like antiemetic

  The recommended maximum number of medicines in the 'antidopaminergic-like antiemetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidopaminergic-like antiemetics' category.

  Example product in the source data (US market): Phenylephrine/promethazine

• antidopaminergic-like antiemetic

  The recommended maximum number of medicines in the 'antidopaminergic-like antiemetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidopaminergic-like antiemetics' category.

  Example product in the source data (US market): Meperidine/promethazine

• antidopaminergic-like antiemetic

  The recommended maximum number of medicines in the 'antidopaminergic-like antiemetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidopaminergic-like antiemetics' category.

  Example product in the source data (US market): Codeine/promethazine

• antidopaminergic-like antiemetic

  The recommended maximum number of medicines in the 'antidopaminergic-like antiemetics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidopaminergic-like antiemetics' category.

  Example product in the source data (US market): Promethazine vc with codeine