Drug interactions
Amitriptyline + Metoclopramide
Severity: Moderate
Amitriptyline and Metoclopramide: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amitriptyline's anticholinergic effects oppose the prokinetic action of metoclopramide, and both drugs can cause sedation. Serotonergic and extrapyramidal effects have also been reported with metoclopramide plus antidepressants, and amitriptyline is a CYP2D6 substrate and weak inhibitor.
What this interaction means in plain words
Amitriptyline and Metoclopramide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Anticholinergic antagonism of prokinetic effects, additive CNS effects, and possible serotonergic and dopaminergic toxicity.
What to do
Monitor for reduced gastrointestinal response, sedation, extrapyramidal symptoms and serotonin toxicity. Consider an alternative antiemetic if symptoms appear.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metoclopramide
Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Metoclopramide?
MediHelp rates the interaction as moderate. Amitriptyline and Metoclopramide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Amitriptyline's anticholinergic effects oppose the prokinetic action of metoclopramide, and both drugs can cause sedation. Serotonergic and extrapyramidal effects have also been reported with metoclopramide plus antidepressants, and amitriptyline is a CYP2D6 substrate and weak inhibitor.
How serious is the interaction between Amitriptyline and Metoclopramide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced gastrointestinal response, sedation, extrapyramidal symptoms and serotonin toxicity. Consider an alternative antiemetic if symptoms appear.
What other medicines interact with Metoclopramide?
MediHelp also lists interactions of Metoclopramide with, for example, Amantadine, Amoxapine, Antipsychotics (e.g., haloperidol). The full list is on the Metoclopramide page.
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