Drug interactions
Apomorphine + Paliperidone
Severity: Major
Apomorphine and Paliperidone: major interaction.
Last updated Sources: US FDA label
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
Paliperidone blocks dopamine D2 receptors and opposes the dopaminergic effect of apomorphine in Parkinson's disease. Both drugs can also prolong the QT interval, and apomorphine adds orthostatic hypotension.
What this interaction means in plain words
Apomorphine and Paliperidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Apomorphine belongs to Central Nervous System; Paliperidone belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism at dopamine D2 receptors, plus additive QT prolongation.
What to do
Avoid the combination; in Parkinson's psychosis use quetiapine or clozapine instead. If it cannot be avoided, monitor ECG, blood pressure and motor control.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Other interactions of Apomorphine
- Alosetron + Apomorphine Contraindicated
- Apomorphine + Cisapride Contraindicated
- Apomorphine + Dolasetron Contraindicated
- Apomorphine + Granisetron Contraindicated
- Apomorphine + Netupitant-palonosetron Contraindicated
- Apomorphine + Ondansetron Contraindicated
Frequently asked questions
Can I take Apomorphine with Paliperidone?
MediHelp rates the interaction as major. Apomorphine and Paliperidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Paliperidone blocks dopamine D2 receptors and opposes the dopaminergic effect of apomorphine in Parkinson's disease. Both drugs can also prolong the QT interval, and apomorphine adds orthostatic hypotension.
How serious is the interaction between Apomorphine and Paliperidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; in Parkinson's psychosis use quetiapine or clozapine instead. If it cannot be avoided, monitor ECG, blood pressure and motor control.
What other medicines interact with Paliperidone?
MediHelp also lists interactions of Paliperidone with, for example, Ibutilide, Pimozide, Vandetanib. The full list is on the Paliperidone page.
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