Drug interactions
Asenapine + Metoclopramide intranasal
Severity: Major
Asenapine and Metoclopramide intranasal: major 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
Metoclopramide is a dopamine antagonist and asenapine has potent D2 blocking activity, so combining them increases the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome.
What this interaction means in plain words
Asenapine and Metoclopramide intranasal 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.
Why it happens
Additive central dopamine D2 receptor antagonism.
What to do
Avoid combining; use a non-dopamine-blocking antiemetic or prokinetic such as ondansetron where appropriate. If unavoidable, monitor for movement disorders, rigidity and fever.
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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Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Frequently asked questions
Can I take Asenapine with Metoclopramide intranasal?
MediHelp rates the interaction as major. Asenapine and Metoclopramide intranasal 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. Metoclopramide is a dopamine antagonist and asenapine has potent D2 blocking activity, so combining them increases the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome.
How serious is the interaction between Asenapine and Metoclopramide intranasal?
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 combining; use a non-dopamine-blocking antiemetic or prokinetic such as ondansetron where appropriate. If unavoidable, monitor for movement disorders, rigidity and fever.
What other medicines interact with Asenapine?
MediHelp also lists interactions of Asenapine with, for example, Pimozide, Thioridazine, Vandetanib. The full list is on the Asenapine page.
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