Drug interactions
Asenapine + Metoclopramide
Severity: Major
Asenapine and Metoclopramide: 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
Both drugs block dopamine D2 receptors, increasing the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. The risk rises with higher doses and longer treatment.
What this interaction means in plain words
Asenapine and Metoclopramide 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.
Asenapine belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Additive central dopamine D2 receptor antagonism.
What to do
Avoid the combination and use a non-dopaminergic antiemetic where possible. If both are required, monitor for movement disorders, rigidity and hyperthermia.
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 Metoclopramide
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?
MediHelp rates the interaction as major. Asenapine and Metoclopramide 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. Both drugs block dopamine D2 receptors, increasing the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. The risk rises with higher doses and longer treatment.
How serious is the interaction between Asenapine and Metoclopramide?
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 and use a non-dopaminergic antiemetic where possible. If both are required, monitor for movement disorders, rigidity and hyperthermia.
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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