Drug interactions
Brexpiprazole + Metoclopramide
Severity: Major
Brexpiprazole and Metoclopramide: major interaction.
Last updated Sources: UK SmPC
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
Brexpiprazole is a partial D2 agonist, but combining it with metoclopramide still increases the risk of extrapyramidal symptoms, akathisia and neuroleptic malignant syndrome. Brexpiprazole is also a CYP2D6 substrate, and metoclopramide is a weak CYP2D6 inhibitor.
What this interaction means in plain words
Brexpiprazole 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.
Brexpiprazole belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Additive dopamine receptor antagonism or modulation leading to extrapyramidal toxicity.
What to do
Avoid the combination if possible and choose a non-dopamine-blocking antiemetic. If it is necessary, monitor for akathisia, rigidity and movement disorders.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Brexpiprazole and Metoclopramide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Metoclopramide
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Metoclopramide?
MediHelp rates the interaction as major. Brexpiprazole 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. Brexpiprazole is a partial D2 agonist, but combining it with metoclopramide still increases the risk of extrapyramidal symptoms, akathisia and neuroleptic malignant syndrome. Brexpiprazole is also a CYP2D6 substrate, and metoclopramide is a weak CYP2D6 inhibitor.
How serious is the interaction between Brexpiprazole 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 if possible and choose a non-dopamine-blocking antiemetic. If it is necessary, monitor for akathisia, rigidity and movement disorders.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
