Drug interactions
Bupropion + Metoclopramide intranasal
Severity: Major
Bupropion 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
Bupropion is a strong CYP2D6 inhibitor and raises metoclopramide exposure. Higher metoclopramide levels increase the risk of extrapyramidal symptoms, tardive dyskinesia, restlessness and sedation. The intranasal product has a fixed dose that cannot be reduced.
What this interaction means in plain words
Bupropion 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
Inhibition of CYP2D6-mediated metoclopramide metabolism by bupropion increases systemic metoclopramide exposure.
What to do
Avoid intranasal metoclopramide with bupropion and use an oral metoclopramide formulation at a reduced dose or an alternative antiemetic or prokinetic. Monitor for movement disorders if exposure cannot be avoided.
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 Bupropion
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal Contraindicated
Frequently asked questions
Can I take Bupropion with Metoclopramide intranasal?
MediHelp rates the interaction as major. Bupropion 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. Bupropion is a strong CYP2D6 inhibitor and raises metoclopramide exposure. Higher metoclopramide levels increase the risk of extrapyramidal symptoms, tardive dyskinesia, restlessness and sedation. The intranasal product has a fixed dose that cannot be reduced.
How serious is the interaction between Bupropion 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 intranasal metoclopramide with bupropion and use an oral metoclopramide formulation at a reduced dose or an alternative antiemetic or prokinetic. Monitor for movement disorders if exposure cannot be avoided.
What other medicines interact with Bupropion?
MediHelp also lists interactions of Bupropion with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Bupropion page.
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