Drug interactions
Carbidopa-entacapone-levodopa + Metoclopramide intranasal
Severity: Major
Carbidopa-entacapone-levodopa 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 blocks dopamine D2 receptors, opposing the effects of levodopa and potentially worsening parkinsonian symptoms. Levodopa may in turn reduce the gastroprokinetic effect of metoclopramide.
What this interaction means in plain words
Carbidopa-entacapone-levodopa 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
Pharmacodynamic antagonism through central dopamine D2 receptor blockade.
What to do
Avoid metoclopramide in patients on levodopa; use domperidone where available or another non-dopamine-blocking antiemetic.
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 Carbidopa-entacapone-levodopa
- Carbidopa-entacapone-levodopa + Isocarboxazid Contraindicated
- Carbidopa-entacapone-levodopa + Phenelzine Contraindicated
- Carbidopa-entacapone-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-entacapone-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-entacapone-levodopa Major
- Asenapine transdermal + Carbidopa-entacapone-levodopa Major
Frequently asked questions
Can I take Carbidopa-entacapone-levodopa with Metoclopramide intranasal?
MediHelp rates the interaction as major. Carbidopa-entacapone-levodopa 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 blocks dopamine D2 receptors, opposing the effects of levodopa and potentially worsening parkinsonian symptoms. Levodopa may in turn reduce the gastroprokinetic effect of metoclopramide.
How serious is the interaction between Carbidopa-entacapone-levodopa 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 metoclopramide in patients on levodopa; use domperidone where available or another non-dopamine-blocking antiemetic.
What other medicines interact with Carbidopa-entacapone-levodopa?
MediHelp also lists interactions of Carbidopa-entacapone-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-entacapone-levodopa page.
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