Drug interactions
Carbidopa-entacapone-levodopa + Metoclopramide
Severity: Major
Carbidopa-entacapone-levodopa and Metoclopramide: major interaction.
Last updated Sources: US FDA label
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 central dopamine D2 receptors and can worsen parkinsonian symptoms, opposing the effect of levodopa. It also speeds gastric emptying, which may alter levodopa absorption. The combination may cause loss of motor control and extrapyramidal reactions.
What this interaction means in plain words
Carbidopa-entacapone-levodopa 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.
Carbidopa-entacapone-levodopa belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Central dopamine D2 receptor antagonism by metoclopramide opposes levodopa's effect, with additional changes in levodopa absorption from faster gastric emptying.
What to do
Avoid metoclopramide in patients with Parkinson's disease. Use domperidone where available, or another antiemetic without central dopamine blockade such as ondansetron, with QT risk considered.
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 Carbidopa-entacapone-levodopa 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 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
Other interactions of Metoclopramide
Frequently asked questions
Can I take Carbidopa-entacapone-levodopa with Metoclopramide?
MediHelp rates the interaction as major. Carbidopa-entacapone-levodopa 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. Metoclopramide blocks central dopamine D2 receptors and can worsen parkinsonian symptoms, opposing the effect of levodopa. It also speeds gastric emptying, which may alter levodopa absorption. The combination may cause loss of motor control and extrapyramidal reactions.
How serious is the interaction between Carbidopa-entacapone-levodopa 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 metoclopramide in patients with Parkinson's disease. Use domperidone where available, or another antiemetic without central dopamine blockade such as ondansetron, with QT risk considered.
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.
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.
