Drug interactions
Carbidopa-levodopa + Metoclopramide
Severity: Major
Carbidopa-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 receptors and can worsen parkinsonism, opposing levodopa. It also speeds gastric emptying, which may alter levodopa absorption.
What this interaction means in plain words
Carbidopa-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-levodopa belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Central D2 receptor antagonism by metoclopramide counteracts levodopa's dopaminergic effect.
What to do
Avoid metoclopramide in Parkinson's disease. Use an antiemetic without central dopamine blockade such as domperidone where available, or ondansetron.
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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References
Other interactions of Carbidopa-levodopa
- Carbidopa-levodopa + Isocarboxazid Contraindicated
- Carbidopa-levodopa + Phenelzine Contraindicated
- Carbidopa-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-levodopa Major
- Asenapine + Carbidopa-levodopa Major
Other interactions of Metoclopramide
Frequently asked questions
Can I take Carbidopa-levodopa with Metoclopramide?
MediHelp rates the interaction as major. Carbidopa-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 receptors and can worsen parkinsonism, opposing levodopa. It also speeds gastric emptying, which may alter levodopa absorption.
How serious is the interaction between Carbidopa-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 Parkinson's disease. Use an antiemetic without central dopamine blockade such as domperidone where available, or ondansetron.
What other medicines interact with Carbidopa-levodopa?
MediHelp also lists interactions of Carbidopa-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-levodopa page.
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