Drug interactions
Citalopram + Metoclopramide
Severity: Moderate
Citalopram and Metoclopramide: moderate 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
Both drugs have been linked to serotonin toxicity, and metoclopramide also causes extrapyramidal reactions. Used together they may raise the risk of serotonin syndrome, dystonia and, rarely, neuroleptic malignant syndrome.
What this interaction means in plain words
Citalopram and Metoclopramide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Citalopram belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Additive serotonergic activity (metoclopramide 5-HT4 agonism and SSRI reuptake inhibition) plus central dopamine D2 blockade; citalopram does not meaningfully inhibit CYP2D6.
What to do
Use the lowest effective metoclopramide dose for the shortest time and monitor for agitation, tremor, hyperthermia, clonus and movement disorders. Stop metoclopramide and consider an alternative antiemetic such as domperidone where available if symptoms appear.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metoclopramide
Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Metoclopramide?
MediHelp rates the interaction as moderate. Citalopram and Metoclopramide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs have been linked to serotonin toxicity, and metoclopramide also causes extrapyramidal reactions. Used together they may raise the risk of serotonin syndrome, dystonia and, rarely, neuroleptic malignant syndrome.
How serious is the interaction between Citalopram and Metoclopramide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective metoclopramide dose for the shortest time and monitor for agitation, tremor, hyperthermia, clonus and movement disorders. Stop metoclopramide and consider an alternative antiemetic such as domperidone where available if symptoms appear.
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.
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