Drug interactions
Clomipramine + Metoclopramide
Severity: Major
Clomipramine and Metoclopramide: 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
Clomipramine is partly metabolized by CYP2D6 and has serotonergic activity, and metoclopramide is a dopamine antagonist with reported serotonin syndrome and neuroleptic malignant syndrome cases. Combined use may increase risk of extrapyramidal effects, sedation and serotonin toxicity.
What this interaction means in plain words
Clomipramine 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.
Clomipramine belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Additive dopamine blockade and serotonergic effects, with possible pharmacokinetic effects via CYP2D6 competition.
What to do
Avoid the combination where possible and choose another antiemetic. If used together, monitor for tremor, rigidity, agitation, hyperthermia and sedation.
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 Metoclopramide
Other interactions of Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Clomipramine with Metoclopramide?
MediHelp rates the interaction as major. Clomipramine 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. Clomipramine is partly metabolized by CYP2D6 and has serotonergic activity, and metoclopramide is a dopamine antagonist with reported serotonin syndrome and neuroleptic malignant syndrome cases. Combined use may increase risk of extrapyramidal effects, sedation and serotonin toxicity.
How serious is the interaction between Clomipramine 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 the combination where possible and choose another antiemetic. If used together, monitor for tremor, rigidity, agitation, hyperthermia and sedation.
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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