Drug interactions
Clozapine + Metoclopramide intranasal
Severity: Major
Clozapine 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
Both drugs block dopamine D2 receptors, so combined use may increase the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. Clozapine has a lower risk of extrapyramidal effects but the risk is still additive.
What this interaction means in plain words
Clozapine 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
Additive central dopamine D2 receptor antagonism.
What to do
Avoid the combination and use a non-dopamine-blocking antiemetic or prokinetic. If unavoidable, monitor for movement disorders, rigidity and fever.
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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Clozapine with Metoclopramide intranasal?
MediHelp rates the interaction as major. Clozapine 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. Both drugs block dopamine D2 receptors, so combined use may increase the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. Clozapine has a lower risk of extrapyramidal effects but the risk is still additive.
How serious is the interaction between Clozapine 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 the combination and use a non-dopamine-blocking antiemetic or prokinetic. If unavoidable, monitor for movement disorders, rigidity and fever.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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