Drug interactions
Deutetrabenazine + Metoclopramide
Severity: Major
Deutetrabenazine and Metoclopramide: major interaction.
Last updated Sources: EMA SmPC
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 can cause or worsen extrapyramidal symptoms, parkinsonism and depression. Metoclopramide also antagonizes dopamine, which may undermine deutetrabenazine's management of hyperkinetic movement disorders.
What this interaction means in plain words
Deutetrabenazine 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.
Deutetrabenazine belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Additive dopamine pathway disruption (D2 blockade plus VMAT2 inhibition with dopamine depletion).
What to do
Avoid combining and choose a non-dopamine-blocking antiemetic. If unavoidable, monitor for parkinsonism, akathisia, dystonia and mood changes.
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 Metoclopramide
Other interactions of Deutetrabenazine
- Deutetrabenazine + Isocarboxazid Contraindicated
- Deutetrabenazine + Linezolid Contraindicated
- Deutetrabenazine + Phenelzine Contraindicated
- Deutetrabenazine + Rasagiline Contraindicated
- Deutetrabenazine + Safinamide Contraindicated
- Deutetrabenazine + Selegiline Contraindicated
Frequently asked questions
Can I take Deutetrabenazine with Metoclopramide?
MediHelp rates the interaction as major. Deutetrabenazine 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. Both drugs can cause or worsen extrapyramidal symptoms, parkinsonism and depression. Metoclopramide also antagonizes dopamine, which may undermine deutetrabenazine's management of hyperkinetic movement disorders.
How serious is the interaction between Deutetrabenazine 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 combining and choose a non-dopamine-blocking antiemetic. If unavoidable, monitor for parkinsonism, akathisia, dystonia and mood changes.
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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