Drug interactions
Fluoxetine + Metoclopramide intranasal
Severity: Major
Fluoxetine 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
Fluoxetine strongly inhibits CYP2D6 and raises metoclopramide exposure, increasing the risk of extrapyramidal effects, tardive dyskinesia, and sedation. Both drugs have also been linked with serotonin syndrome and neuroleptic malignant syndrome.
What this interaction means in plain words
Fluoxetine 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
CYP2D6 inhibition by fluoxetine increases metoclopramide levels, with additive serotonergic and dopaminergic effects.
What to do
Because the intranasal dose cannot be adjusted, use an alternative antiemetic or a metoclopramide form that allows dose reduction. Monitor for movement disorders and serotonin toxicity.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Metoclopramide intranasal?
MediHelp rates the interaction as major. Fluoxetine 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. Fluoxetine strongly inhibits CYP2D6 and raises metoclopramide exposure, increasing the risk of extrapyramidal effects, tardive dyskinesia, and sedation. Both drugs have also been linked with serotonin syndrome and neuroleptic malignant syndrome.
How serious is the interaction between Fluoxetine 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: Because the intranasal dose cannot be adjusted, use an alternative antiemetic or a metoclopramide form that allows dose reduction. Monitor for movement disorders and serotonin toxicity.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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