Drug interactions
Levodopa + Metoclopramide
Severity: Major
Levodopa 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
Metoclopramide antagonizes dopamine in the brain and can worsen Parkinson disease symptoms in patients on levodopa. It also speeds gastric emptying, which may alter levodopa absorption.
What this interaction means in plain words
Levodopa 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.
Levodopa belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Pharmacodynamic antagonism by central D2 blockade; increased gastric emptying may raise levodopa absorption.
What to do
Avoid metoclopramide in Parkinson disease. Use domperidone where available, or ondansetron, as the antiemetic.
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 Levodopa
- Isocarboxazid + Levodopa Contraindicated
- Levodopa + Phenelzine Contraindicated
- Levodopa + Phenelzine (nonselective MAOI) Contraindicated
- Levodopa + Procarbazine Contraindicated
- Levodopa + Tranylcypromine Contraindicated
- Amisulpride + Levodopa Major
Frequently asked questions
Can I take Levodopa with Metoclopramide?
MediHelp rates the interaction as major. Levodopa 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. Metoclopramide antagonizes dopamine in the brain and can worsen Parkinson disease symptoms in patients on levodopa. It also speeds gastric emptying, which may alter levodopa absorption.
How serious is the interaction between Levodopa 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 metoclopramide in Parkinson disease. Use domperidone where available, or ondansetron, as the antiemetic.
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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