Drug interactions
Lithium + Metoclopramide
Severity: Major
Lithium 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 with lithium has been associated with increased risk of neurotoxicity and extrapyramidal symptoms, and may raise lithium exposure through faster gastric emptying. Symptoms can include tremor, rigidity, confusion and drowsiness.
What this interaction means in plain words
Lithium 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.
Lithium belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Additive dopamine-blocking neurotoxicity and possible increased lithium absorption from accelerated gastric emptying.
What to do
Avoid if possible or use the lowest metoclopramide dose for the shortest time. Monitor serum lithium and for neurological 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 Metoclopramide
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Lithium with Metoclopramide?
MediHelp rates the interaction as major. Lithium 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 with lithium has been associated with increased risk of neurotoxicity and extrapyramidal symptoms, and may raise lithium exposure through faster gastric emptying. Symptoms can include tremor, rigidity, confusion and drowsiness.
How serious is the interaction between Lithium 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 if possible or use the lowest metoclopramide dose for the shortest time. Monitor serum lithium and for neurological toxicity.
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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