Drug interactions
Loxapine + Metoclopramide
Severity: Major
Loxapine and Metoclopramide: major interaction.
Last updated Sources: Health Canada product monograph
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
Loxapine is a D2-blocking antipsychotic and with metoclopramide increases the likelihood of extrapyramidal reactions, tardive dyskinesia and neuroleptic malignant syndrome.
What this interaction means in plain words
Loxapine 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.
Loxapine belongs to Central Nervous System; Metoclopramide belongs to Gastrointestinal Tract.
Why it happens
Additive central dopamine D2 receptor antagonism.
What to do
Avoid the combination and use ondansetron or a similar non-dopaminergic antiemetic. If it must be used, monitor for movement disorders and signs of NMS.
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 Loxapine
- Alfentanil + Loxapine Major
- Alprazolam + Loxapine Major
- Amisulpride + Loxapine Major
- Amoxapine + Loxapine Major
- Apomorphine + Loxapine Major
- Belladonna and opium + Loxapine Major
Frequently asked questions
Can I take Loxapine with Metoclopramide?
MediHelp rates the interaction as major. Loxapine 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. Loxapine is a D2-blocking antipsychotic and with metoclopramide increases the likelihood of extrapyramidal reactions, tardive dyskinesia and neuroleptic malignant syndrome.
How serious is the interaction between Loxapine 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 the combination and use ondansetron or a similar non-dopaminergic antiemetic. If it must be used, monitor for movement disorders and signs of NMS.
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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