Drug interactions
Metoclopramide + Milnacipran
Severity: Moderate
Metoclopramide and Milnacipran: moderate 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
Milnacipran increases serotonin and norepinephrine activity, and metoclopramide may add to serotonergic effects. Serotonin syndrome and extrapyramidal reactions are the potential concerns.
What this interaction means in plain words
Metoclopramide and Milnacipran can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Metoclopramide belongs to Gastrointestinal Tract; Milnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic effects with dopamine D2 receptor blockade by metoclopramide.
What to do
Limit metoclopramide dose and duration and monitor for clonus, tremor, fever, agitation and dystonia. Stop metoclopramide if serotonin toxicity is suspected.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metoclopramide
Other interactions of Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Frequently asked questions
Can I take Metoclopramide with Milnacipran?
MediHelp rates the interaction as moderate. Metoclopramide and Milnacipran can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Milnacipran increases serotonin and norepinephrine activity, and metoclopramide may add to serotonergic effects. Serotonin syndrome and extrapyramidal reactions are the potential concerns.
How serious is the interaction between Metoclopramide and Milnacipran?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit metoclopramide dose and duration and monitor for clonus, tremor, fever, agitation and dystonia. Stop metoclopramide if serotonin toxicity is suspected.
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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