Drug interactions
Metoclopramide + Nortriptyline
Severity: Moderate
Metoclopramide and Nortriptyline: 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
Nortriptyline is a CYP2D6 substrate with anticholinergic and sedating properties and is a weak to moderate CYP2D6 inhibitor. With metoclopramide, extrapyramidal symptoms, sedation and serotonergic toxicity are possible, and anticholinergic effects may oppose gastric motility enhancement.
What this interaction means in plain words
Metoclopramide and Nortriptyline 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; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive antidopaminergic, sedative and serotonergic effects, with possible CYP2D6 competition and anticholinergic antagonism of prokinetic action.
What to do
Monitor for extrapyramidal symptoms, sedation and serotonin toxicity features. Use the lowest effective metoclopramide dose for the shortest period.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Metoclopramide with Nortriptyline?
MediHelp rates the interaction as moderate. Metoclopramide and Nortriptyline 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. Nortriptyline is a CYP2D6 substrate with anticholinergic and sedating properties and is a weak to moderate CYP2D6 inhibitor. With metoclopramide, extrapyramidal symptoms, sedation and serotonergic toxicity are possible, and anticholinergic effects may oppose gastric motility enhancement.
How serious is the interaction between Metoclopramide and Nortriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for extrapyramidal symptoms, sedation and serotonin toxicity features. Use the lowest effective metoclopramide dose for the shortest period.
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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