Drug interactions
Metoclopramide + Paliperidone
Severity: Major
Metoclopramide and Paliperidone: major interaction.
Last updated Sources: UK SmPC
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
Paliperidone is a potent D2 antagonist and with metoclopramide increases the chance of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome.
What this interaction means in plain words
Metoclopramide and Paliperidone 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 belongs to Gastrointestinal Tract; Paliperidone belongs to Central Nervous System.
Why it happens
Additive central dopamine D2 receptor antagonism.
What to do
Avoid the combination and use ondansetron or another non-dopamine-blocking antiemetic. If unavoidable, monitor for dystonia, rigidity and hyperthermia.
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 Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Metoclopramide with Paliperidone?
MediHelp rates the interaction as major. Metoclopramide and Paliperidone 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. Paliperidone is a potent D2 antagonist and with metoclopramide increases the chance of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome.
How serious is the interaction between Metoclopramide and Paliperidone?
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 another non-dopamine-blocking antiemetic. If unavoidable, monitor for dystonia, rigidity and hyperthermia.
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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