Drug interactions
Metoclopramide + Perphenazine
Severity: Major
Metoclopramide and Perphenazine: 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
Perphenazine and metoclopramide both block D2 receptors, increasing the risk of acute dystonia, parkinsonism, tardive dyskinesia and neuroleptic malignant syndrome. Perphenazine is also a CYP2D6 substrate and inhibitor, which may raise metoclopramide exposure.
What this interaction means in plain words
Metoclopramide and Perphenazine 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; Perphenazine belongs to Central Nervous System.
Why it happens
Additive central dopamine D2 antagonism, with possible CYP2D6 inhibition raising metoclopramide levels.
What to do
Avoid the combination and choose an antiemetic without D2 blockade such as ondansetron. If unavoidable, use the lowest metoclopramide dose briefly and monitor for extrapyramidal symptoms.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Metoclopramide and Perphenazine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Metoclopramide
Other interactions of Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Metoclopramide with Perphenazine?
MediHelp rates the interaction as major. Metoclopramide and Perphenazine 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. Perphenazine and metoclopramide both block D2 receptors, increasing the risk of acute dystonia, parkinsonism, tardive dyskinesia and neuroleptic malignant syndrome. Perphenazine is also a CYP2D6 substrate and inhibitor, which may raise metoclopramide exposure.
How serious is the interaction between Metoclopramide and Perphenazine?
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 choose an antiemetic without D2 blockade such as ondansetron. If unavoidable, use the lowest metoclopramide dose briefly and monitor for extrapyramidal symptoms.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
