Drug interactions
Metoclopramide + Pimozide
Severity: Major
Metoclopramide and Pimozide: 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
Both drugs block central dopamine D2 receptors, so combining them raises the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. Pimozide also prolongs the QT interval, which adds a cardiac concern.
What this interaction means in plain words
Metoclopramide and Pimozide 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; Pimozide belongs to Central Nervous System.
Why it happens
Additive central dopamine D2 receptor antagonism producing pharmacodynamic synergy.
What to do
Avoid the combination where possible and use an antiemetic or prokinetic without dopamine antagonism. If both are unavoidable, monitor closely for movement disorders, rigidity, fever and ECG changes.
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 Pimozide
- Adagrasib + Pimozide Contraindicated
- Amiodarone + Pimozide Contraindicated
- Amisulpride + Pimozide Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amoxapine + Pimozide Contraindicated
- Anagrelide + Pimozide Contraindicated
Frequently asked questions
Can I take Metoclopramide with Pimozide?
MediHelp rates the interaction as major. Metoclopramide and Pimozide 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. Both drugs block central dopamine D2 receptors, so combining them raises the risk of extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. Pimozide also prolongs the QT interval, which adds a cardiac concern.
How serious is the interaction between Metoclopramide and Pimozide?
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 where possible and use an antiemetic or prokinetic without dopamine antagonism. If both are unavoidable, monitor closely for movement disorders, rigidity, fever and ECG changes.
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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