Drug interactions
Metoclopramide + Risperidone
Severity: Major
Metoclopramide and Risperidone: 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
Risperidone is a potent D2 antagonist, and adding metoclopramide increases the risk of acute extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. Hyperprolactinemia may also be worsened.
What this interaction means in plain words
Metoclopramide and Risperidone 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; Risperidone belongs to Central Nervous System.
Why it happens
Additive central dopamine D2 receptor blockade.
What to do
Avoid the combination and use a non-dopaminergic antiemetic or prokinetic. If both are required, monitor for extrapyramidal signs and stop metoclopramide if they appear.
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 Risperidone
- Ibutilide + Risperidone Contraindicated
- Risperidone + Vandetanib Contraindicated
- Adagrasib + Risperidone Major
- Amiodarone + Risperidone Major
- Amisulpride + Risperidone Major
- Amoxapine + Risperidone Major
Frequently asked questions
Can I take Metoclopramide with Risperidone?
MediHelp rates the interaction as major. Metoclopramide and Risperidone 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. Risperidone is a potent D2 antagonist, and adding metoclopramide increases the risk of acute extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome. Hyperprolactinemia may also be worsened.
How serious is the interaction between Metoclopramide and Risperidone?
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 a non-dopaminergic antiemetic or prokinetic. If both are required, monitor for extrapyramidal signs and stop metoclopramide if they appear.
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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