Drug interactions
Metoclopramide + Rolapitant
Severity: Major
Metoclopramide and Rolapitant: major 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
Rolapitant is a strong CYP2D6 inhibitor and can substantially increase metoclopramide exposure, raising the risk of extrapyramidal reactions and tardive dyskinesia. Inhibition persists for days after rolapitant dosing.
What this interaction means in plain words
Metoclopramide and Rolapitant 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; Rolapitant belongs to Gastrointestinal Tract.
Why it happens
Inhibition of CYP2D6-mediated metabolism of metoclopramide by rolapitant.
What to do
Avoid fixed-dose metoclopramide formulations with rolapitant; if oral metoclopramide is used, lower the dose and monitor for movement disorders and sedation.
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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Other interactions of Metoclopramide
Other interactions of Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant Major
Frequently asked questions
Can I take Metoclopramide with Rolapitant?
MediHelp rates the interaction as major. Metoclopramide and Rolapitant 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. Rolapitant is a strong CYP2D6 inhibitor and can substantially increase metoclopramide exposure, raising the risk of extrapyramidal reactions and tardive dyskinesia. Inhibition persists for days after rolapitant dosing.
How serious is the interaction between Metoclopramide and Rolapitant?
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 fixed-dose metoclopramide formulations with rolapitant; if oral metoclopramide is used, lower the dose and monitor for movement disorders and sedation.
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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