Drug interactions
Metoclopramide + Safinamide
Severity: Major
Metoclopramide and Safinamide: major interaction.
Last updated Sources: US FDA label
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
Metoclopramide blocks dopamine receptors and can counteract the antiparkinsonian effect of safinamide, causing worsening motor symptoms. Metoclopramide may also provoke extrapyramidal reactions in a patient with Parkinson disease.
What this interaction means in plain words
Metoclopramide and Safinamide 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; Safinamide belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism: central D2 receptor blockade opposes the dopaminergic effect of safinamide.
What to do
Avoid metoclopramide in patients taking safinamide and use an alternative antiemetic without central dopamine antagonism, such as domperidone where available or ondansetron.
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 Safinamide
- Amitriptyline + Safinamide Contraindicated
- Amoxapine + Safinamide Contraindicated
- Amphetamine polistirex + Safinamide Contraindicated
- Clomipramine + Safinamide Contraindicated
- Cyclobenzaprine + Safinamide Contraindicated
- Desipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Metoclopramide with Safinamide?
MediHelp rates the interaction as major. Metoclopramide and Safinamide 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 blocks dopamine receptors and can counteract the antiparkinsonian effect of safinamide, causing worsening motor symptoms. Metoclopramide may also provoke extrapyramidal reactions in a patient with Parkinson disease.
How serious is the interaction between Metoclopramide and Safinamide?
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 metoclopramide in patients taking safinamide and use an alternative antiemetic without central dopamine antagonism, such as domperidone where available or ondansetron.
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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