Drug interactions
Metoclopramide + Terbinafine
Severity: Major
Metoclopramide and Terbinafine: 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
Terbinafine is a strong CYP2D6 inhibitor and can raise metoclopramide concentrations, increasing the risk of extrapyramidal symptoms, tardive dyskinesia and sedation. Fixed-dose intranasal metoclopramide cannot be adjusted for this effect.
What this interaction means in plain words
Metoclopramide and Terbinafine 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; Terbinafine belongs to Anti Fungals.
Why it happens
Inhibition of CYP2D6-mediated metabolism of metoclopramide by terbinafine.
What to do
Avoid fixed-dose metoclopramide with terbinafine. With oral metoclopramide, reduce the dose and monitor for movement disorders.
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 Terbinafine
- Terbinafine + Thioridazine Contraindicated
- Desipramine + Terbinafine Major
- Eliglustat + Terbinafine Major
- Flecainide + Terbinafine Major
- Imipramine + Terbinafine Major
- Maprotiline + Terbinafine Major
Frequently asked questions
Can I take Metoclopramide with Terbinafine?
MediHelp rates the interaction as major. Metoclopramide and Terbinafine 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. Terbinafine is a strong CYP2D6 inhibitor and can raise metoclopramide concentrations, increasing the risk of extrapyramidal symptoms, tardive dyskinesia and sedation. Fixed-dose intranasal metoclopramide cannot be adjusted for this effect.
How serious is the interaction between Metoclopramide and Terbinafine?
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 with terbinafine. With oral metoclopramide, reduce the dose and monitor for movement disorders.
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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