Drug interactions
Metoclopramide + Tetrabenazine
Severity: Major
Metoclopramide and Tetrabenazine: 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 can cause parkinsonism, akathisia, depression and neuroleptic malignant syndrome. Combined use increases the risk of these movement and psychiatric effects.
What this interaction means in plain words
Metoclopramide and Tetrabenazine 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; Tetrabenazine belongs to Central Nervous System.
Why it happens
Additive dopamine pathway disruption (D2 blockade plus VMAT2 inhibition).
What to do
Avoid combining and use a non-dopamine-blocking antiemetic. Monitor for extrapyramidal symptoms and mood changes if unavoidable.
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 Tetrabenazine
- Dronedarone + Tetrabenazine Contraindicated
- Isocarboxazid + Tetrabenazine Contraindicated
- Linezolid + Tetrabenazine Contraindicated
- Phenelzine + Tetrabenazine Contraindicated
- Pimozide + Tetrabenazine Contraindicated
- Procarbazine + Tetrabenazine Contraindicated
Frequently asked questions
Can I take Metoclopramide with Tetrabenazine?
MediHelp rates the interaction as major. Metoclopramide and Tetrabenazine 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 can cause parkinsonism, akathisia, depression and neuroleptic malignant syndrome. Combined use increases the risk of these movement and psychiatric effects.
How serious is the interaction between Metoclopramide and Tetrabenazine?
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 combining and use a non-dopamine-blocking antiemetic. Monitor for extrapyramidal symptoms and mood changes if unavoidable.
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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