Drug interactions
Metoclopramide + Tolcapone
Severity: Major
Metoclopramide and Tolcapone: 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
Metoclopramide is a central dopamine D2 antagonist and can worsen Parkinson disease symptoms, directly opposing the dopaminergic benefit of tolcapone-enhanced levodopa therapy. It is generally avoided in parkinsonian patients.
What this interaction means in plain words
Metoclopramide and Tolcapone 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; Tolcapone belongs to Central Nervous System.
Why it happens
Central dopamine D2 receptor blockade by metoclopramide antagonizes dopaminergic therapy.
What to do
Avoid metoclopramide in patients with Parkinson disease; use domperidone where available or another non-dopamine-blocking antiemetic such as 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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Other interactions of Metoclopramide
Other interactions of Tolcapone
- Isocarboxazid + Tolcapone Contraindicated
- Phenelzine + Tolcapone Contraindicated
- Tolcapone + Tranylcypromine Contraindicated
- Apomorphine + Tolcapone Moderate
- Asenapine + Tolcapone Moderate
- Brexpiprazole + Tolcapone Moderate
Frequently asked questions
Can I take Metoclopramide with Tolcapone?
MediHelp rates the interaction as major. Metoclopramide and Tolcapone 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 is a central dopamine D2 antagonist and can worsen Parkinson disease symptoms, directly opposing the dopaminergic benefit of tolcapone-enhanced levodopa therapy. It is generally avoided in parkinsonian patients.
How serious is the interaction between Metoclopramide and Tolcapone?
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 with Parkinson disease; use domperidone where available or another non-dopamine-blocking antiemetic such as 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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