Drug interactions
Metoclopramide intranasal + Rasagiline
Severity: Major
Metoclopramide intranasal and Rasagiline: 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 is a dopamine antagonist that can oppose the antiparkinsonian effect of rasagiline and has also been reported to potentiate pressor responses with MAO inhibitors. The combination may worsen parkinsonian symptoms and raise blood pressure.
What this interaction means in plain words
Metoclopramide intranasal and Rasagiline 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.
Why it happens
Central D2 receptor blockade antagonizes dopaminergic therapy, and possible catecholamine release or potentiation adds to pressor effects with MAO inhibition.
What to do
Avoid metoclopramide in patients with Parkinson disease taking rasagiline; use an antiemetic without central dopamine blockade such as domperidone where available or ondansetron (with serotonergic caution). If unavoidable, monitor blood pressure and motor function.
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 Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Metoclopramide intranasal with Rasagiline?
MediHelp rates the interaction as major. Metoclopramide intranasal and Rasagiline 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 dopamine antagonist that can oppose the antiparkinsonian effect of rasagiline and has also been reported to potentiate pressor responses with MAO inhibitors. The combination may worsen parkinsonian symptoms and raise blood pressure.
How serious is the interaction between Metoclopramide intranasal and Rasagiline?
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 taking rasagiline; use an antiemetic without central dopamine blockade such as domperidone where available or ondansetron (with serotonergic caution). If unavoidable, monitor blood pressure and motor function.
What other medicines interact with Rasagiline?
MediHelp also lists interactions of Rasagiline with, for example, Atomoxetine, Brimonidine, Bupropion-naltrexone. The full list is on the Rasagiline page.
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