Drug interactions
Metoclopramide intranasal + Rolapitant
Severity: Major
Metoclopramide intranasal and Rolapitant: 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
Rolapitant is a long-acting CYP2D6 inhibitor and can raise metoclopramide exposure. This may increase extrapyramidal effects, somnolence and other adverse effects, and the intranasal dose cannot be adjusted.
What this interaction means in plain words
Metoclopramide intranasal and Rolapitant 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
Rolapitant inhibits CYP2D6, reducing metoclopramide clearance.
What to do
Avoid the combination; use an oral or injectable metoclopramide product with dose reduction, or another antiemetic. Monitor for extrapyramidal symptoms.
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 Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant Major
Frequently asked questions
Can I take Metoclopramide intranasal with Rolapitant?
MediHelp rates the interaction as major. Metoclopramide intranasal and Rolapitant 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. Rolapitant is a long-acting CYP2D6 inhibitor and can raise metoclopramide exposure. This may increase extrapyramidal effects, somnolence and other adverse effects, and the intranasal dose cannot be adjusted.
How serious is the interaction between Metoclopramide intranasal and Rolapitant?
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 the combination; use an oral or injectable metoclopramide product with dose reduction, or another antiemetic. Monitor for extrapyramidal symptoms.
What other medicines interact with Rolapitant?
MediHelp also lists interactions of Rolapitant with, for example, Pimozide, Thioridazine, Atomoxetine. The full list is on the Rolapitant page.
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