Drug interactions
Metoclopramide intranasal + Terbinafine
Severity: Major
Metoclopramide intranasal and Terbinafine: 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
Terbinafine is a strong CYP2D6 inhibitor and raises metoclopramide concentrations. Higher exposure increases the risk of extrapyramidal symptoms, tardive dyskinesia and other CNS adverse effects. The fixed-dose nasal spray cannot be titrated to compensate.
What this interaction means in plain words
Metoclopramide intranasal 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.
Why it happens
Inhibition of CYP2D6 by terbinafine reduces metabolic clearance of metoclopramide.
What to do
Avoid the combination with the fixed-dose nasal product and use an oral metoclopramide formulation with a reduced dose or an alternative antiemetic or prokinetic. Monitor for movement disorders and sedation if combined.
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 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 intranasal with Terbinafine?
MediHelp rates the interaction as major. Metoclopramide intranasal 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 raises metoclopramide concentrations. Higher exposure increases the risk of extrapyramidal symptoms, tardive dyskinesia and other CNS adverse effects. The fixed-dose nasal spray cannot be titrated to compensate.
How serious is the interaction between Metoclopramide intranasal 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 the combination with the fixed-dose nasal product and use an oral metoclopramide formulation with a reduced dose or an alternative antiemetic or prokinetic. Monitor for movement disorders and sedation if combined.
What other medicines interact with Terbinafine?
MediHelp also lists interactions of Terbinafine with, for example, Thioridazine, Desipramine, Eliglustat. The full list is on the Terbinafine page.
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