Reglan - Interactions Metoclopramide Hydrochloride

Interactions for REGLAN (metoclopramide hydrochloride tablet) explain how Reglan works in concert with other medications and substances.

This section below outlines the advice given to doctors and pharmacists when prescribing and dispensing Reglan

Drug Interactions

effects of other drugs on metoclopramide

Table 3 displays the effects of other drugs on metoclopramide.

Table 3. Effects of Other Drugs on Metoclopramide

Antipsychotics

Clinical Impact

Potential for additive effects, including increased frequency and severity of tardive dyskinesia (TD), other extrapyramidal symptoms (EPS), and neuroleptic malignant syndrome (NMS).

Intervention

Avoid concomitant use [see Warnings and Precautions (5.1, 5.2, 5.3)].

Strong CYP2D6 Inhibitors, not Included in Antipsychotic Category Above

Clinical Impact

Increased plasma concentrations of metoclopramide; risk of exacerbation of extrapyramidal symptoms [see Clinical Pharmacology (12.3)].

Intervention

Reduce the Reglan dosage [see Dosage and Administration (2.2, 2.3)].

Examples

quinidine, bupropion, fluoxetine, and paroxetine

Monoamine Oxidase Inhibitors

Clinical Impact

Increased risk of hypertension [see Warnings and Precautions (5.5)].

Intervention

Avoid concomitant use.

Central Nervous System (CNS) Depressants

Clinical Impact

Increased risk of CNS depression [see Warnings and Precautions (5.8)].

Intervention

Avoid Reglan or the interacting drug, depending on the importance of the drug to the patient.

Examples

alcohol, sedatives, hypnotics, opiates and anxiolytics

Drugs that Impair Gastrointestinal Motility

Clinical Impact

Decreased systemic absorption of metoclopramide.

Intervention

Monitor for reduced therapeutic effect.

Examples

antiperistaltic antidiarrheal drugs, anticholinergic drugs, and opiates

Dopaminergic Agonists and Other Drugs that Increase Dopamine Concentrations

Clinical Impact

Decreased therapeutic effect of metoclopramide due to opposing effects on dopamine.

Intervention

Monitor for reduced therapeutic effect.

Examples

apomorphine, bromocriptine, cabergoline, levodopa, pramipexole, ropinirole, and rotigotine

effects of metoclopramide on other drugs

Table 4 displays the effects of Metoclopramide on other drugs.

Table 4. Effects of Metoclopramide on Other Drugs

Dopaminergic Agonists and Drugs Increasing Dopamine Concentrations

Clinical Impact

Opposing effects of metoclopramide and the interacting drug on dopamine. Potential exacerbation of symptoms (e.g., parkinsonian symptoms).

Intervention

Avoid concomitant use [see Warnings and Precautions (5.2)].

Examples

Apomorphine, bromocriptine, cabergoline, levodopa, pramipexole, ropinirole, rotigotine

Succinylcholine, Mivacurium

Clinical Impact

Metoclopramide inhibits plasma cholinesterase leading to enhanced neuromuscular blockade.

Intervention

Monitor for signs and symptoms of prolonged neuromuscular blockade.

Drugs with Absorption Altered due to Increased Gastrointestinal Motility

Clinical Impact

The effect of metoclopramide on other drugs is variable. Increased gastrointestinal (GI) motility by metoclopramide may impact absorption of other drugs leading to decreased or increased drug exposure.

Intervention

Drugs with Decreased Absorption (e.g., digoxin, atovaquone, posaconazole oral suspension*, fosfomycin): Monitor for reduced therapeutic effect of the interacting drug. For digoxin monitor therapeutic drug concentrations and increase the digoxin dose as needed (see prescribing information for digoxin).

Drugs with Increased Absorption (e.g., sirolimus, tacrolimus, cyclosporine): Monitor therapeutic drug concentrations and adjust the dose as needed. See prescribing information for the interacting drug.

Insulin

Clinical Impact

Increased GI motility by metoclopramide may increase delivery of food to the intestines and increase blood glucose.

Intervention

Monitor blood glucose and adjust insulin dosage regimen as needed.

* Interaction does not apply to posaconazole delayed-release tablets

This drug label information is as submitted to the Food and Drug Administration (FDA) and is intended for informational purposes only. If you think you may have a medical emergency, immediately call your doctor or dial 911. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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