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Drug Interactions between clozapine and metoclopramide

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

cloZAPine metoclopramide

Applies to: clozapine and metoclopramide

Using metoclopramide together with cloZAPine is not recommended. Treatment with either medication alone can cause Parkinson-like symptoms and abnormal muscle movements, and combining them may increase that risk. The most serious of the movement disorders associated with the use of these medications is a condition known as tardive dyskinesia (TD). TD mostly involves muscles in the face, but may also involve those in the limbs. You cannot control these movements, and they may not go away even after stopping the medications. There is no treatment for TD, but symptoms may lessen or disappear over time after stopping the medications. You may be more likely to develop TD if you are elderly, especially if you are a woman, or if you have diabetes. Your risk also increases the longer you take these medications and the more of each you take. As such, treatment with metoclopramide should generally be limited to 12 weeks. Let your doctor know promptly if you experience muscle spasm or movements that you can't stop or control, such as lip smacking, chewing, puckering, frowning or scowling, tongue thrusting, teeth clenching, jaw twitching, blinking, eye rolling, shaking or jerking of arms and legs, tremor, jitteriness, restlessness, pacing, and foot tapping. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Drug and food interactions

Moderate

cloZAPine food

Applies to: clozapine

Alcohol can increase the nervous system side effects of cloZAPine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with cloZAPine. Do not use more than the recommended dose of cloZAPine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate

metoclopramide food

Applies to: metoclopramide

Alcohol can increase the nervous system side effects of metoclopramide such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with metoclopramide. Do not use more than the recommended dose of metoclopramide, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate

cloZAPine food

Applies to: clozapine

Consumer information for this interaction is not currently available.

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.

Minor

cloZAPine food

Applies to: clozapine

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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