Skip to main content

Drug Interactions between meperidine / promethazine and Reglan

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

Edit list (add/remove drugs)

Interactions between your drugs

Major

metoclopramide promethazine

Applies to: Reglan (metoclopramide) and meperidine / promethazine

Using metoclopramide together with promethazine 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.

Moderate

meperidine metoclopramide

Applies to: meperidine / promethazine and Reglan (metoclopramide)

Narcotic pain medications like meperidine may reduce the effects of metoclopramide. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact. In addition, combining these medications may increase nervous systemic side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. You should avoid or limit the use of alcohol while being treated with these medications, and also avoid driving or operating hazardous machinery until you know how the medications affect you. 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.

Moderate

meperidine promethazine

Applies to: meperidine / promethazine and meperidine / promethazine

Using meperidine together with promethazine may increase side effects such as drowsiness, dizziness, lightheadedness, confusion, depression, low blood pressure, slow or shallow breathing, and impairment in thinking, judgment, and motor coordination. Occasionally, severe reactions may result in coma and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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/lifestyle interactions

Major

meperidine food/lifestyle

Applies to: meperidine / promethazine

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur. In addition, alcohol may affect opioid release from sustained-release formulations.

GENERALLY AVOID: Grapefruit or grapefruit juice may increase the plasma concentrations of opioid analgesics by inhibiting CYP450 3A4-mediated metabolism of these agents, although the interaction has not been studied. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Pharmacokinetic interactions involving grapefruit juice are also subject to a high degree of interpatient variability, thus the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients should not consume alcoholic beverages or use drug products that contain alcohol during treatment with opioid analgesics. Any history of alcohol or illicit drug use should be considered when prescribing an opioid analgesic, and therapy initiated at a lower dosage if necessary. Patients should be closely monitored for signs and symptoms of sedation, respiratory depression, and hypotension. Due to a high degree of interpatient variability with respect to grapefruit juice interactions, patients treated with opioid analgesics should preferably avoid the consumption of grapefruit and grapefruit juice.

Moderate

metoclopramide food/lifestyle

Applies to: Reglan (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

promethazine food/lifestyle

Applies to: meperidine / promethazine

Ask your doctor before using promethazine together with ethanol (alcohol). This can cause uncontrollable movements, agitation, seizures, severe dizziness or fainting, coma, very deep sleep, irregular heartbeats, and high or low body temperature. Use caution when driving, operating machinery, or performing other hazardous activities, these medicaions may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. 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.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antidopaminergic-like antiemetics

Therapeutic duplication

The recommended maximum number of medicines in the 'antidopaminergic-like antiemetics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidopaminergic-like antiemetics' category:

  • meperidine/promethazine
  • Reglan (metoclopramide)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer