Interactions between Metoclopramide and Rotigotine

Rotigotine has a moderate potential interaction with Asthma.

Rotigotine (transdermal patch) contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life threatening or less severe asthmatic episodes in certain susceptible people. Sulfite sensitivity is seen more frequently in people with asthma than people without it.

Rotigotine has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Some patients treated with rotigotine exhibited an increased pulse, greater than 100 beats per minute, while supine or standing. Also, like other dopaminergic agents, rotigotine might impair the systemic regulation of blood pressure causing postural/orthostatic hypotension, especially during dose escalation. These findings of blood pressure and heart rate elevations should be considered when treating patients with cardiovascular disease.

Metoclopramide has a moderate potential interaction with Cirrhosis.

Metoclopramide produces a transient increase in plasma aldosterone and may cause fluid retention and volume overload in susceptible patients. Therapy with metoclopramide should be administered cautiously in patients with or at risk for fluid overload (e.g., cirrhosis, congestive heart failure). If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued.

Metoclopramide has a major potential interaction with Depression.

Metoclopramide has been reported to cause mental depression in patients with and without a prior history of depression. Symptoms have ranged from mild to severe and have included suicidal ideation and suicide. Therapy with metoclopramide in patients with a history of mental depression, especially suicidal tendencies, should be administered cautiously, and only if benefits are anticipated to outweigh the potential risks. Some patients who experience depression with metoclopramide have improved following temporary discontinuation of the drug and reinstitution at a lower dosage with gradual titration.

Metoclopramide has a moderate potential interaction with Fluid Retention.

Metoclopramide produces a transient increase in plasma aldosterone and may cause fluid retention and volume overload in susceptible patients. Therapy with metoclopramide should be administered cautiously in patients with or at risk for fluid overload (e.g., cirrhosis, congestive heart failure). If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued.

Metoclopramide has a major potential interaction with Gastrointestinal Hemorrhage.

The use of metoclopramide is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage.

Metoclopramide has a major potential interaction with Gastrointestinal Perforation.

The use of metoclopramide is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage.

Metoclopramide has a moderate potential interaction with Heart Failure.

Metoclopramide produces a transient increase in plasma aldosterone and may cause fluid retention and volume overload in susceptible patients. Therapy with metoclopramide should be administered cautiously in patients with or at risk for fluid overload (e.g., cirrhosis, congestive heart failure). If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued.

Rotigotine has a moderate potential interaction with Heart Failure.

Patients taking rotigotine had a higher incidence of weight gain associated with fluid retention, when compared with patients taking placebo. Weight gain and fluid retention should be monitored in patients using rotigotine, specially in those with concomitant illnesses as congestive heart failure and renal insufficiency.

Metoclopramide has a moderate potential interaction with High Blood Pressure.

In a study involving patients with essential hypertension, intravenously administered metoclopramide was shown to induce the release of catecholamines. Therapy with metoclopramide should be administered cautiously in patients with hypertension because of potential increases in blood pressure.

Rotigotine has a moderate potential interaction with Hypotension.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension at any time, but especially during dose escalation. Additionally, patients with Parkinson's disease may have an impaired capacity to respond to an orthostatic challenge. For these reasons, patients with Parkinson's disease (or restless legs syndrome) who are being treated with dopaminergic agonists typically require careful monitoring for signs/symptoms of orthostatic hypotension, especially during dose escalation, and should be advised of this risk.

Metoclopramide has a major potential interaction with Intestinal Obstruction.

The use of metoclopramide is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage.

Metoclopramide has a major potential interaction with Neuroleptic Malignant Syndrome.

Although not a neuroleptic agent, metoclopramide has antidopaminergic effects and may rarely precipitate or aggravate a potentially fatal symptom complex known as Neuroleptic Malignant Syndrome (NMS). Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, involuntary movements, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Metoclopramide therapy should not be initiated in patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of metoclopramide or other antidopaminergic therapy should be carefully considered, since NMS may recur.

Metoclopramide has a moderate potential interaction with Parkinsonism.

Metoclopramide has antidopaminergic effects and may cause parkinsonian-like symptoms such as akinesia, bradykinesia, tremors, pill-rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually within the first six months following initiation of therapy but occasionally after longer periods. Symptoms generally subside within 2 to 3 months after drug discontinuation. Therapy with metoclopramide should be administered cautiously, if at all, in patients with Parkinson's disease or parkinsonian symptoms.

Metoclopramide has a major potential interaction with Pheochromocytoma.

The use of metoclopramide is contraindicated in patients with pheochromocytoma. In a study involving patients with essential hypertension, intravenously administered metoclopramide was shown to induce the release of catecholamines. Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.

Rotigotine has a moderate potential interaction with Psychosis.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinsonian agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs. The use of bromocriptine in patients with severe psychotic disorders is not recommended.

Metoclopramide has a moderate potential interaction with Renal Dysfunction.

Renal function affects the clearance of metoclopramide. In patients with varying degrees of renal impairment, a reduction in creatinine clearance was correlated with a reduction in plasma clearance, renal clearance, and non-renal clearance, and increase in elimination half-life of metoclopramide. Therapy with metoclopramide should be administered cautiously in patients with impaired renal function. A dosage reduction may be appropriate to avoid drug accumulation.

Rotigotine has a moderate potential interaction with Renal Dysfunction.

Patients taking rotigotine had a higher incidence of weight gain associated with fluid retention, when compared with patients taking placebo. Weight gain and fluid retention should be monitored in patients using rotigotine, specially in those with concomitant illnesses as congestive heart failure and renal insufficiency.

Metoclopramide has a major potential interaction with Seizures.

The use of metoclopramide is contraindicated in patients with seizure disorders. Metoclopramide may increase the frequency and severity of seizures.

Metoclopramide has a major potential interaction with Tardive Dyskinesia.

Metoclopramide may precipitate symptoms of tardive dyskinesia (TD) following chronic administration. Elderly patients, particularly women, are most susceptible. Both the risk of developing TD and the likelihood that it will become irreversible increase with the duration and total cumulative dose of metoclopramide or other antidopaminergic therapy administered. Metoclopramide therapy should be discontinued in patients who develop signs or symptoms of tardive dyskinesia. There is no known treatment for tardive dyskinesia. In some patients, symptoms may lessen or resolve after metoclopramide treatment is stopped. Treatment with metoclopramide for longer than 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing tardive dyskinesia. In patients with preexisting drug-induced TD, initiating or increasing the dosage of metoclopramide therapy may temporarily mask the symptoms of TD but may eventually worsen the condition.