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    Sarafem

    Interactions

    Metoclopramide/SSRIs; SNRIs

    This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

    Medical warning:

    Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

    How the interaction occurs:

    Both of your medicines increase serotonin levels in your blood. Also, some antidepressants may slow down how quickly your liver processes metoclopramide.

    What might happen:

    High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening. If you are taking fluoxetine or paroxetine with metoclopramide, the amount of metoclopramide in your blood may increase. This can increase the risk of abnormal, uncontrollable muscle movements called tardive dyskinesia. There is no cure for tardive dyskinesia, but symptoms may lessen or go away after you stop taking the medicines; however, the symptoms may be permanent.

    What you should do about this interaction:

    Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you have any increase in irritability, double vision, nausea, confusion, anxiety, fever, increased muscle stiffness, or loss of consciousness.Contact your doctor right away if you develop any movements you cannot stop or control such as: lip smacking, chewing, puckering of the mouth, frowning or scowling, sticking out the tongue, blinking and moving the eyes, and shaking of the arms and/or legsYour healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

    References:

    1.Reglan (metoclopramide) tablets US prescribing information. ANI Pharmaceuticals, Inc. August 29, 2017.

    2.Vlase L, Leucuta A, Farcau D, Nanulescu M. Pharmacokinetic interaction between fluoxetine and metoclopramide in healthy volunteers. Biopharm Drug Dispos 2006 Sep;27(6):285-9.

    3.Coulter DM, Pillans PI. Fluoxetine and extrapyramidal side effects. Am J Psychiatry 1995 Jan;152(1):122-5.

    4.Palop V, Jimenez MJ, Catalan C, Martinez-Mir I. Acute dystonia associated with fluvoxamine-metoclopramide. Ann Pharmacother 1999 Mar;33(3):382.

    5.Christensen RC, Byerly MJ. Mandibular dystonia associated with the combination of sertraline and metoclopramide. J Clin Psychiatry 1996 Dec; 57(12):596.

    6.Vandemergel X, Beukinga I, Neve P. Serotonin syndrome secondary to the use of sertraline and metoclopramide. Rev Med Brux 2000 Jun;21(3):161-3.

    7.Fisher AA, Davis MW. Serotonin syndrome caused by selective serotonin reuptake-inhibitors-metoclopramide interaction. Ann Pharmacother 2002 Jan; 36(1):67-71.

    Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

    CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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