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Interaction with other medicinal products and other forms of interaction:
Metoclopramide-related interactions:
Alcohol potentiates the sedative effect of metoclopramide.
Anticholinergics and morphine derivatives antagonise the effects of metoclopramide on gastrointestinal motility.
Combination of CNS depressants (morphine derivatives, hypnotics, anxiolytics, sedative H1 antihistamines, sedative antidepressants, barbiturates, clonidine and related) with metoclopramide may result in potentiation of sedative effects.
Combination of antipsychotics with metoclopramide may result in potentiation of extrapyramidal effects.
Due to the promotion of gastric emptying and normal peristalsis caused by metoclopramide, the absorption of certain drugs may be modified:
Metoclopramide decreased the gastric absorption of digoxin. Therefore, dose adjustment may be required.
Metoclopramide increases ciclosporin bioavailability. Dose adjustment may be required. In one study, dosing requirements for ciclosporin were reported to be reduced by 20% when metoclopramide was administered concomitantly. To avoid toxicity, careful monitoring of ciclosporin plasma concentration is required.
Levodopa and metoclopramide have a mutual antagonism. Concomitant use should be avoided.
Salicylate-related interactions:
Salicylates may enhance the effects of anti-coagulants.
Salicylates may enhance the effects of oral anti-diabetic agents.
Anti-epileptics: Salicylates may enhance the effects of phenytoin, sodium valproate.
Antimetabolites: Salicylates may enhance the effects of methotrexate.
Immunomodulating agents: Salicylates may inhibit the action of alpha interferon.
Salicylates may interact with other NSAIDs, antacids and glucorticosteroids, which may lower blood salicylate concentration during treatment and result in high levels when treatment is stopped.
The effects of diuretics and uricosurics may also be affected by salicylates.
Other anti-platelet drugs:
Salicylates may increase risk of bleeding with clopidogrel and ticlopidine.
Aspirin may increase plasma concentration of zafirlukast (Leukotriene antagonists).
Based on theoretical grounds, mifepristone may interact with salicylates.
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