Bupropion with Metoclopramide Interaction Details

Brand Names Associated with Bupropion

Brand Names Associated with Metoclopramide

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Mar 06, 2024

Interaction Effect

Increased metoclopramide exposure and risk of increased adverse events

Interaction Summary

Concomitant use of metoclopramide and a strong CYP2D6 inhibitor may result in increased metoclopramide exposure. In a study, coadministration resulted in increased metoclopramide Cmax, AUC, and t(1/2). If coadministered in patients with gastroesophageal reflux, decrease the metoclopramide dosage to 5 mg orally 4 times daily or 10 mg three times daily; maximum dose 30 mg/day. In patients with acute and recurrent diabetic gastroparesis, decrease the metoclopramide dosage to 5 mg orally 4 times daily; maximum dose 20 mg/day[1].

Severity

Major

Onset

Unspecified

Evidence

Theoretical

How To Manage Interaction

Concomitant use of metoclopramide and a strong CYP2D6 inhibitor may result in increased metoclopramide exposure. If coadministered in patients with gastroesophageal reflux, decrease the metoclopramide dosage to 5 mg orally 4 times daily or 10 mg three times daily; maximum dose 30 mg/day. In patients with acute and recurrent diabetic gastroparesis, decrease the metoclopramide dosage to 5 mg orally 4 times daily; maximum dose 20 mg/day[1].

Mechanism Of Interaction

Inhibition of CYP2D6-mediated metoclopramide metabolism

Literature Reports

A) Coadministration of metoclopramide 20 mg and fluoxetine 60 mg orally for 8 days (a strong CYP2D6 inhibitor) in healthy subjects resulted in increases in metoclopramide Cmax of 40%, AUC(0 to infinity) by 90%, and t(1/2) from 5.5 to 8.5 hours compared with metoclopramide alone [1].

References

1 ) Product Information: REGLAN(R) oral tablets, metoclopramide oral tablets. ANI Pharmaceuticals, Inc. (per FDA), Baudette, MN, 2017.

Bupropion Overview

• Bupropion (Aplenzin, Wellbutrin, Wellbutrin SR, Wellbutrin XL) is used to treat depression. Bupropion (Aplenzin, Wellbutrin XL) is also used to treat seasonal affective disorder (SAD; episodes of depression that occur at the same time each year [usually in the fall and winter but rarely may occur in the spring or summer months]). Bupropion (Zyban) is used to help people stop smoking. Bupropion is in a class of medications called antidepressants. It works by increasing certain types of activity in the brain.

Metoclopramide Overview

• Metoclopramide is used to relieve heartburn and speed the healing of ulcers and sores in the esophagus (tube that connects the mouth to the stomach) in people who have gastroesophageal reflux disease (GERD; condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus) that did not get better with other treatments. Metoclopramide is also used to relieve symptoms caused by slow stomach emptying in people who have diabetes. These symptoms include nausea, vomiting, heartburn, loss of appetite, and feeling of fullness that lasts long after meals. Metoclopramide is in a class of medications called prokinetic agents. It works by speeding the movement of food through the stomach and intestines.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.