Metoclopramide Injection and Sertraline: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Sertraline
No brand names on recordMetoclopramide Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of metoclopramide exposure and an increased risk of extrapyramidal reactions and neuroleptic malignant syndrome
Interaction Deep Dive
Concomitant use of metoclopramide for injection with other drugs likely to cause extrapyramidal reactions (EPS), such as sertraline is contraindicated2. Avoid use of drugs associated with EPS in patients receiving orally administered metoclopramide due to a risk of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome. If concurrent therapy is required, monitor patients closely for signs and symptoms of extrapyramidal reactions or neuroleptic malignant syndrome (fever, sweating, confusion, muscle stiffness). If symptoms occur, discontinue both agents and manage medically 1. Concomitant use of sertraline (CYP2D6 inhibitor) with CYP2D6 substrate, such as metoclopramide may increase the exposure of metoclopramide. If coadministration is required, reduce the dosage of metoclopramide as necessary; conversely, an increase in the dosage of metoclopramide may be needed with discontinuation of sertraline 3.
Why it happens (mechanism)
Inhibition of CYP2D6-mediated metabolism of metoclopramide; unknown
Literature reports
1 report — tap to read
a) In drug interactions studies, PARoxetine demonstrated the following effects on drugs metabolized by CYP2D6. PARoxetine 20 mg once daily at steady-state increased a single dose of desipramine 100 mg Cmax, AUC, and t(1/2) by approximately 2-, 5-, and 3-fold, respectively. In patients stabilized on risperiDONE 4 to 8 mg/day, daily PARoxetine 20 mg increased mean plasma concentrations of risperiDONE by 4-fold, decreased 9-hydroxyrisperiDONE concentrations by 10%, and increased concentrations of the active moiety by 1.4-fold. In healthy volunteers who were extensive CYP2D6 metabolizes, steady-sate atomoxetine AUC values were 6- to 8-fold higher and Cmax values were 3- to 4-fold higher with concomitant PARoxetine compared with atomoxetine alone. Mean digoxin steady-state AUC decreased by 15% in the presence of PARoxetine. In a study with propranolol 80 mg twice daily for 18 days, the steady-state plasma concentrations of propranolol were unaltered during coadministration with PARoxetine 30 mg once daily for the final 10 days 4.
Common questions
Can I take Metoclopramide Injection and Sertraline together?
Increased risk of metoclopramide exposure and an increased risk of extrapyramidal reactions and neuroleptic malignant syndrome Always confirm with your pharmacist or prescriber before making any change.
How serious is the Metoclopramide Injection and Sertraline interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Metoclopramide Injection or Sertraline need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (4)
- Product Information: REGLAN(R) oral tablets, metoclopramide oral tablets. ANI Pharmaceuticals, Inc. (per FDA), Baudette, MN, 2017. DailyMed
- Product Information: Metoclopramide hydrochloride intravenous, intramuscular injection, metoclopramide hydrochloride intravenous, intramuscular injection. Fresenius Kabi (per DailyMed), Lake Zurich, IL, 2016. DailyMed
- Product Information: ZOLOFT oral tablets, oral solution, sertraline hydrochloride oral tablets, oral solution. Viatris Specialty LLC (per FDA), Morgantown, WV, 2023. DailyMed
- Product Information: PEXEVA(R) oral tablets, paroxetine mesylate oral tablets. Sebela Pharmaceuticals Inc (per FDA), Roswell, GA, 2023.
Keep reading about Sertraline
Keep reading about Metoclopramide Injection
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