Metoclopramide and Buprenorphine: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Buprenorphine
Metoclopramide
No brand names on record
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.
Buprenorphine is an opioid used for pain or opioid use disorder, and metoclopramide helps with nausea and stomach emptying. Both can make you feel sleepy or slowed down. When you take them together, those calming effects can add up, so you might feel extra drowsy, dizzy, foggy, or short of breath.
The good news is this is a known combination your care team can handle. They may watch you a bit more closely or adjust things so you stay safe. Take both exactly as prescribed, and let your pharmacist or doctor know if you feel unusually sleepy or hard to wake.
Effect: Additive CNS depression when buprenorphine (opioid agonist/partial agonist) is combined with metoclopramide.
- Mechanism: Additive pharmacodynamic CNS-depressant effect. Not a PK/enzyme interaction (neither is acting as a prodrug here).
- Direction: Increased sedation, psychomotor impairment, and respiratory depression risk.
- Evidence: Theoretical; severity rated major.
- Onset: Unspecified.
- Management: Avoid concomitant use where possible. If necessary, use lowest effective doses, monitor sedation level and respiratory status, and counsel on additive CNS effects.
What happens
Increased risk of CNS depression
Interaction Deep Dive
Taking metoclopramide together with a CNS depressant (for example, sedatives, hypnotics, opiates, and anxiolytics) can heighten the likelihood of CNS depression, so this combination should be avoided. Should coadministration be required, watch for adverse effects1.
Why it happens (mechanism)
Additive pharmacologic effect
How to manage this interaction
This combination is manageable when your care team knows you are on both.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your team may prefer to avoid this pairing when there is an alternative, or use the lowest effective doses tailored to you.
- They may monitor you more closely for sedation and breathing, especially early on.
- Tell your pharmacist or doctor about any severe drowsiness, confusion, slow or shallow breathing, or dizziness.
- Avoid alcohol and other sedating medicines unless cleared by your team.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Metoclopramide and Buprenorphine together?
Taking buprenorphine and metoclopramide together can add up to more drowsiness and slowed breathing, so this pairing is best avoided when possible; if you use both, take them as prescribed and tell your care team about any unusual sedation. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Metoclopramide and Buprenorphine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Metoclopramide and Buprenorphine interaction managed?
This combination is manageable when your care team knows you are on both. Keep taking both as prescribed unless your prescriber tells you otherwise. Your team may prefer to avoid this pairing when there is an alternative, or use the lowest effective doses tailored to you. They may monitor you more closely for sedation and breathing, especially early on. Tell your pharmacist or doctor about any sev… Management is individual — always follow your own care team's guidance.
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 or Buprenorphine 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 (1)
- Product Information: REGLAN(R) oral tablets, metoclopramide oral tablets. ANI Pharmaceuticals, Inc. (per FDA), Baudette, MN, 2017. DailyMed
Keep reading about Buprenorphine
Keep reading about Metoclopramide
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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