Drug & supplement interaction

L-tryptophan + Metoclopramide

Metoclopramide brand names: Reglan, Metoclopramide Injection, Octamide.

Major Interaction
The bottom line Major

Metoclopramide falls into 2 drug categories that L-tryptophan can interact with; the most serious is rated major. Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

L-tryptophan and Metoclopramide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

L-tryptophan interacts with whole categories of medication. Metoclopramide falls into 2 of those categories, so it can interact with L-tryptophan in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

CNS DEPRESSANTS

1 of 2

Why this applies to Metoclopramide

Metoclopramide falls under CNS DEPRESSANTS — the group L-tryptophan interacts with.

Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Clinical research shows that L-tryptophan can cause fatigue and drowsiness.
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to keep in mind with this pairing: metoclopramide (Reglan) already tends to make people feel tired, foggy, or drowsy on its own. L-tryptophan can add to that, since your body turns it into serotonin and then melatonin, which is part of why some folks feel sleepy after taking it. Put them together and those calming effects can stack up, leaving you more sedated than you'd expect.

This isn't about tryptophan changing how metoclopramide is broken down. It's simply two things that can each cause drowsiness working in the same direction. The concern is rated as serious, though much of it is based on the general sleepiness tryptophan can cause. If you take both, watch for extra grogginess, and please check with your pharmacist or doctor before combining them, especially before driving.

References
  1. Lieberman HR, Corkin S, Spring BJ. The effects of dietary neurotransmitter precursors on human behavior. Am J Clin Nutr 1985;42:366-70. PubMed
Moderate

SEROTONERGIC DRUGS

2 of 2

Metoclopramide also falls under SEROTONERGIC DRUGS.

Theoretically, combining L-tryptophan with serotonergic drugs might cause additive serotonergic effects.
L-tryptophan is a precursor to serotonin. Theoretically, combining serotonergic drugs with L-tryptophan might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: your body turns L-tryptophan into serotonin. Metoclopramide (Reglan) also nudges serotonin activity in the brain and gut as part of how it works. So when you stack the two together, you may end up adding a little extra serotonin on top of a little extra serotonin, and that's where the concern comes from.

In rare cases too much serotonin causes serotonin syndrome, with symptoms like agitation, shakiness, sweating, a racing heart, fever, or confusion. I want to be honest, though: this warning is theoretical, based on how these substances behave, not on strong real-world reports. It's worth a quick chat with your pharmacist or doctor before combining them, especially if you take other mood or migraine medicines too.

References
  1. Messiha FS. Fluoxetine: adverse effects and drug-drug interactions. J Toxicol Clin Toxicol 1993;31:603-30. PubMed
  2. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

L-tryptophan Also Interacts With Other Medications

L-tryptophan has 247 major, 146 moderate known drug interactions in our database — the Metoclopramide one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against L-tryptophan

Covers the 2,830 medications we’ve checked against L-tryptophan. Pick one to open its full report.

From our Q&A

Questions About L-tryptophan or Metoclopramide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers L-tryptophan or Metoclopramide, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Metoclopramide

This page covers L-tryptophan only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metoclopramide page lists 111 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 8 major · 88 moderate · 15 minor.

Open the Metoclopramide interaction page

One more smart check

Taking L-tryptophan as Part of a Dietary Supplement Product? Check It for Interactions

We hold 5 real supplement products containing L-tryptophan, each one broken down to its full ingredient list — and combination products often carry several ingredients besides L-tryptophan. Your product may carry other ingredients that interact with Metoclopramide too, on top of L-tryptophan — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where L-tryptophan and Metoclopramide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement L-tryptophan
Steady interest

#1,025 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Metoclopramide
Steady interest

#1,985 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About L-tryptophan

What is L-tryptophan?

L-tryptophan
  • Sleep problems
  • Low mood and depression
  • Anxiety
  • Premenstrual symptoms
  • Appetite and food cravings

L-tryptophan is an essential amino acid the body uses to make serotonin and melatonin, and people take it to support sleep and mood. The evidence for supplement use is limited and mixed, and there are real safety concerns, so talk to a pharmacist or doctor before trying it.

Read the full L-tryptophan monograph & all interactions
Medication

About Metoclopramide

What Is Metoclopramide Used For?

Brand names: Reglan, Metoclopramide Injection, Octamide

Metoclopramide tablets are used in adults for two main conditions. First, they treat symptomatic gastroesophageal reflux (GERD — when stomach acid backs up into the esophagus) in people who haven't gotten relief from standard treatments. Second, they ease symptoms of diabetic gastroparesis, a condition where nerve damage from diabetes causes the stomach to empty too slowly.

Treatment is meant to be short-term. For acid reflux, it's used for 4 to 12 weeks. For diabetic gastroparesis, it's generally used for 2 to 8 weeks. It is not recommended for children due to serious safety concerns.

See full Metoclopramide drug information
Keep checking

Other Drugs & L-tryptophan

Browse every other medication we’ve checked against L-tryptophan — both the ones with a known interaction and the ones without. Select any drug for the full detail.

247Major
146Moderate
0Minor
2,436No known interaction
Major

247 interactions

Showing 60 of 247 major interactions — see all 247 on the L-tryptophan page.

Moderate

146 interactions

Showing 60 of 146 moderate interactions — see all 146 on the L-tryptophan page.

No interaction 2,436 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking L-tryptophan and Metoclopramide Together: Common Questions

Can you take L-tryptophan with Metoclopramide?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for L-tryptophan and Metoclopramide?
Metoclopramide belongs to more than one drug category, and L-tryptophan interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the L-tryptophan and Metoclopramide interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.