Metoclopramide is used to treat heartburn and regurgitation; to prevent vomiting in people receiving drugs to treat cancer; and to prevent nausea, vomiting, heartburn, and fullness after a meal in certain individuals with diabetes.
Salicylic acid is a compound formed in the body from either aspirin or willow bark (Salix alba). Taking metoclopramide before aspirin or willow bark results in higher concentrations of salicylic acid and greater pain relief in people suffering from an acute migraine headache.1 Controlled studies are necessary to confirm the benefit of this interaction.
Individuals who have lactose intolerance (difficulty digesting milk sugar) may experience more severe symptoms while taking metoclopramide.2 Lactose is the milk sugar present in dairy products.
A single case report described a 15-year-old girl who suffered oxygen deprivation in her body tissues after being given high amounts of metoclopramide and N-acetyl-cysteine to treat her for an overdose of acetaminophen.3 It is unknown whether N-acetyl-cysteine supplementation in the absence of acetaminophen overdose could cause similar effects in people taking metoclopramide. Until controlled research determines the safety of this combination, it should be used only under the supervision of a qualified physician.
1. Miner JO. Drug interactions involving aspirin (acetylsalicylic acid) and salicylic acid. Clin Pharmacokinet 1989;17:327–44.
2. Peuhkuri K, Vapaatalo H, Nevala R, Korpela R. Influence of the pharmacological modification of gastric emptying on lactose digestion and gastrointestinal symptoms. Aliment Pharmacol Ther 1999;13:81–6.
3. Langford JS, Sheikh S. An adolescent case of sulfhemoglobinemia associated with high-dose metoclopramide and N-acetylcysteine. Ann Emerg Med 1999;34:538–41.
Last Review: 05-01-2013
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