Metoclopramide Paracetamol

Fixed dose combination of metoclopramide with systemically absorbed drugs except fixed dose combination of metoclopramide with aspirin/paracetamol. 

Concomitant administration of paracetamol with other hepatotoxic drugs or drugs acting on liver microsomal enzymes enhances paracetamol toxicity. Other drugs that interact with paracetamol are metoclopramide, probenecid, and cholestyramine.81... 

Paracetamol Metoclopramide increases the rate of absorption and of paracetamol. 

The absorption of paracetamol is decreased by anion exchange resins (colestyramine), whereas some drugs used to control nausea and vomiting, such as metoclopramide and domperidone, hasten the absorption of paracetamol. 

In five health subjects intravenous metoclopramide increased the rate of absorption of a single dose of paracetamol 1.5 g (23). 

A number of ANALGESICS can be used to offset the pain of the attack, including aspirin, codeine and paracetamol, and these are often incorporated into compound preparations together with a variety of other drugs and drug types, e.g. caffeine, buclizine, doxylamine, isometheptene, pizotifen. Sometimes drugs with antinauseant or ANTIEMETIC properties are included, e.g. cyclizine and metoclopramide. 

Metoclopramide increases the rate of absorption of paracetamol and raises its maximum plasma levels. Similarly, domperidone may increase the rate of absorption of paracetamol. 

Intravenous metoclopramide 10 mg increased the peak plasma levels of a single 1.5-g dose of paracetamol by 64% in 5 healthy subjects (slow absorbers of paracetamol), and increased its rate of absorption (peak levels reached in 48 minutes instead of 120 minutes), but the total amount absorbed remained virtually unaltered. Oral metoclopramide also increases the rate of paracetamol absorption, probably because the rate of gastric emptying is increased. Similarly, the speed of absorption of paracetamol may also be increased by domperidone. This interaction is exploited in Paramax (a proprietary oral preparation containing both paracetamol and metoclopramide) to increase the effectiveness and onset of analgesia for the treatment of migraine. This is obviously an advantageous interaction in this situation. 

Nimmo J, Heading RC, Tothill P, Prescott LF. Pharmacological modification of gastric emptying effects of propantheline and metoclopramide on paracetamol absorption. BA4/(1973) 1, 587-9. 

Crome P, Kimber GR, Wainscott G, Widdop B. The effect of the simultaneous administration of oral metoclopramide on the absorption of paracetamol in healthy volunteers. BrJ Clin Phar-maco/(1981)ll,430P 31P. 

Seaber EJ, Ridout G, Layton G, Posner J, Peck RW. The novel anti-migraine zolmitriptan (Zomig 311C90) has no clinically significant interactions with paracetamol or metoclopramide. EurJ Clin Pharmacol (1997) 53,229-34. 

Metoclopramide for nausea paracetamol for pain antihistamine for itch... 

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