Drug General Information (ID: DDI04XEOKH)
Drug Name			Amantadine		Drug Info		Metoclopramide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Antiemetics
Structure

Mechanism of Amantadine-Metoclopramide Interaction (Severity Level: Moderate)
Antagonize the effect of dopaminergic agents Click to Show/Hide Mechanism Graph
Drug Name		Amantadine				Metoclopramide
Mechanism		Dopaminergic effects Dopamine receptor  Agonist				Antidopaminergic effects Dopamine receptor  Antagonist
Key Mechanism Factor 1
		Factor Name		Dopamine receptor				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		Dopamine receptor whose activity is mediated by G proteins which activate adenylyl cyclase.     Click to Show/Hide
Mechanism Description		Antagonize the effect of Amantadine when combined with Metoclopramide

Recommended Action
Management		Patients receiving amantadine for Parkinson's disease or drug-induced extrapyramidal reactions should generally avoid antidopaminergic agents including metoclopramide. If these agents have been administered together chronically, amantadine dosing should not be abruptly reduced or discontinued due to the potential to precipitate a parkinsonian crisis, delirium, agitation, delusions, hallucinations, paranoid reaction, stupor, anxiety, depression, slurred speech, and rarely, neuroleptic malignant syndrome. In patients receiving amantadine for influenza A prophylaxis or treatment, the possibility of diminished efficacy of metoclopramide should be considered during coadministration.

References
1	Product Information. Reglan (metoclopramide). Wyeth-Ayerst Laboratories, Philadelphia, PA.
2	Product Information. Symmetrel (amantadine). DuPont Pharmaceuticals, Wilmington, DE.