Drug General Information (ID: DDI3EKHAZU)
Drug Name			Pergolide		Drug Info		Metoclopramide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiparkinson Agents				Antiemetics
Structure

Mechanism of Pergolide-Metoclopramide Interaction (Severity Level: Moderate)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Pergolide				Metoclopramide
Mechanism 1		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Pergolide and Metoclopramide
Antagonize the effect of dopaminergic agents Click to Show/Hide Mechanism Graph
Drug Name		Pergolide				Metoclopramide
Mechanism 2		Dopaminergic agent Dopamine receptor  Agonist				Antidopaminergic effects Dopamine receptor  Antagonist
Key Mechanism Factor 2
		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 Pergolide when combined with Metoclopramide

Recommended Action
Management		Concomitant use of dopaminergic drugs with antidopaminergic agents should generally be avoided. If coadministration is necessary, patients should be alerted to the possibility of excessive drowsiness and monitored for potentially diminished therapeutic response to both treatments. Patients treated for Parkinson's disease should generally avoid antidopaminergic agents, since they may cause extrapyramidal reactions and exacerbate the symptoms of Parkinson's disease.

References
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2	Product Information. Dostinex (cabergoline). Pharmacia and Upjohn, Kalamazoo, MI.
3	Product Information. Geodon (ziprasidone). Pfizer US Pharmaceuticals, New York, NY.
4	Product Information. Mirapex (pramipexole). Boehringer Ingelheim, Ridgefield, CT.
5	Product Information. Norprolac (quinagolide). Ferring Inc, North York, IA.
6	Product Information. Parlodel (bromocriptine). Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
7	Product Information. Permax (pergolide). Athena Neurosciences Inc, South San Francisco, CA.
8	Product Information. Reglan (metoclopramide). Wyeth-Ayerst Laboratories, Philadelphia, PA.
9	Product Information. Requip (ropinirole). SmithKline Beecham, Philadelphia, PA.
10	Product Information. Risperdal (risperidone). Janssen Pharmaceutica, Titusville, NJ.
11	Product Information. Seroquel (quetiapine). Zeneca Pharmaceuticals, Wilmington, DE.
12	Product Information. Zyprexa (olanzapine). Lilly, Eli and Company, Indianapolis, IN.
13	Robbins RJ, Kern PA, Thompson TL "Interactions between thioridazine and bromocriptine in a patient with a prolactin-secreting pituitary adenoma." Am J Med 76 (1984): 921-3. [PMID: 6720732]
14	Weingarten JC, Thompson TL "The effect of thioridazine on prolactinoma growth in a schizophrenic man: case report." Gen Hosp Psychiatry 7 (1985): 364-6. [PMID: 4065553]
15	Yahr MD, Duvoisin RC "Drug therapy of parkinsonism." N Engl J Med 287 (1972): 20-4. [PMID: 4555145]