Can you take metoclopramide and omeprazole together?

October 12, 2025 •

4 min read

Studies show that up to a third of adults with gastroesophageal reflux disease (GERD) may also have delayed gastric emptying. This raises the question for many: Can you take metoclopramide and omeprazole together to manage these overlapping symptoms?

Quick Summary

Metoclopramide and omeprazole can be taken together under medical supervision to address both acid production and stomach motility, but it's crucial to be aware of the individual risks of each medication.

Key Points

No Direct Interaction: No clinically significant drug-on-drug interactions are reported between metoclopramide and omeprazole.
Complementary Actions: Omeprazole reduces stomach acid production, while metoclopramide speeds up stomach emptying, providing a two-pronged treatment approach.
Primary Uses: This combination is often used for severe GERD, especially when accompanied by gastroparesis (delayed stomach emptying).
Metoclopramide Risk: Metoclopramide has a black box warning for tardive dyskinesia, a serious movement disorder, especially with long-term use.
Omeprazole Risk: Long-term omeprazole use is linked to risks like bone fractures and certain infections.
Medical Supervision is Essential: This drug combination should only be used under the guidance and prescription of a healthcare provider.
Timing of Administration: Follow your doctor's specific instructions for taking these medications.

Understanding the Combination: Metoclopramide and Omeprazole

When dealing with complex gastrointestinal issues like severe gastroesophageal reflux disease (GERD) or diabetic gastroparesis, healthcare providers may prescribe more than one medication to manage symptoms effectively. A common question that arises is whether it's safe and effective to combine a prokinetic agent like metoclopramide with a proton pump inhibitor (PPI) such as omeprazole. The short answer is yes, they are often prescribed together, as they target different aspects of these conditions. However, understanding how they work, their benefits, and their potential risks is vital.

What is Metoclopramide?

Metoclopramide (often sold under brand names like Reglan) is primarily used to treat gastroparesis (slow stomach emptying), especially in individuals with diabetes. It works by increasing the contractions of the stomach muscles, which helps move food through the digestive system more quickly. Additionally, it acts as an antiemetic by blocking dopamine receptors in the brain, which helps relieve nausea and vomiting. It is typically recommended for short-term use due to the risk of serious side effects.

What is Omeprazole?

Omeprazole (known by brand names such as Prilosec) belongs to a class of drugs called proton pump inhibitors (PPIs). Its main function is to reduce the production of stomach acid. It does this by irreversibly blocking the H+/K+ ATPase enzyme system—the 'proton pump'—in the stomach's parietal cells. This action makes it highly effective for treating conditions like GERD, stomach ulcers, and erosive esophagitis by allowing the esophagus and stomach lining to heal.

A Synergistic Approach: How They Work Together

Combining metoclopramide and omeprazole creates a dual-action approach to treating certain gastrointestinal disorders. While omeprazole directly tackles the problem of excess acid, metoclapramide addresses the mechanical issue of delayed gastric emptying. For a patient with severe GERD complicated by gastroparesis, this can be particularly beneficial. Omeprazole reduces the acidic content available to reflux into the esophagus, while metoclopramide helps empty the stomach's contents downward, reducing the volume and pressure that can lead to reflux. Research indicates that concomitant administration of metoclopramide does not negatively affect the absorption or action of omeprazole.

Benefits of the Combination

Comprehensive Symptom Control: Manages both acid-related symptoms (heartburn, regurgitation) and motility-related symptoms (nausea, vomiting, bloating, early satiety).
Improved GERD Management: In patients where delayed gastric emptying contributes to GERD, adding metoclopramide can help when PPIs alone are not fully effective.
Treatment for Gastroparesis with Reflux: Directly targets the primary issues in patients who suffer from both slow stomach emptying and acid reflux.

Potential Risks and Important Considerations

While there are no direct negative interactions found between the two drugs, each carries its own set of potential side effects and risks that must be considered.

Metoclopramide's Black Box Warning: The most significant risk associated with metoclopramide is tardive dyskinesia (TD), a serious and often irreversible movement disorder characterized by involuntary, repetitive movements. The risk increases with the duration of treatment. For this reason, the FDA requires a boxed warning on its label, and its use is typically limited. Other potential side effects include drowsiness, restlessness, fatigue, and other extrapyramidal symptoms.

Omeprazole's Long-Term Risks: While generally well-tolerated, long-term use of omeprazole and other PPIs has been associated with an increased risk of bone fractures, Clostridioides difficile infection, and hypomagnesemia.

Comparison Table: Metoclopramide vs. Omeprazole


Feature	Metoclopramide	Omeprazole
Drug Class	Prokinetic Agent, GI Stimulant, Antiemetic	Proton Pump Inhibitor (PPI)
Mechanism of Action	Increases stomach and intestinal contractions; blocks dopamine receptors to reduce nausea.	Reduces stomach acid production by blocking the H+/K+ ATPase enzyme system (proton pump).
Primary Uses	Diabetic gastroparesis, GERD (short-term), prevention of nausea/vomiting.	GERD, stomach and duodenal ulcers, erosive esophagitis, Zollinger-Ellison syndrome.
Common Side Effects	Restlessness, drowsiness, fatigue, anxiety, tremors.	Headache, abdominal pain, nausea, diarrhea, increased intestinal gas.
Key Warning	Black box warning for tardive dyskinesia with long-term use.	Increased risk of bone fractures and C. difficile infection with long-term use.
Administration	Should be taken as prescribed by a healthcare provider, often before meals and at bedtime.	Should be taken as prescribed by a healthcare provider, usually once daily before a meal.

Conclusion: A Decision for Your Doctor

Ultimately, the decision to take metoclopramide and omeprazole together rests with a healthcare professional. While the combination can be an effective strategy for managing complex gastrointestinal symptoms, it requires careful medical supervision. The benefits of improved symptom control must be weighed against the significant potential risks, particularly the risk of tardive dyskinesia from metoclopramide. Always discuss your full medical history and all current medications with your doctor to ensure this combination is a safe and appropriate choice for you.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting or changing any medication.

Authoritative Link: Metoclopramide Information from the National Library of Medicine

Frequently Asked Questions

Yes, they can be taken during the same treatment period, but you should follow your doctor's specific instructions for timing.

While there are no direct interactions between the two drugs, it is crucial to use them together only under a doctor's supervision due to the individual risks of each medication, particularly the black box warning for metoclopramide.

Metoclopramide is a prokinetic agent that improves stomach and intestinal muscle contractions to speed up digestion and reduce nausea. Omeprazole is a proton pump inhibitor that works by reducing the amount of acid your stomach produces.

A doctor might prescribe both to treat conditions like severe GERD that are complicated by gastroparesis (delayed gastric emptying). Omeprazole reduces the acid that can cause reflux, and metoclopramide helps empty the stomach to reduce the amount of content available to reflux.

The most serious risk is tardive dyskinesia (TD), a potentially irreversible movement disorder. The risk increases with long-term use, which is why treatment is generally limited.

Due to the risk of tardive dyskinesia, treatment with metoclopramide should be as short as possible. The FDA recommends avoiding treatment for longer than 12 weeks except in rare cases where the benefit outweighs the risk.

You should generally avoid or limit alcohol when taking metoclopramide, as alcohol can increase its nervous system side effects like dizziness and drowsiness. There are no known interactions between alcohol and omeprazole, but it is always best to consult your healthcare provider.