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Drug Interactions between Focalin XR and Orap

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

pimozide dexmethylphenidate

Applies to: Orap (pimozide) and Focalin XR (dexmethylphenidate)

CONTRAINDICATED: Stimulants used to treat attention deficit hyperactivity disorder (ADHD) can precipitate or aggravate motor and phonic tics in some patients. The use of pimozide while patients are receiving these medications may make it difficult to determine whether the tics are due to Tourette's disorder or the use of these medications.

MANAGEMENT: When treating Tourette's disorder, the use of pimozide in patients receiving drugs that may cause motor and phonic tics (e.g., amphetamines, methylphenidate, pemoline) is considered contraindicated until such patients have been withdrawn from these drugs to determine whether they are, in fact, responsible for the tics.

References

  1. "Product Information. Orap (pimozide)." Gate Pharmaceuticals PROD

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Drug and food interactions

Major

pimozide food

Applies to: Orap (pimozide)

GENERALLY AVOID: Theoretically, the coadministration with grapefruit juice may increase the plasma concentrations of pimozide. The mechanism is decreased clearance of pimozide due to inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The use of pimozide alone has been associated with dose-dependent prolongation of the QT interval. Although clinical data are lacking, this interaction may result in potentiation of the proarrhythmic effect of pimozide and consequently an increased risk of ventricular arrhythmias such as ventricular tachycardia and torsade de pointes. In addition, alcohol may potentiate some of the pharmacologic effects of pimozide. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: The manufacturer recommends avoiding grapefruit juice (and probably grapefruits) during therapy with pimozide. Patients should also be advised to avoid or limit consumption of alcohol.

References

  1. "Product Information. Orap (pimozide)." Gate Pharmaceuticals PROD
  2. Dresser GK, Spence JD, Bailey DG "Pharmacokinetic-pharmacodynamic consequences and clinical relevance of cytochrome P450 3A4 inhibition." Clin Pharmacokinet 38 (2000): 41-57

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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