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Orap

Generic Name: pimozide (PIM oh zide)
Brand Name: Orap

What is Orap (pimozide)?

Pimozide is an antipsychotic medication. It works by changing the actions of chemicals in the brain.

Pimozide is used to suppress the motor and phonic tics associated with Tourette's disorder.

Pimozide may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Orap (pimozide)?

There are many other drugs that can cause serious or life threatening medical problems if you take them together with pimozide, especially if you have a heart rhythm disorder. Tell your doctor about all other medicines you use.

Slideshow: Grapefruit and Medicines: A Possible Deadly Mix?

Grapefruit and grapefruit juice can react adversely with over 85 prescription medications.

Grapefruit and grapefruit juice may interact with pimozide and lead to potentially dangerous effects. Avoid eating or drinking grapefruit products while taking this medication.

Pimozide may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase certain side effects of pimozide.

Call your doctor right away if you have uncontrollable movements of your eyes, lips, tongue, face, arms, or legs.

What should I discuss with my healthcare provider before taking Orap (pimozide)?

You should not use this medication if you are allergic to pimozide or other antipsychotic medicines, or if you have:

  • low levels of potassium or magnesium in your blood; or

  • a history of Long QT syndrome.

There are many other drugs that can cause serious or life-threatening medical problems if you take them together with pimozide. The following drugs should not be used while you are taking pimozide:

  • itraconazole (Sporanox) or ketoconazole (Nizoral);

  • tacrolimus (Prograf);

  • zileuton (Zyflo);

  • an ADHD (attention deficit hyperactivity disorder) medication, such as Ritalin, Concerta, Daytrana, Focalin, Adderall, and others);

  • antibiotics including azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), moxifloxacin (Avelox), and pentamidine (NebuPent, Pentam);

  • antidepressants including amitriptylline (Elavil, Vanatrip, Limbitrol), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluvoxamine (Luvox), nefazodone, paroxetine (Paxil), and sertraline (Zoloft);

  • anti-malaria medications such as chloroquine (Arelan), or mefloquine (Lariam);

  • heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), ibutilide (Corvert), procainamide (Pronestyl), propafenone (Rythmol), quinidine (Quin-G), or sotalol (Betapace);

  • HIV/AIDS medicine such as atazanavir (Reyataz), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra);

  • medicine to prevent or treat nausea and vomiting such as dolasetron (Anzemet), droperidol (Inapsine), or ondansetron (Zofran);

  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), thioridazine (Mellaril), or ziprasidone (Geodon);

  • migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig); or

  • narcotic medication such as methadone (Methadose, Diskets, Dolophine).

To make sure you can safely take pimozide, tell your doctor if you have any of these other conditions:

  • liver disease;

  • kidney disease;

  • seizures or epilepsy;

  • heart disease, high blood pressure, a heart rhythm disorder, or a history of a heart attack;

  • enlarged prostate or urination problems; or

  • glaucoma.

Before you start taking pimozide, your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG). This machine measures electrical activity of the heart.

FDA pregnancy category C. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Taking this medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking pimozide, do not stop taking it without your doctor's advice.

Pimozide should not be given to a child younger than 12 years old.

It is not known whether pimozide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using pimozide.

How should I take Orap (pimozide)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting. You may develop an electrolyte imbalance, which could cause heart rhythm problems while you are taking pimozide.

It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve, or if they get worse.

Do not stop using pimozide suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using pimozide.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while taking Orap (pimozide)?

Pimozide may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase certain side effects of pimozide.

Grapefruit and grapefruit juice may interact with pimozide and lead to potentially dangerous effects. Avoid eating or drinking grapefruit products while taking this medication.

Orap (pimozide) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • seizure (convulsions);

  • twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs; or

  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Less serious side effects may include:

  • fever;

  • headache, dizziness, drowsiness;

  • feeling restless;

  • vision problems;

  • constipation; or

  • dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Orap (pimozide)?

Before using pimozide, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety). They can add to sleepiness caused by pimozide.

Tell your doctor about all other medicines you use, especially:

  • ciprofloxacin (Cipro), norfloxacin (Noroxin), ofloxacin (Floxin);

  • a diuretic (water pill);

  • fluoxetine (Prozac, Sarafem, Symbyax);

  • lidocaine (Xylocaine);

  • methoxsalen (Oxsoralen, Uvadex, 8-Mop);

  • mexiletine (Mexitil);

  • thiabendazole (Mintezol); or

  • medicine to treat or prevent seizures.

This list is not complete and other drugs may interact with pimozide. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about pimozide.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 10.01. Revision Date: 2011-11-02, 1:35:51 PM.

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