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Pimozide Disease Interactions

There are 18 disease interactions with pimozide:

Major

Atypical Antipsychotic Agents (Includes Pimozide) ↔ Dementia

Severe Potential Hazard, High plausibility

Applies to: Dementia

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death, mostly from cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) causes. A causal relationship with antipsychotic use has not been established. In controlled trials, treatment with some atypical antipsychotic drugs had was also associated with an increased risk of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, in elderly patients with dementia-related psychosis. These agents are not approved for the treatment of patients with dementia-related psychosis.

Major

Miscellaneous Antipsychotics (Includes Pimozide) ↔ Cns Depression/Coma

Severe Potential Hazard, Moderate plausibility

Applies to: Altered Consciousness, Acute Alcohol Intoxication

The use of most miscellaneous antipsychotics is contraindicated in patients with severe central nervous system depression or comatose states from any cause (e.g., lesion, disease, drug or alcohol induced).

Major

Miscellaneous Antipsychotics (Includes Pimozide) ↔ Previous Neuroleptic Malignant Syndrome (Nms)

Severe Potential Hazard, Moderate plausibility

Applies to: Neuroleptic Malignant Syndrome

Neuroleptic Malignant Syndrome (NMS), a potentially fatal symptom complex, has been reported in association with the use of antipsychotic drugs. The diagnostic evaluation is complicated and the management requires immediate discontinuation of the antipsychotic therapy and intensive symptomatic treatment and medical monitoring. If a patient that has recovered from NMS requires antipsychotic drug treatment again, the reintroduction of therapy should be carefully considered as NMS recurrences have been reported.

Major

Miscellaneous Antipsychotics (Includes Pimozide) ↔ Seizure Disorders

Severe Potential Hazard, Moderate plausibility

Applies to: CNS Disorder, Alcoholism, Seizures

Antipsychotics can lower the seizure threshold and trigger seizures in a dose-dependent manner. Seizures have been reported in patients receiving antipsychotic therapy and may occur in epileptic patients even with maintenance of routine anticonvulsant treatment. Therapy with antipsychotics should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism. High dosages should be avoided if possible.

References

  1. "Product Information. Loxitane C Oral Concentrate (loxapine)" Watson Laboratories Inc, Corona, CA.
  2. Markowitz J, Brown R "Seizures with neuroleptics and antidepressants." Gen Hosp Psychiatry 9 (1987): 135-41
  3. Lowry MR, Dunner FJ "Seizures during tricyclic therapy." Am J Psychiatry 137 (1980): 1461-2
Major

Neuroleptics (Includes Pimozide) ↔ Acute Alcohol Intoxication

Severe Potential Hazard, High plausibility

Applies to: Alcoholism

The use of neuroleptic agents is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of neuroleptic agents may be additive with those of alcohol. Severe respiratory depression and respiratory arrest may occur. Therapy with neuroleptic agents should be administered cautiously in patients who might be prone to acute alcohol intake.

References

  1. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  2. "Product Information. Geodon (ziprasidone)." Pfizer US Pharmaceuticals, New York, NY.
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company, Indianapolis, IN.
View all 10 references
Major

Neuroleptics (Includes Pimozide) ↔ Cns Depression

Severe Potential Hazard, High plausibility

Applies to: Altered Consciousness, Respiratory Arrest

The use of neuroleptic agents is contraindicated in comatose patients and patients with severe central nervous system depression. Neuroleptic agents may potentiate the CNS and respiratory depression in these patients.

References

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  2. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
View all 7 references
Major

Neuroleptics (Includes Pimozide) ↔ Nms

Severe Potential Hazard, High plausibility

Applies to: Neuroleptic Malignant Syndrome

The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur.

References

  1. Anderson ES, Powers PS "Neuroleptic malignant syndrome associated with clozapine use." J Clin Psychiatry 52 (1991): 102-4
  2. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical, Raritan, NJ.
  3. Sharma R, Trappler B, Ng YK, Leeman CP "Risperidone-induced neutroleptic malignant syndrome." Ann Pharmacother 30 (1996): 775-8
View all 40 references
Major

Neuroleptics (Includes Pimozide) ↔ Tardive Dyskinesia

Severe Potential Hazard, High plausibility

Applies to: Tardive Dyskinesia

Neuroleptic agents may precipitate symptoms of tardive dyskinesia (TD), a syndrome consisting of rhythmic involuntary movements variously involving the tongue, face, mouth, lips, jaw, and/or trunk and extremities, following chronic use of at least several months but often years. Elderly patients, particularly women, are most susceptible. Both the risk of developing the syndrome and the likelihood that it will become irreversible increase with the duration and total cumulative dose of neuroleptic therapy administered. However, patients may infrequently develop symptoms after relatively brief treatment periods at low dosages. If TD occurs during neuroleptic therapy, prompt withdrawal of the offending agent or at least a lowering of the dosage should be considered. TD symptoms may become more severe after drug discontinuation or a dosage reduction, but may gradually improve over months to years. In patients with preexisting drug-induced TD, initiating or increasing the dosage of neuroleptic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. The newer, atypical neuroleptic agents (e.g., risperidone, quetiapine, olanzapine) tend to be associated with a substantially reduced risk of inducing TD and are considered the drugs of choice in patients being treated for psychosis.

References

  1. Ghelber D, Belmaker RH "Tardive dyskinesia with quetiapine." Am J Psychiat 156 (1999): 796-7
  2. Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS "Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry." Drugs 12 (1976): 1-40
  3. "Product Information. Risperdal (risperidone)." Janssen Pharmaceutica, Titusville, NJ.
View all 42 references
Major

Pimozide (Includes Pimozide) ↔ Pituitary Tumors

Severe Potential Hazard, Moderate plausibility

Applies to: Pituitary Tumor

Pimozide may have a tumorigenic potential and has been shown to cause a dose-related increase in pituitary tumors in mice. When treated for up to 18 months, pituitary gland changes that occurred were characterized as hyperplasia at doses approximating the human dose and adenoma at doses about 15 times the maximum recommended human dose on a mg/kg basis. The full significance of this finding is unknown but should be considered when prescribing pimozide, particularly in patients with preexisting pituitary tumors.

References

  1. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
Major

Pimozide (Includes Pimozide) ↔ Qt Interval Prolongation

Severe Potential Hazard, Moderate plausibility

Applies to: Hypokalemia, Electrolyte Abnormalities, Arrhythmias, Diarrhea, Magnesium Imbalance, Abnormal Electrocardiogram, Long QT Syndrome

The use of pimozide is contraindicated in patients with congenital or acquired QT interval prolongation syndromes or a history of cardiac arrhythmias. Pimozide can prolong the QT interval of the electrocardiogram. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of pimozide on the QT interval and should be corrected prior to institution of pimozide therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with pimozide. Because sudden deaths have been reported in patients using pimozide, and electrocardiogram should be performed before starting treatment and periodically thereafter, especially during periods of dose adjustment.

References

  1. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  2. Glassman AH, Bigger JT Jr "Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death." Am J Psychiatry 158 (2001): 1774-82
  3. Krahenbuhl S, Sauter B, Kupferschmidt H, Krause M, Wyss PA, Meier PJ "Case report: reversible QT prolongation with torsades de pointes in a patient with pimozide intoxication." Am J Med Sci 309 (1995): 315-6
Major

Pimozide (Includes Pimozide) ↔ Tics

Severe Potential Hazard, Moderate plausibility

Applies to: Tic Disorder

Pimozide is contraindicated in the treatment of simple tics or tics other than those associated with Tourette's Disorder.

Moderate

Miscellaneous Antipsychotics (Includes Pimozide) ↔ Hyperprolactinemia/Breast Cancer

Moderate Potential Hazard, Moderate plausibility

Applies to: Breast Cancer, Hyperprolactinemia

Antipsychotic drugs can elevate serum prolactin concentrations, and this elevation persists during chronic administration. This should be considered if therapy will be prescribed in patients with previously detected breast cancer as one-third of human breast cancers are prolactin-dependent in vitro. Associated disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported. Appropriate laboratory testing and follow-up is advised.

Moderate

Miscellaneous Antipsychotics (Includes Pimozide) ↔ Neutropenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Neutropenia

The use of antipsychotics has been associated with events of leukopenia, neutropenia and agranulocytosis. Possible risk factors include preexisting low white blood cell count, and history of drug induced leukopenia/neutropenia. Patients with these risk factors should have complete blood count monitored frequently during the first few months of therapy. Patients should also be monitored for any signs or symptoms of infection. Treatment should be discontinued in any patient who develops a sore throat, fever, stomatitis, or other signs of infection along with a low WBC count or severe neutropenia (ANC < 1000/mm3).

Moderate

Neuroleptics (Includes Pimozide) ↔ Anticholinergic Effects

Moderate Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction, Glaucoma/Intraocular Hypertension, Urinary Retention

Most neuroleptic agents have anticholinergic activity, to which elderly patients are particularly sensitive. Clozapine and low-potency agents such as chlorpromazine and thioridazine tend to exhibit the greatest degree of anticholinergic effects in the class, while haloperidol as well as the newer, atypical agents like quetiapine, risperidone and ziprasidone have generally been associated with very low frequencies of anticholinergic adverse effects. Therapy with neuroleptic agents should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders.

References

  1. Frankenburg FR, Kando JC, Centorrino F, Gilbert JM "Bladder dysfunction associated with clozapine therapy." J Clin Psychiatry 57 (1996): 39-40
  2. "Product Information. Navane (thiothixene)." Roerig Division, New York, NY.
  3. Grohmann R, Ruther E, Sassim N, Schmidt LG "Adverse effects of clozapine." Psychopharmacology (Berl) 99 (1989): s101-4
View all 14 references
Moderate

Neuroleptics (Includes Pimozide) ↔ Breast Cancer

Moderate Potential Hazard, Moderate plausibility

Applies to: Breast Cancer

The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer.

References

  1. Dickson RA, Dalby JT, Williams R, Edwards AL "Risperidone-induced prolactin elevations in premenopausal women with schizophrenia." Am J Psychiatry 152 (1995): 1102-3
  2. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  3. Meco G, Falaschi P, Casacchia M, et al "Neuroendocrine effects of haloperidol decanoate in patients with chronic schizophrenia." Adv Biochem Psychopharmacol 40 (1985): 89-93
View all 16 references
Moderate

Neuroleptics (Includes Pimozide) ↔ Parkinsonism

Moderate Potential Hazard, High plausibility

Applies to: Parkinsonism

The use of neuroleptic agents is associated with pseudo-parkinsonian symptoms such as akinesia, bradykinesia, tremors, pill-rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually 1 to 2 weeks following initiation of therapy or an increase in dosage. Older neuroleptic agents such as haloperidol are more likely to induce these effects, and their use may be contraindicated in patients with Parkinson's disease or parkinsonian symptoms.

References

  1. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  2. Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS "Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry." Drugs 12 (1976): 1-40
  3. Moleman P, Janzen G, von Bargen BA, et al "Relationship between age and incidence of parkinsonism in psychiatric patients treated with haloperidol." Am J Psychiatry 143 (1986): 232-4
View all 14 references
Moderate

Neuroleptics (Includes Pimozide) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: CNS Disorder, Alcoholism

Neuroleptic agents can lower the seizure threshold and induce seizures, particularly when dosages are high or increased rapidly and during the initiation of therapy. Clozapine appears to have the greatest epileptogenic potential, while most of the other newer, atypical neuroleptic agents (e.g., risperidone, quetiapine, olanzapine), as well as haloperidol and molindone, have the least. Therapy with neuroleptic agents should be administered cautiously in patients with a history of seizures or other factors predisposing to seizures such as abnormal EEG, preexisting CNS pathology, or head trauma. Adequate anticonvulsant therapy should be maintained during administration of neuroleptic agents. Clozapine should not be used in patients with uncontrolled epilepsy.

References

  1. Mahr GC, Berchou R, Balon R "A grand mal seizure associated with desipramine and haloperidol." Can J Psychiatry 32 (1987): 463-4
  2. Welch J, Manschreck T, Redmond D "Clozapine-induced seizures and EEG changes." J Neuropsychiatry Clin Neurosci 6 (1994): 250-6
  3. Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS "Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry." Drugs 12 (1976): 1-40
View all 29 references
Moderate

Pimozide (Includes Pimozide) ↔ Renal/Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Renal Dysfunction

Pimozide is extensively metabolized by the liver, and both parent drug and metabolites are eliminated by the kidney. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects due to drug and metabolite accumulation. Therapy with pimozide should be administered cautiously in such patients.

References

  1. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  2. Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS "Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry." Drugs 12 (1976): 1-40

pimozide drug Interactions

There are 1002 drug interactions with pimozide

pimozide alcohol/food Interactions

There are 2 alcohol/food interactions with pimozide

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Do not stop taking any medications without consulting your healthcare provider.

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