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Drug Interactions between Botox and Orap

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

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Interactions between your drugs

Moderate

pimozide onabotulinumtoxinA

Applies to: Orap (pimozide) and Botox (onabotulinumtoxinA)

MONITOR: Use of anticholinergic drugs after administration of botulinum toxin may potentiate systemic anticholinergic effects such as dry mouth, blurred vision, and urinary disorders. Botulinum toxin inhibits the release of acetylcholine from peripheral cholinergic nerve endings, thus additive or synergistic anticholinergic effects may occur when these agents are used together.

MANAGEMENT: Patients should be advised that systemic anticholinergic side effects such as dry mouth, blurred vision, and urinary disorders may increase if agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants; disopyramide) are used after administration of botulinum toxin.

References

  1. "Product Information. Myobloc (rimabotulinumtoxinB)." Elan Pharmaceuticals PROD
  2. "Product Information. Dysport (abobotulinumtoxinA)." Tercica Inc PROD
  3. "Product Information. Botox (onabotulinumtoxinA)." Allergan Inc PROD
  4. "Product Information. Xeomin (incobotulinumtoxinA)." Merz Pharmaceuticals (2022):
  5. "Product Information. Jeuveau (prabotulinumtoxinA)." Evolus, Inc. (2022):
  6. "Product Information. Daxxify (daxibotulinumtoxinA)." Revance Therapeutics, Inc. 1 (2022):
  7. "Product Information. Letybo (letibotulinumtoxinA)." CROMA Australia Pty Ltd 1 (2022):
  8. "Product Information. Letybo (letibotulinumtoxinA)." Hugel Aesthetics (2024):
View all 8 references

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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.