Pimozide

Pimozide is a long-acting antipsychotic with general properties similar to that of chlorpromazine. Pimozide is used in psychotic disorder specially in schizophrenia, paranoid states and Tourette`s syndrome. Pimozide is also used to control nausea, vomitting and intractable hiccups.

Brands
Adult Dose
Dose: 0.085 to 0.171 mg/kg
Single Dose: 0.13 (0.128)
Frequency: 24 hourly
Route: PO
Instructions: -
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Characteristics
. It is of Synthetic origin and belongs to Phenylalkylpiperidine. It belongs to D2 antagonist pharmacological group on the basis of mechanism of action and also classified in Psychotherapeutic Drugs pharmacological group.The Molecular Weight of Pimozide is 461.54. Its pKa is 8.63.
Contraindications
Pimozide is contraindicated in conditions like Cardiac arrhythmia,Depression,Parkinsonism,CNS depression,Ecg abnormalities.
Effects
The severe or irreversible adverse effects of Pimozide, which give rise to further complications include Tardive dyskinesia.Pimozide produces potentially life-threatening effects which include Coma, Muscle rigidity, Agranulocytosis, Neuroleptic Malignant Syndrome, Unconsciousness. which are responsible for the discontinuation of Pimozide therapy.The symptomatic adverse reactions produced by Pimozide are more or less tolerable and if they become severe, they can be treated symptomatically, these include Tiredness, Anorexia, Insomnia, Acute dystonia, Gynecomastia, Galactorrhea, Extrapyramidal effects, HyperprolactinemiaX, Oligomenorrhea, Amenorrhea, Pseudoparkinsonism, Rigidity, Akinesia.
Indications
Pimozide is primarily indicated in conditions like Delusional disorder, Erotomania, Gille de la tourette syndrome, Mania, Psychosis, Schizophrenia.
Interactions
Pimozide is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcoholAmprenavirAmprenavir increases plasma concentration of Sertindole; increased risk of ventricular arrhythmias. ADVICE: Avoid concomitant use.AprepitantInhibition of CYP3A4 by aprepitant could result in elevated plasma concentrations of this drugs, potentially causing serious or life-threatening reactions. It should not be used concurrently with pimozide, terfenadine, astemizole, or cisapride.BendrofluazideChlorothiazideChlorthalidoneCimetidine (HCl)Citalopram (HBr)ClarithromycinClarithromycin increases the plasma concentration of pimozide by inhibiting its metabolism results inprolongation of QT interval, ventricular arrythmia, cardiac arrest and sudden death.MajorCoadministration is considered contraindicated.Azithromycin and dirithromycin is considered more safer alternative of clarithromycin.Disopyramide Pimozide prolongs QT interval results in ventricular arrhythmias, ventricular tachycardia and torsade de pointes.ModerateCoadministration is considered contraindicated.DroperidolHydrochlorothiazideConcomitant administeration can lead to prolong QT intervalMaprotiline (HCl)pimozide prolong QT interval result in increased risk of ventricular arrythmia,ventricular tachycardia and torsade de pointes because of arrhythmogenic potential related to their effect on cadiac conduction.Majorcocurrent use with other agent is considered contraindicated.MolindoneConcurrent use with Molindone increases certain serious side effects.PergolideLikely interaction of PERGOLIDE MESILATE increasing the EXTRAPYRAMIDAL side effects of PIMOZIDE. PolythiazidePropranolol (HCl)QuinineSodium PhosphateShould not be use concurrently without doctors prescription.TelithromycinThere is a potential risk of increased pimozide plasma levels by inhibition of CYP 3A4 pathways by Teicoplanin. Concurrent use is contraindicated.VORICONAZOLEVoriconazole may increase the serum concentration of pimozide by decreasing its metabolism.d.Concomitant use is contraindicate These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store Below 40°C. Protect from Sunlight and Heat.
Warnings
Patients should be observed caution while driving or performing other tasks requiring alertness, because it may produced drowsiness or blurred vision. Pimozide should be used with caution in patients with kidney or liver diseases. Correct potassium insufficiency and diarrhea before initiating therapy. It should be used with caution in patients whose condition may be aggravated by anticholinergic activity.
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