PIMOZIDE

Pimozide 1mg, Oral tablet

Marijuana

· Severity: Major

· Notes for Consumers: Avoid combining Pimozide and marijuana. This combination may cause your condition to get worse. Marijuana may also decrease the efficacy of Pimozide, making it not work as well for you. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice unusual changes in moods or behaviors of any type.

· Notes for Professionals: It is recommended that patients avoid the use of marijuana, by any route, if they are treated for a psychiatric history, including psychosis and bipolar disorder, as the cannabinoids (the psychoactive ingredients, such as THC) in marijuana can produce psychotoxic effects and may exacerbate psychiatric disorders. A high frequency of use and use of products with high-potency of THC are potential risk factors for psychiatric effects. Additionally, additive CNS effects, such as sedation or CNS depression are possible. Clinical studies suggest that cannabis use may reduce the efficacy of some antipsychotic drugs. In addition, several cannabinoids in marijuana appear to influence the activity of CYP enzymes and P-glycoprotein, which may alter the concentrations of antipsychotics and influence either safety or efficacy.

Pimozide 1mg, Oral tablet

Alcohol

· Severity: Moderate

· Notes for Consumers: It is recommended that you limit or avoid Alcoholic drinks while you are taking this medication. Alcohol can increase the risk of side effects, such as drowsiness and dizziness. Do not drive or operate machinery if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: In general, patients should limit or avoid alcohol during pimozide treatment. Pimozide may impair alertness, especially at the start of treatment. These effects may be potentiated by alcohol. Patients should be warned of the risks of sedation and advised of associated precautions.

Pimozide 1mg, Oral tablet

Tobacco

· Severity: Mild

· Notes for Consumers: In theory, tobacco smoking may reduce the effectiveness of this drug in treating your condition; tobacco smoke contains substances that speed the removal of this drug from the body. Alternatively, if you take this drug and suddenly stop tobacco smoking, you may feel more drowsy or tired, or may experience confusion, dizziness, difficulty in movement or other side effects. If you will stop smoking, use care in driving or operating machinery until you know how this drug will affect you. Make sure your prescriber is aware that you smoke tobacco or if you plan to stop smoking. Report any unusual side effects promptly.

· Notes for Professionals: Theoretically, tobacco smoking could lower pimozide levels through induction of CYP1A2 hepatic isoenzymes; however no dosage adjustments have been recommended in smokers since a significant effect would not be expected. Conversely, the sudden cessation of tobacco smoking could potentially result in reduced pimozide clearance; monitor patients carefully for clinical effect and the presence of drug-related side effects when changes in smoking status occur.

Pimozide 1mg, Oral tablet

Grapefruit juice

· Severity: Severe

· Notes for Consumers: Avoid Grapefruit and Grapefruit juice while taking Pimozide. Grapefruit juice can increase the levels of pimozide. Serious side effects (a dangerous change in heartbeat or heart rhythm) may occur if Pimozide levels increase. Contact your prescriber immediately if you experience chest pain, dizziness, fainting or falling spells, palpitations, shortness of breath, or a change in your usual heart beat (such as a fast or irregular heart beat) while taking Pimozide.

· Notes for Professionals: Patients should be advised to avoid grapefruit juice products while taking pimozide due to the possibility of pimozide toxicity.[43463] Grapefruit juice inhibits the cytochrome P-450 3A4 isozyme in the gut wall. Grapefruit juice contains furanocoumarins that are metabolized by CYP3A4 to reactive intermediates. These intermediates form a covalent bond to the active site of the CYP3A4 enzyme, causing irreversible inactivation (mechanism-based inhibition). Consequently, CYP3A4 activity in the gut wall is inhibited until de novo synthesis returns the enzyme to its previous level. Therefore, grapefruit juice may inhibit the metabolism of pimozide by CYP3A4, resulting in possible QT prolongation and torsade de pointes (TdP).

Pimozide 1mg, Oral tablet

Areca nut (Betel nut)

· Severity: Moderate

· Notes for Consumers: It is recommended that you avoid use of Betel Nut (Areca Nut) during use of this medicine. Using Pimozide and Betel nut together can increase the risk of side effects like uncontrollable muscle movements, tremor, restlessness, or other problems with movement or speech. Contact your health care prescriber immediately if any of these reactions occur. Check with your pharmacist or healthcare provider before taking any herbal or dietary supplements while you are being treated with Pimozide.

· Notes for Professionals: The use of Areca Nut (Betel Nut) with pimozide is not recommended. Concurrent use of pimozide and betel nut, may result in an increased risk of extrapyramidal symptoms (EPS). Monitor closely for EPS if this combination is used. Case reports have documented an increase in EPS when betel nut was chewed by patients taking phenothiazine antipsychotics for schizophrenia. Use of an anticholinergic agent did not improve the extrapyramidal effects, but the symptoms resolved when the betel nut was discontinued. A similar interaction can be expected to occur when betel nut is used with other antipsychotics, including pimozide. Case reports suggest the onset of these effects occur within 2 weeks, and that resolution occurs within 4 to 7 days after discontinuation of betel nut. The cholinergic activity of betel nut has been attributed to the arecoline content of the herb.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>