Irenka and Pimozide

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

DULoxetine may significantly increase the blood levels of pimozide. This can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, as well as other side effects of pimozide such as drowsiness, blurred vision, dry mouth, constipation, blood pressure decreases, Parkinson-like symptoms, and abnormal muscle movements. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Let your doctor know promptly if you experience muscle spasm or movements that you can't stop or control, such as lip smacking, chewing, puckering, frowning or scowling, tongue thrusting, teeth clenching, jaw twitching, blinking, eye rolling, shaking or jerking of arms and legs, tremor, jitteriness, restlessness, pacing, and foot tapping. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration with inhibitors of CYP450 2D6 may increase the plasma concentrations of pimozide, which is partially metabolized by the isoenzyme. In a controlled study of healthy volunteers, administration of pimozide (2 mg single dose) with the potent inhibitor paroxetine (60 mg daily) resulted in mean increases of 62% and 151% in pimozide peak plasma concentration (Cmax) and systemic exposure (AUC), respectively, compared to pimozide given alone. Quinidine, another potent inhibitor of CYP450 2D6, has been shown in vitro to also inhibit the metabolism of pimozide. Pretreatment with a moderate CYP450 2D6 inhibitor, sertraline (200 mg daily to steady state), increased the Cmax and AUC of a single 2 mg dose of pimozide by about 40%. While no EKG changes were reported in the study, the effect on pharmacokinetic parameters of pimozide when given at doses greater than 2 mg is not currently known. The use of pimozide has been associated with dose-related prolongation of the QT interval, thus elevated plasma levels of the drug may potentiate the risk of ventricular arrhythmias such as ventricular tachycardia and torsade de pointes as well as cardiac arrest and sudden death.

MANAGEMENT: Due to the narrow therapeutic index of pimozide, concomitant use of pimozide in combination with moderate inhibitors of CYP450 2D6 should preferably be avoided if possible. Otherwise, close monitoring for the development of electrocardiographic abnormalities, extrapyramidal reactions (i.e., acute dystonic reactions, tardive dyskinesia, akathisia, Parkinson-like symptoms), and hypotension is recommended if concurrent use is required. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitations, irregular heartbeat, shortness of breath, or syncope. The manufacturers consider the use of pimozide with potent CYP450 2D6 inhibitors such as fluoxetine, paroxetine, and quinidine to be contraindicated.

Irenka

Generic Name: duloxetine

Brand name: Cymbalta, Irenka, Drizalma Sprinkle

Synonyms: n.a.

What is Irenka?

Pimozide

Generic Name: pimozide

Brand name: Orap

Synonyms: n.a.

What is Pimozide?