Orap and Prozac Capsules

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.

Using FLUoxetine and pimozide is not recommended. Taking these drugs together can affect the rhythm of your heart. Call your doctor if you have symptoms of irregular heartbeat, chest tightness, blurred vision or nausea. 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.

CONTRAINDICATED: Coadministration with fluoxetine may significantly increase the plasma concentrations of pimozide. The proposed mechanism is fluoxetine inhibition of the metabolism of pimozide via CYP450 2D6 and 3A4. Although the interaction has not been formally studied with fluoxetine, data exist for paroxetine, a drug with similar CYP450 inhibition characteristics. In a controlled study of healthy volunteers, pretreatment with immediate-release paroxetine (titrated up to 60 mg/day) increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of pimozide (2 mg single oral dose) by an average of 62% and 151%, respectively, compared to administration of pimozide alone. 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. In addition, case reports suggest that concurrent administration of fluoxetine and pimozide may be associated with mental status changes and adverse cardiovascular effects. The mechanism of interaction has not been determined but may involve additive pharmacodynamic effects and/or fluoxetine inhibition of pimozide metabolism. In one case report, a young woman receiving pimozide for obsessive delusional thoughts became stuporous and complained of inability to think clearly following the addition of fluoxetine. She also had hypersalivation while receiving the combination. In another case, an elderly patient treated with pimozide developed severe bradycardia approximately one week after the addition of fluoxetine. Decreases in pulse also occurred during titration of the pimozide dose, but they were more significant with the combination of fluoxetine and pimozide. In other reports, use of selective serotonin reuptake inhibitors in combination with neuroleptics or other agents with antidopaminergic effect have resulted in increased extrapyramidal symptoms.

MANAGEMENT: Given the narrow therapeutic index of pimozide and its known ability to prolong the QT interval, concomitant use of pimozide and fluoxetine is considered contraindicated. Due to the long half-life of fluoxetine and its metabolite norfluoxetine, the risk of an interaction may exist for an extended period (up to several weeks) after discontinuation of fluoxetine.

Orap

Generic Name: pimozide

Brand name: Orap

Synonyms: n.a.

What is Orap?

Prozac Capsules

Generic Name: fluoxetine

Brand name: Prozac, Prozac Weekly, Sarafem, Rapiflux, Selfemra, PROzac Pulvules

Synonyms: Prozac

What is Prozac Capsules?