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Orap and Wellbutrin XL

Determining the interaction of Orap and Wellbutrin XL and the possibility of their joint administration.

Check result:
Orap <> Wellbutrin XL
Relevance: 15.09.2023 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Using pimozide together with buPROPion is not recommended. Combining these medications can significantly increase the blood levels of pimozide. This may 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. 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 pimozide. 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.

Professional:

CONTRAINDICATED: 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. 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, the manufacturers consider its use with potent CYP450 2D6 inhibitors to be contraindicated.

References
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports. Available from: URL: http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid."
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  • Canadian Pharmacists Association "e-CPS. Available from: URL: http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink."
  • "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
Orap

Generic Name: pimozide

Brand name: Orap

Synonyms: n.a.

Wellbutrin XL

Generic Name: bupropion

Brand name: Aplenzin, Buproban, Forfivo XL, Wellbutrin SR, Wellbutrin XL, Zyban, Zyban Advantage Pack, Budeprion XL

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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