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Paxil CR and Pimozide

Determining the interaction of Paxil CR and Pimozide and the possibility of their joint administration.

Check result:

Paxil CR <> Pimozide

Relevance: 07.11.2022 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 and PARoxetine 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.

Professional:

CONTRAINDICATED: Coadministration with paroxetine may significantly increase the plasma concentrations of pimozide. The proposed mechanism is paroxetine inhibition of the metabolism of pimozide via CYP450 2D6 and 3A4. 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. Additionally, coadministration of paroxetine and pimozide may increase the risk of extrapyramidal symptoms. In an isolated case report, a 9-year-old boy with congenital albinism receiving pimozide for Tourette's disorder and other psychological disturbances developed oculogyric problems each day for several days after his morning dose of paroxetine. The episodes lasted 8 to 10 hours each and did not occur when the paroxetine dose was withheld for one day and following permanent discontinuation of the drug. Some investigators suggest that these drugs may have additive or synergistic pharmacodynamic effects. Combinations of selective serotonin reuptake inhibitors and neuroleptics or other agents with antidopaminergic effect have resulted in mental status changes and 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 paroxetine is considered contraindicated.

References

Lock JD, Gwirtsman HE, Targ EF "Possible adverse drug interactions between fluoxetine and other psychotropics." J Clin Psychopharmacol 10 (1990): 383-4
Palop V, Jimenez MJ, Catalan C, MartinezMir I "Acute dystonia associated with fluvoxamine-metoclopramide." Ann Pharmacother 33 (1999): 382
Dsouza DC, Bennett A, Abidargham A, Krystal JH "Precipitation of a psychoneuromotor syndrome by fluoxetine in a haloperidol-treated schizophrenic patient." J Clin Psychopharmacol 14 (1994): 361-3
"Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
Ahmed I, Dagincourt PG, Miller LG, Shader RI "Possible interaction between fluoxetine and pimozide causing sinus bradycardia." Can J Psychiatry 38 (1993): 62-3
Nicholson SD "Extra pyramidal side effects associated with paroxetine." West Engl Med J 107 (1992): 90-1
Tate JL "Extrapyramidal symptoms in a patient taking haloperidol and fluoxetine." Am J Psychiatry 146 (1989): 399-400
Ketai R "Interaction between fluoxetine and neuroleptics." Am J Psychiatry 150 (1993): 836-7
Hansen-Grant S, Silk KR, Guthrie S "Fluoxetine-pimozide interaction." Am J Psychiatry 150 (1993): 1751-2
Ozdemir V, Naranjo CA, Herrmann N, Reed K, Sellers EM, Kalow W "Paroxetine potentiates the central nervous system side effects of perphenazine: contribution of cytochrome P4502D6 inhibition in vivo." Clin Pharmacol Ther 62 (1997): 334-47
Stein MH "Tardive dyskinesia in a patient taking haloperidol and fluoxetine." Am J Psychiatry 148 (1991): 683
Horrigan JP, Barnhill LJ "Paroxetine-pimozide drug interaction." J Am Acad Child Adolesc Psychiatry 33 (1994): 1060-1

Paxil CR

Generic Name: paroxetine

Brand name: Brisdelle, Paxil, Paxil CR, Pexeva

Synonyms: n.a.

What is Paxil CR?

Pimozide

Generic Name: pimozide

Brand name: Orap

Synonyms: n.a.

What is Pimozide?

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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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