Drug interactions
Asenapine + Pimavanserin
Severity: Major
Asenapine and Pimavanserin: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs can lengthen the QT interval, and pimavanserin labeling advises against use with other QT-prolonging agents. Combined use increases the risk of torsades de pointes and sudden cardiac events.
What this interaction means in plain words
Asenapine and Pimavanserin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Asenapine belongs to Central Nervous System; Pimavanserin belongs to Central Nervous System.
Why it happens
Additive QT prolongation through delayed ventricular repolarization.
What to do
Avoid the combination and use an alternative agent. If both must be used, monitor ECG and electrolytes closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Other interactions of Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Asenapine with Pimavanserin?
MediHelp rates the interaction as major. Asenapine and Pimavanserin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs can lengthen the QT interval, and pimavanserin labeling advises against use with other QT-prolonging agents. Combined use increases the risk of torsades de pointes and sudden cardiac events.
How serious is the interaction between Asenapine and Pimavanserin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use an alternative agent. If both must be used, monitor ECG and electrolytes closely.
What other medicines interact with Asenapine?
MediHelp also lists interactions of Asenapine with, for example, Pimozide, Thioridazine, Vandetanib. The full list is on the Asenapine page.
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