Drug interactions
Darunavir + Pimavanserin
Severity: Major
Darunavir and Pimavanserin: major interaction.
Last updated
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
Darunavir, usually given with a booster such as ritonavir or cobicistat, strongly inhibits CYP3A4, which is the main route of pimavanserin metabolism. Pimavanserin exposure rises, increasing the risk of QT prolongation and other adverse effects.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Pimavanserin belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated metabolism of pimavanserin increases its plasma concentrations.
What to do
Reduce the pimavanserin dose to 10 mg daily (from 34 mg) when given with a strong CYP3A4 inhibitor, and monitor the ECG and for adverse effects.
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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Other interactions of Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Other interactions of Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Pimavanserin?
MediHelp rates the interaction as major. Darunavir 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. Darunavir, usually given with a booster such as ritonavir or cobicistat, strongly inhibits CYP3A4, which is the main route of pimavanserin metabolism. Pimavanserin exposure rises, increasing the risk of QT prolongation and other adverse effects.
How serious is the interaction between Darunavir 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: Reduce the pimavanserin dose to 10 mg daily (from 34 mg) when given with a strong CYP3A4 inhibitor, and monitor the ECG and for adverse effects.
What other medicines interact with Pimavanserin?
MediHelp also lists interactions of Pimavanserin with, for example, Lefamulin, Pimozide, Vandetanib. The full list is on the Pimavanserin page.
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