Drug interactions
Dextromethorphan + Pimavanserin
Severity: Minor
Dextromethorphan and Pimavanserin: minor 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
Pimavanserin is a serotonin 5-HT2A inverse agonist, and dextromethorphan has serotonergic activity, so a theoretical risk of serotonin toxicity or neuroleptic malignant syndrome exists. Clinical reports are lacking and the risk is mainly theoretical.
What this interaction means in plain words
Dextromethorphan and Pimavanserin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Dextromethorphan belongs to Respiratory; Pimavanserin belongs to Central Nervous System.
Why it happens
Theoretical additive serotonergic effects; the mechanism is not firmly established.
What to do
No routine dose change is needed; counsel the patient to report fever, rigidity, tremor or confusion promptly.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
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 Dextromethorphan with Pimavanserin?
MediHelp rates the interaction as minor. Dextromethorphan and Pimavanserin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Pimavanserin is a serotonin 5-HT2A inverse agonist, and dextromethorphan has serotonergic activity, so a theoretical risk of serotonin toxicity or neuroleptic malignant syndrome exists. Clinical reports are lacking and the risk is mainly theoretical.
How serious is the interaction between Dextromethorphan and Pimavanserin?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed; counsel the patient to report fever, rigidity, tremor or confusion promptly.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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