Drug interactions
Dofetilide + Pimavanserin
Severity: Major
Dofetilide and Pimavanserin: major interaction.
Last updated Sources: US FDA label
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
Dofetilide carries a significant risk of dose-related torsades de pointes, and pimavanserin adds further QT prolongation. The combination may precipitate life-threatening arrhythmia.
What this interaction means in plain words
Dofetilide 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.
Dofetilide belongs to Cardiovascular; Pimavanserin belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with dofetilide blocking the IKr potassium current.
What to do
Avoid the combination. If it cannot be avoided, give dofetilide only under in-hospital ECG monitoring with normal electrolytes and dose-adjust for renal function.
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 Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Other interactions of Dofetilide
- Amiodarone + Dofetilide Contraindicated
- Amisulpride + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
Frequently asked questions
Can I take Dofetilide with Pimavanserin?
MediHelp rates the interaction as major. Dofetilide 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. Dofetilide carries a significant risk of dose-related torsades de pointes, and pimavanserin adds further QT prolongation. The combination may precipitate life-threatening arrhythmia.
How serious is the interaction between Dofetilide 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. If it cannot be avoided, give dofetilide only under in-hospital ECG monitoring with normal electrolytes and dose-adjust for renal function.
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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