Drug interactions
Elranatamab + Pimozide
Severity: Major
Elranatamab and Pimozide: 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
Elranatamab causes cytokine release syndrome, which can transiently suppress CYP450 activity and raise exposure to CYP3A4 substrates. Pimozide has a narrow therapeutic index and its higher levels can prolong the QT interval and cause torsades de pointes.
What this interaction means in plain words
Elranatamab and Pimozide 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.
Elranatamab belongs to Oncology; Pimozide belongs to Central Nervous System.
Why it happens
Cytokine-mediated suppression of CYP3A4 activity during cytokine release syndrome reduces pimozide clearance.
What to do
During step-up dosing and for the period after, and during any CRS, monitor ECG/QTc and signs of pimozide toxicity. Consider holding or reducing pimozide, or choosing an alternative, during this period.
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 Pimozide
- Adagrasib + Pimozide Contraindicated
- Amiodarone + Pimozide Contraindicated
- Amisulpride + Pimozide Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amoxapine + Pimozide Contraindicated
- Anagrelide + Pimozide Contraindicated
Other interactions of Elranatamab
- Elranatamab + Ergotamine Major
- Bendamustine + Elranatamab Moderate
- Carbamazepine + Elranatamab Moderate
- Clomipramine + Elranatamab Moderate
- Clozapine + Elranatamab Moderate
- Colchicine + Elranatamab Moderate
Frequently asked questions
Can I take Elranatamab with Pimozide?
MediHelp rates the interaction as major. Elranatamab and Pimozide 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. Elranatamab causes cytokine release syndrome, which can transiently suppress CYP450 activity and raise exposure to CYP3A4 substrates. Pimozide has a narrow therapeutic index and its higher levels can prolong the QT interval and cause torsades de pointes.
How serious is the interaction between Elranatamab and Pimozide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: During step-up dosing and for the period after, and during any CRS, monitor ECG/QTc and signs of pimozide toxicity. Consider holding or reducing pimozide, or choosing an alternative, during this period.
What other medicines interact with Pimozide?
MediHelp also lists interactions of Pimozide with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Pimozide page.
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