Drug interactions
Gepirone + Pimavanserin
Severity: Major
Gepirone 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
Both drugs prolong the QTc interval, so combined use may increase the risk of torsades de pointes. Risk is higher with electrolyte disturbances, bradycardia or underlying heart disease.
What this interaction means in plain words
Gepirone 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.
Gepirone belongs to Central Nervous System; Pimavanserin belongs to Central Nervous System.
Why it happens
Additive QT prolongation through cardiac repolarization effects.
What to do
Avoid the combination where possible; if used, obtain a baseline and follow-up ECG and correct potassium and magnesium. Note that gepirone dosing is also limited with CYP3A4 inhibitors.
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 Gepirone
- Clarithromycin + Gepirone Contraindicated
- Gepirone + Isocarboxazid Contraindicated
- Gepirone + Itraconazole Contraindicated
- Gepirone + Ketoconazole Contraindicated
- Gepirone + Linezolid Contraindicated
- Gepirone + Phenelzine Contraindicated
Frequently asked questions
Can I take Gepirone with Pimavanserin?
MediHelp rates the interaction as major. Gepirone 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 prolong the QTc interval, so combined use may increase the risk of torsades de pointes. Risk is higher with electrolyte disturbances, bradycardia or underlying heart disease.
How serious is the interaction between Gepirone 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 where possible; if used, obtain a baseline and follow-up ECG and correct potassium and magnesium. Note that gepirone dosing is also limited with CYP3A4 inhibitors.
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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