Drug interactions
Ivosidenib + Pimavanserin
Severity: Moderate
Ivosidenib and Pimavanserin: moderate 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
Ivosidenib induces CYP3A4 and can lower plasma concentrations of pimavanserin, a CYP3A4 substrate. This may reduce antipsychotic efficacy against Parkinson's disease psychosis.
What this interaction means in plain words
Ivosidenib and Pimavanserin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Ivosidenib belongs to Oncology; Pimavanserin belongs to Central Nervous System.
Why it happens
Ivosidenib induces hepatic and intestinal CYP3A4, increasing pimavanserin metabolism.
What to do
Monitor for loss of antipsychotic effect and consider an alternative to ivosidenib if possible. Pimavanserin dose increase may be needed if efficacy declines, guided by clinical response.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Ivosidenib with Pimavanserin?
MediHelp rates the interaction as moderate. Ivosidenib and Pimavanserin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ivosidenib induces CYP3A4 and can lower plasma concentrations of pimavanserin, a CYP3A4 substrate. This may reduce antipsychotic efficacy against Parkinson's disease psychosis.
How serious is the interaction between Ivosidenib and Pimavanserin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of antipsychotic effect and consider an alternative to ivosidenib if possible. Pimavanserin dose increase may be needed if efficacy declines, guided by clinical response.
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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