Drug interactions
Lefamulin + Pimavanserin
Severity: Contraindicated
Lefamulin and Pimavanserin: contraindicated 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
Lefamulin inhibits CYP3A4 and raises exposure to CYP3A substrates, and it also prolongs the QT interval. Pimavanserin is a CYP3A4 substrate that itself prolongs QT, so the combination increases the risk of torsades de pointes. Lefamulin labeling contraindicates the oral form with QT-prolonging CYP3A substrates.
What this interaction means in plain words
Lefamulin and Pimavanserin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Lefamulin belongs to Anti Bacterial; Pimavanserin belongs to Central Nervous System.
Why it happens
CYP3A4 inhibition raises pimavanserin exposure, and both drugs have additive QT-prolonging effects.
What to do
Avoid the combination and choose an antibiotic without QT or CYP3A4 effects. If unavoidable, ECG and electrolyte monitoring are needed with pimavanserin dose reduction.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Pimavanserin
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
- Amobarbital + Pimavanserin Major
Other interactions of Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
- Amisulpride + Lefamulin Major
Frequently asked questions
Can I take Lefamulin with Pimavanserin?
MediHelp rates the interaction as contraindicated. Lefamulin and Pimavanserin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Lefamulin inhibits CYP3A4 and raises exposure to CYP3A substrates, and it also prolongs the QT interval. Pimavanserin is a CYP3A4 substrate that itself prolongs QT, so the combination increases the risk of torsades de pointes. Lefamulin labeling contraindicates the oral form with QT-prolonging CYP3A substrates.
How serious is the interaction between Lefamulin and Pimavanserin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and choose an antibiotic without QT or CYP3A4 effects. If unavoidable, ECG and electrolyte monitoring are needed with pimavanserin dose reduction.
What other medicines interact with Pimavanserin?
MediHelp also lists interactions of Pimavanserin with, for example, Pimozide, Vandetanib, Adagrasib. The full list is on the Pimavanserin page.
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