Drug interactions
Levomilnacipran + Pimozide
Severity: Moderate
Levomilnacipran and Pimozide: 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
Combining a serotonin-norepinephrine reuptake inhibitor with a dopamine-blocking antipsychotic may increase the risk of serotonin toxicity and, less commonly, neuroleptic malignant syndrome. Levomilnacipran can also raise heart rate and blood pressure, which is unfavorable in a patient on pimozide, a drug with a recognized QT liability.
What this interaction means in plain words
Levomilnacipran and Pimozide 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.
Levomilnacipran belongs to Central Nervous System; Pimozide belongs to Central Nervous System.
Why it happens
Additive serotonergic and dopaminergic pharmacodynamic effects; levomilnacipran is not a significant CYP3A4 inhibitor at usual doses.
What to do
Monitor for mental status change, autonomic instability, neuromuscular hyperactivity, hyperthermia and rigidity after starting or increasing either drug. Consider baseline and follow-up ECG given pimozide's QT effects.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Levomilnacipran and Pimozide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Levomilnacipran
- Isocarboxazid + Levomilnacipran Contraindicated
- Levomilnacipran + Linezolid Contraindicated
- Levomilnacipran + Methylthioninium chloride Contraindicated
- Levomilnacipran + Phenelzine Contraindicated
- Levomilnacipran + Procarbazine Contraindicated
- Levomilnacipran + Rasagiline Contraindicated
Frequently asked questions
Can I take Levomilnacipran with Pimozide?
MediHelp rates the interaction as moderate. Levomilnacipran and Pimozide 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. Combining a serotonin-norepinephrine reuptake inhibitor with a dopamine-blocking antipsychotic may increase the risk of serotonin toxicity and, less commonly, neuroleptic malignant syndrome. Levomilnacipran can also raise heart rate and blood pressure, which is unfavorable in a patient on pimozide, a drug with a recognized QT liability.
How serious is the interaction between Levomilnacipran and Pimozide?
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 mental status change, autonomic instability, neuromuscular hyperactivity, hyperthermia and rigidity after starting or increasing either drug. Consider baseline and follow-up ECG given pimozide's QT effects.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
