Drug interactions
Methylenedioxymethamphetamine + Pimozide
Severity: Major
Methylenedioxymethamphetamine and Pimozide: major interaction.
Last updated Sources: Health Canada product monograph
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
MDMA releases serotonin and norepinephrine and can cause tachycardia, hyperthermia and QT prolongation. Combined with pimozide, it may increase the risk of arrhythmia, and with serotonin toxicity or neuroleptic malignant syndrome being possible concerns. MDMA is also a CYP2D6 inhibitor.
What this interaction means in plain words
Methylenedioxymethamphetamine 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.
Why it happens
Additive QT and cardiovascular effects, with serotonergic and dopaminergic pharmacodynamic interplay and possible CYP2D6 inhibition.
What to do
Advise against combining them and counsel the patient on the risks of recreational MDMA use. If exposure occurs, assess ECG, temperature and electrolytes.
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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References
Other interactions of Pimozide
- Adagrasib + Pimozide Contraindicated
- Amiodarone + Pimozide Contraindicated
- Amisulpride + Pimozide Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amoxapine + Pimozide Contraindicated
- Anagrelide + Pimozide Contraindicated
Frequently asked questions
Can I take Methylenedioxymethamphetamine with Pimozide?
MediHelp rates the interaction as major. Methylenedioxymethamphetamine 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. MDMA releases serotonin and norepinephrine and can cause tachycardia, hyperthermia and QT prolongation. Combined with pimozide, it may increase the risk of arrhythmia, and with serotonin toxicity or neuroleptic malignant syndrome being possible concerns. MDMA is also a CYP2D6 inhibitor.
How serious is the interaction between Methylenedioxymethamphetamine 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: Advise against combining them and counsel the patient on the risks of recreational MDMA use. If exposure occurs, assess ECG, temperature and electrolytes.
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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