Drug interactions
Miconazole + Pimozide
Severity: Major
Miconazole and Pimozide: 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
Vaginal or topical miconazole has low systemic absorption, but systemic exposure can occur and miconazole is a potent CYP3A4 inhibitor. Pimozide has a narrow therapeutic index and QT prolongation risk. Interaction is mainly relevant for oral or buccal miconazole.
What this interaction means in plain words
Miconazole 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.
Miconazole belongs to Anti Fungals; Pimozide belongs to Central Nervous System.
Why it happens
Miconazole inhibits CYP3A4 metabolism of pimozide, raising levels and QT prolongation risk.
What to do
Avoid systemic (oral gel, buccal) miconazole with pimozide. With vaginal use, prefer an alternative antifungal if the patient has QT risk factors.
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 Miconazole
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 Miconazole with Pimozide?
MediHelp rates the interaction as major. Miconazole 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. Vaginal or topical miconazole has low systemic absorption, but systemic exposure can occur and miconazole is a potent CYP3A4 inhibitor. Pimozide has a narrow therapeutic index and QT prolongation risk. Interaction is mainly relevant for oral or buccal miconazole.
How serious is the interaction between Miconazole 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: Avoid systemic (oral gel, buccal) miconazole with pimozide. With vaginal use, prefer an alternative antifungal if the patient has QT risk factors.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Miconazole page.
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