Drug interactions
Milnacipran + Pimozide
Severity: Moderate
Milnacipran 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
Pimozide is a potent dopamine antagonist that also prolongs the QT interval. Combined with an SNRI it may rarely cause serotonin syndrome or neuroleptic malignant syndrome, and milnacipran can raise heart rate, adding cardiac concern.
What this interaction means in plain words
Milnacipran 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.
Milnacipran belongs to Central Nervous System; Pimozide belongs to Central Nervous System.
Why it happens
Additive serotonergic and dopaminergic modulation; the mechanism of the rare syndromes is not fully established.
What to do
Monitor for hyperthermia, rigidity, clonus and autonomic instability, and consider an ECG at baseline and after dose changes. Withdraw the agents if a syndrome is suspected.
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 Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
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 Milnacipran with Pimozide?
MediHelp rates the interaction as moderate. Milnacipran 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. Pimozide is a potent dopamine antagonist that also prolongs the QT interval. Combined with an SNRI it may rarely cause serotonin syndrome or neuroleptic malignant syndrome, and milnacipran can raise heart rate, adding cardiac concern.
How serious is the interaction between Milnacipran 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 hyperthermia, rigidity, clonus and autonomic instability, and consider an ECG at baseline and after dose changes. Withdraw the agents if a syndrome is suspected.
What other medicines interact with Milnacipran?
MediHelp also lists interactions of Milnacipran with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Milnacipran page.
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