Drug interactions
Pimavanserin + Posaconazole
Severity: Major
Pimavanserin and Posaconazole: 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
Posaconazole increases pimavanserin exposure, and pimavanserin prolongs the QT interval in a concentration-related manner. This raises the risk of arrhythmia.
What this interaction means in plain words
Pimavanserin and Posaconazole 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.
Pimavanserin belongs to Central Nervous System; Posaconazole belongs to Anti Fungals.
Why it happens
CYP3A4 inhibition by posaconazole reduces pimavanserin clearance, with additive QT prolongation.
What to do
Reduce the pimavanserin dose to 10 mg daily per labeling (for the 34 mg dose) and monitor ECG; consider an alternative antifungal.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Other interactions of Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Pimavanserin with Posaconazole?
MediHelp rates the interaction as major. Pimavanserin and Posaconazole 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. Posaconazole increases pimavanserin exposure, and pimavanserin prolongs the QT interval in a concentration-related manner. This raises the risk of arrhythmia.
How serious is the interaction between Pimavanserin and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the pimavanserin dose to 10 mg daily per labeling (for the 34 mg dose) and monitor ECG; consider an alternative antifungal.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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