Drug interactions
Pimavanserin + Tacrolimus
Severity: Major
Pimavanserin and Tacrolimus: 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
Both drugs can prolong the QT interval, so combining them may add to the risk of torsades de pointes. Risk is greater with electrolyte disturbances, bradycardia or underlying heart disease.
What this interaction means in plain words
Pimavanserin and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive pharmacodynamic QT prolongation through effects on cardiac repolarization.
What to do
Prefer an alternative to pimavanserin if feasible. If both are needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc during therapy.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus 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 Tacrolimus?
MediHelp rates the interaction as major. Pimavanserin and Tacrolimus 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. Both drugs can prolong the QT interval, so combining them may add to the risk of torsades de pointes. Risk is greater with electrolyte disturbances, bradycardia or underlying heart disease.
How serious is the interaction between Pimavanserin and Tacrolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative to pimavanserin if feasible. If both are needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc during therapy.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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