Drug interactions
Pimozide + Pramipexole
Severity: Major
Pimozide and Pramipexole: 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
Pimozide blocks dopamine D2 receptors and opposes the effect of the dopamine agonist pramipexole. This can worsen Parkinson symptoms or reduce control of restless legs syndrome, and the combination also adds to extrapyramidal risk.
What this interaction means in plain words
Pimozide and Pramipexole 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.
Pimozide belongs to Central Nervous System; Pramipexole belongs to Cardiovascular.
Why it happens
Pharmacodynamic antagonism at dopamine D2/D3 receptors.
What to do
Avoid the combination. In Parkinson disease with psychosis, use quetiapine or clozapine instead of pimozide.
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 Pimozide
- Adagrasib + Pimozide Contraindicated
- Amiodarone + Pimozide Contraindicated
- Amisulpride + Pimozide Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amoxapine + Pimozide Contraindicated
- Anagrelide + Pimozide Contraindicated
Other interactions of Pramipexole
- Amisulpride + Pramipexole Contraindicated
- Chlorpromazine + Pramipexole Major
- Droperidol + Pramipexole Major
- Fluphenazine + Pramipexole Major
- Haloperidol + Pramipexole Major
- Iloperidone + Pramipexole Major
Frequently asked questions
Can I take Pimozide with Pramipexole?
MediHelp rates the interaction as major. Pimozide and Pramipexole 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. Pimozide blocks dopamine D2 receptors and opposes the effect of the dopamine agonist pramipexole. This can worsen Parkinson symptoms or reduce control of restless legs syndrome, and the combination also adds to extrapyramidal risk.
How serious is the interaction between Pimozide and Pramipexole?
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 the combination. In Parkinson disease with psychosis, use quetiapine or clozapine instead of pimozide.
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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