Drug interactions
Pimozide + Stiripentol
Severity: Major
Pimozide and Stiripentol: 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
Stiripentol inhibits and induces several CYP enzymes including CYP3A4 and CYP1A2, both involved in pimozide metabolism. Pimozide exposure may therefore become unpredictable, with possible loss of effect or an increase in levels that heightens the risk of QT prolongation and arrhythmia.
What this interaction means in plain words
Pimozide and Stiripentol 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; Stiripentol belongs to Central Nervous System.
Why it happens
Mixed inhibition and induction of CYP3A4 and CYP1A2 by stiripentol alters pimozide clearance.
What to do
Avoid coadministration where possible given pimozide's narrow QT margin. If unavoidable, obtain a baseline and follow-up ECG and adjust pimozide to response and tolerability.
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 Stiripentol
Frequently asked questions
Can I take Pimozide with Stiripentol?
MediHelp rates the interaction as major. Pimozide and Stiripentol 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. Stiripentol inhibits and induces several CYP enzymes including CYP3A4 and CYP1A2, both involved in pimozide metabolism. Pimozide exposure may therefore become unpredictable, with possible loss of effect or an increase in levels that heightens the risk of QT prolongation and arrhythmia.
How serious is the interaction between Pimozide and Stiripentol?
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 coadministration where possible given pimozide's narrow QT margin. If unavoidable, obtain a baseline and follow-up ECG and adjust pimozide to response and tolerability.
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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