Drug interactions
Pimozide + Zotepine
Severity: Major
Pimozide and Zotepine: major interaction.
Last updated Sources: Health Canada product monograph
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
Two antipsychotics together increase the risk of extrapyramidal symptoms, sedation and neuroleptic malignant syndrome. Both prolong the QT interval, and zotepine also carries a seizure risk, so arrhythmia risk is higher.
What this interaction means in plain words
Pimozide and Zotepine 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.
Why it happens
Additive dopamine D2 antagonism, sedation and QT prolongation.
What to do
Avoid combining the two antipsychotics where possible. If unavoidable, use the lowest doses, obtain an ECG and monitor for rigidity, hyperthermia and movement disorders.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Pimozide and Zotepine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
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 Pimozide with Zotepine?
MediHelp rates the interaction as major. Pimozide and Zotepine 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. Two antipsychotics together increase the risk of extrapyramidal symptoms, sedation and neuroleptic malignant syndrome. Both prolong the QT interval, and zotepine also carries a seizure risk, so arrhythmia risk is higher.
How serious is the interaction between Pimozide and Zotepine?
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 combining the two antipsychotics where possible. If unavoidable, use the lowest doses, obtain an ECG and monitor for rigidity, hyperthermia and movement disorders.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
