- Tardive dyskinesia has occurred with therapy, incidences of this syndrome are higher in elderly patients especially in women
- Risk of developing tardive dyskinesia and chances that it becomes irreversible may increase as the total dose of therapy is increased
- No known treatment for tardive dyskinesia have been established, although the syndrome may remit, partially or completely if therapy is withdrawn
- Discontinue the therapy if signs and symptoms of tardive dyskinesia occur. In some patients treatment should be continue despite the presence of the syndrome
- Neuroleptic Malignant Syndrome (NMS) has been reported with use of therapy. Signs and symptoms of NMS includes hyperpyrexia, muscle rigidity, altered mental status, evidence of autonomic instability, elevated creatine phosphokinase, myoglobinuria and acute renal failure
- If NMS occur discontinue the therapy and follow intensive symptomatic treatment with medical monitoring
- Re-administer drug with careful monitoring; if patient requires after recovery from NMS; as recurrences of NMS have been reported
- Sudden, unexpected deaths due to prolongation of the QT interval, predisposing patients to ventricular arrhythmia have occurred in patients receiving dosages in the range of 1 mg/kg
- Perform ECG prior to initiating pimozide and periodically thereafter especially during dose adjustment
- Post-marketing experience studies have found that leukopenia/neutropenia and agranulocytosis events have been reported with therapy. Patient with low WBC or drug induced leukopenia/neutropenia should evaluate complete blood count (CBC) and monitored frequently during the first few months of therapy
- Avoid performing potentially hazardous tasks, such as driving a car or operating machinery, especially during the first few days of therapy
- Correct hypokalemia and hypomagnesemia before initiating therapy and normal potassium and magnesium levels are maintained during therapy
- Withhold therapy if QTc interval prolongs beyond 0.47 sec (children), 0.52 sec (adults), or more than 25% above baseline QTc
Cautions: Use cautiously in:
- Hepatic impairment
- Renal impairment
- Angle-closure glaucoma
- Prostatic hypertrophy
- GI/GU obstruction
- Asthma
- COPD
- Seizure disorder
- Dementia
- History of drug-induced leukopenia or neutropenia
- Anticonvulsant medication
- EEG abnormalities
- Elderly patients
- Concomitant use with inhibitors of P450 IA2 and CYP 3A4 drugs
- Concomitant use with fluoxetine
- Grapefruit consumption
Pregnancy Category:C
Breastfeeding: Safety unknown. Because there is no published experience with pimozide during breastfeeding, other drugs are preferred. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT Last accessed 24 March 2011).
Pricing data from www.DrugStore.com in U.S.A.
- Orap 2 MG TABS [Bottle] (GATE)
60 mg = $109.99
180 mg = $296.98 - Orap 1 MG TABS [Bottle] (GATE)
60 mg = $85.99
180 mg = $247.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
