Formulary
Pimozide: Indications, Dosing, Side Effects and Interactions
Pimozide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 5 min read
Pimozide: Indications, Dosing, Side Effects and Interactions
Pimozide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Schizophrenia**
- **Adult** (By Mouth): Initially 2 mg daily, adjusted according to response, then increased in steps of 2-4 mg at intervals of not less than 1 week; usual dose 2-20 mg daily.
- **Elderly** (By Mouth): Initially 1 mg daily, adjusted according to response, increased in steps of 2-4 mg at intervals of not less than 1 week; usual dose 2-20 mg daily.
**Monosymptomatic hypochondriacal psychosis,Paranoid psychosis**
- **Adult** (By Mouth): Initially 4 mg daily, adjusted according to response, then increased in steps of 2-4 mg at intervals of not less than 1 week; maximum 16 mg per day.
- **Elderly** (By Mouth): Initially 2 mg daily, adjusted according to response, increased in steps of 2-4 mg at intervals of not less than 1 week; maximum 16 mg per day.
**Schizophrenia for pimozide**
- **Child 12-17 years (under expert supervision)** (By mouth): Initially 1 mg daily, adjusted according to response, then increased in steps of 2-4 mg at intervals of not less than 1 week; usual dose 2-20 mg daily.
**Tourette syndrome (under expert supervision) for pimozide**
- **Child 2-11 years** (By mouth): 1-4 mg daily.
- **Child 12-17 years** (By mouth): 2-10 mg daily.
Cautions
For all antipsychotic drugs Blood dyscrasias; cardiovascular disease; conditions predisposing to seizures; depression; diabetes (may raise blood glucose); epilepsy; history of jaundice; myasthenia gravis; Parkinson's disease (may be exacerbated); photosensitisation (may occur with higher dosages); prostatic hypertrophy; severe respiratory disease; susceptibility to angle-closure glaucoma Cautions, further information Cardiovascular disease An ECG may be required, particularly if physical examination identifies cardiovascular risk factors, personal history of cardiovascular disease, or if the patient is being admitted as an inpatient. Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: for all antipsychotics (other than quetiapine and clozapine) in patients with parkinsonism or Lewy Body Disease (risk of severe extrapyramidal symptoms) in behavioural and psychological symptoms of dementia (BPSD), unless symptoms are severe and other non-pharmacological treatments have failed (increased risk of stroke) for use as a hypnotic, unless sleep disorder is due to psychosis or dementia (risk of confusion, hypotension, extrapyramidal side-effects, and falls) in patients prone to falls (may cause gait dyspraxia, parkinsonism) if prescribed a phenothiazine (other than prochlorperazine for nausea, vomiting, or vertigo; chlorpromazine for relief of persistent hiccups; levomepromazine as an antiemetic in palliative care) as first-line treatment (sedative, significant antimuscarinic (anticholinergic) toxicity in older people, and safer and more efficacious alternatives exist) if prescribed an antipsychotic drug with moderate or marked antimuscarinic effects (e.g. chlorpromazine, clozapine, flupenthixol, fluphenazine, pipothiazine, promazine, and zuclopenthixol) in patients with a history of prostatism or urinary retention (high risk of urinary retention)
Contraindications
CNS depression; comatose states; history of arrhythmias; history or family history of congenital QT prolongation; phaeochromocytoma
Side effects
For all antipsychotic drugs Common or very common Agitation; amenorrhoea; arrhythmias; constipation; dizziness; drowsiness; dry mouth; erectile dysfunction; fatigue; galactorrhoea; gynaecomastia; hyperglycaemia; hyperprolactinaemia; hypersalivation; hypotension (dose-related); insomnia; leucopenia; movement disorders; muscle rigidity; neutropenia; parkinsonism; postural hypotension (dose-related); QT interval prolongation; rash; seizure; tremor; urinary retention; vomiting; weight increased Uncommon Agranulocytosis; confusion; neuroleptic malignant syndrome (discontinue-potentially fatal) Rare or very rare Sudden death; withdrawal syndrome neonatal Side-effects, further information For depot antipsychotics-side-effects may persist until the drug has been cleared from its depot site. Overdose Phenothiazines cause less depression of consciousness and respiration than other sedatives. Hypotension, hypothermia, sinus tachycardia, and arrhythmias may complicate poisoning. For details on the management of poisoning see Antipsychotics under Emergency treatment of poisoning . Side-effects For pimozide Common or very common Appetite decreased; depression; headache; hyperhidrosis; restlessness; sebaceous gland overactivity; urinary disorders; vision blurred Uncommon Dysarthria; face oedema; muscle spasms; oculogyric crisis; skin reactions Frequency not known Cardiac arrest; generalised tonic-clonic seizure; glycosuria; hyponatraemia; libido decreased; neck stiffness; temperature regulation disorders
Interactions
**Other interactions (7):**
- Please also refer to the Precautions and Warnings and Contra-indications sections.
- The dosage of anticonvulsants may need to be increased to take account of lowered seizure threshold.
- Examples include certain antiarrhythmics, such as those of Class IA (such as quinidine, disopyramide and procainamide) and Class III (such as amiodarone and sotalol), tricyclic antidepressants (such...
- This list is not comprehensive.
- Low potency neuroleptics such as chlorpromazine and thioridazine should not be used concomitantly with pimozide.
- Citalopram did not alter the AUC and Cmax of pimozide (see Section 4.3).
Pregnancy
For all antipsychotic drugs Extrapyramidal effects and withdrawal syndrome have been reported occasionally in the neonate when antipsychotic drugs are taken during the third trimester of pregnancy. Following maternal use of antipsychotic drugs in the third trimester, neonates should be monitored for symptoms including agitation, hypertonia, hypotonia, tremor, drowsiness, feeding problems, and respiratory distress.
Breast feeding
For all antipsychotic drugs There is limited information available on the short- and long-term effects of antipsychotic drugs on the breast-fed infant. Animal studies indicate possible adverse effects of antipsychotic medicines on the developing nervous system. Chronic treatment with antipsychotic drugs whilst breast-feeding should be avoided unless absolutely necessary. Phenothiazine derivatives are sometimes used in breast-feeding women for short-term treatment of nausea and vomiting.
Hepatic impairment
Manufacturer advises caution.
Renal impairment
Caution in renal failure. M
Medicinal forms
Suspension
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Pimozide in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

