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NERVOUS SYSTEM › PSYCHOLEPTICS › ANTIPSYCHOTICS › Other antipsychotics
pimavanserin
N05AX17
Forms & Strengths
- Oral tablets: 34 mg
- Oral capsules: 10 mg
Adult Dosing
- Parkinson's disease psychosis: 34 mg orally once daily
- No titration required; can be taken with or without food
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Treatment of hallucinations and delusions associated with Parkinson's disease psychosis
Mechanism of Action
- Inverse agonist and antagonist at serotonin 5-HT2A receptors, with lower potency at 5-HT2C receptors
- Lacks appreciable affinity for dopamine, adrenergic, histaminergic, or muscarinic receptors
Contraindications
- Known history of hypersensitivity to pimavanserin or any of its components
- Patients with a history of QT prolongation or concomitant use of drugs known to significantly prolong the QT interval
Adverse Reactions
- Peripheral edema
- Nausea
- Confusional state
- Hallucinations
- Constipation
- Gait disturbance
- UTI
- QT interval prolongation
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole) increase pimavanserin exposure; reduce dose by half (17 mg daily)
- Strong or moderate CYP3A4 inducers (e.g., rifampin, carbamazepine) decrease pimavanserin efficacy; avoid coadministration
- Concomitant use with other drugs that prolong the QT interval increases risk of arrhythmias and sudden death
Curated Content: Needs Vetting Before Put to Clinical Use