Pimozide (Oral)

Overview

Pimozide is a drug that is prescribed to patients with Tourette's syndrome as a means to help reduce the symptoms they suffer from. It is designed to help treat severe symptoms that cannot be reduced through other medicines. Therefore, this drug is not suitable for everyone with Tourette's syndrome but only certain patients.

Pimozide is effective at helping control physical uncontrollable tics, as well as vocal outbursts. It does this by working inside the central nervous system. It is worth noting that Pimozide is not a cure for Tourette's syndrome and will not cure all ticks, but can help reduce their number and severity. Due to the nature of the medication and the wide variety of interactions and side effects it can cause, Pimozide is only available with a doctor's prescription.

Condition(s) treated

  • Tourette's syndrome

Type of medicine

  • Tablet

Side Effects

Along with helping to limit the effects of Tourette's syndrome, it is possible that taking Pimozide could cause a number of unwanted side effects. In some cases, these side effects are not very severe, but in other cases, they are more troubling. Directly below is a list of these more serious side effects which require you to inform your doctor and seek immediate medical assistance.

More common

  • Lack of facial expressions

Less common or rare

  • Difficulty swallowing

Here are the symptoms of overdose. If you experience any of these, seek emergency medical attention.

  • Severe uncontrolled movements

As well as these more serious side effects, you may experience others that require less immediate attention. In fact, you may find that as your body adjusts to the medicine, the effects disappear. Below is a list of such effects. If you do experience any of these and if they are causing you worry or stress, you can still contact your doctor who may be able to advise means to reduce them.

More common

  • Blurred vision or other problems related to vision

Less common

  • Decrease in sexual ability

Beyond these lists, there are other side effects that you may experience. If this is the case and you are worried at all, then you can contact your doctor. Again, they may be able to advise on ways to reduce the effects, such as by altering your dosage.

Dosage

Below you can find typical dosages of Pimozide that are prescribed to patients suffering from Tourette's syndrome. Be aware that these are simply averages, and may differ greatly from your prescription. If this is the case, then you should stick to the doses recommended by your doctor. These will depend on your exact medical situation and will minimise any potential side effects and maximise the benefits you receive. Similarly, do not take the medicine for longer than has been advised. If you do think that your prescription should be changed, then you will need to discuss this with your doctor.

  • Adults. To start, take 1 to 2 mg each day. This amount must be taken in divided doses. It is possible that your doctor may increase the dose every other day if needed. However, this total dose is never normally more than 10mg a day.

It is important that you never miss a dose, as doing so will reduce the effectiveness of the medicine. If however, you miss one, you should take the missed dose as soon as possible. However, if it is almost time for you to take the next scheduled dose, skip the missed one and return to normal scheduling. It is important that you do not double dose.

Note that, for the period that you are taking these tablets, you should not be drinking grapefruit juice or eating grapefruit. Doing so affects the amount of medicine that is actually absorbed into your body.

It is recommended that you take your doses at bedtime.

Interactions

It is possible that the Pimozide you take will interact with other drugs you currently take. These interactions can be unpleasant and dangerous so are normally avoided. To help predict any interactions, you should clearly inform your doctor of all drugs you currently take. This includes prescription and nonprescription ones, as well as any supplements of herbal remedies. Directly below is a list of drugs with which it is recommended you do not take at the same time as Pimozide. You should make your doctor well aware if you are taking any of these.

  • Hydroquinidine

Below is a list of drugs with which it is usually not recommended you take alongside Pimozide. In some cases however, it may be necessary that you take both at the same time. In such instances, your doctor can advise on the best way to proceed, such as by reducing the doses of one or both of the drugs.

  • Secukinumab

If you take Pimozide with any of the following drugs, you may be at greater risk of certain side effects occurring. Again, however, it may be that taking both is the best course of treatment. Your doctor will, therefore, make any necessary adjustments to help avoid any side effects arising.

  • Betel Nut

As well as interacting with drugs, it is possible that Pimozide will interact with certain aspects of your dietary intake. This includes what you eat, drink, and smoke. To help avoid such interactions, your doctor may require you to alter certain parts of your diet or limit the amount you consume of certain things. You should give your doctor a typical rundown of what you consume each day so that they can anticipate any changes that should be made. Directly below is a list of things that are known to more seriously interact with Pimozide. If you consume any of the following, you should make it clear to the prescribing doctor.

  • Tobacco

Finally, Pimozide could potentially interact with other medical problems you currently have. You should give your doctor a firm understanding of your complete medical history so they can prevent unwanted interactions. Below is a list of medical problems which make it not recommended start taking Pimozide.

  • Bone marrow or blood problems ( such as agranulocytosis)

Warnings

Before you are prescribed Pimozide, your doctor will need to fully examine you to ensure it is a suitable drug to start taking. As a part of this examination, they will need to understand any and all allergies you suffer from. This includes those to other drugs, preservatives, foods, animals, and dyes.

The studies performed on pediatric patients using Pimozide have not yet demonstrated any problems that would make this drug any less useful for children aged 12 and above. However, as of writing, no safety and efficacy standards have yet been established for those children aged below 12. Your doctor will need to decide whether there are any increased risks when using this drug and to decide whether these are outweighed by benefits on offer.

Similarly, there is no information available regarding the use of Pimozide in geriatric patients. You will need to be assessed by your doctor to decide whether is a safe and suitable drug to start using.

It is unclear as to whether suitable tests have been carried out on pregnant women using Pimozide. If there are any risks associated, your doctor can make you aware of them before deciding to prescribe or not. If, whilst taking Pimozide, you become pregnant, you should inform your doctor as they may need to adjust your prescription.

Similarly, there are no adequate studies which have yet been performed on breastfeeding women. You and your doctor will need to consider any associated risks alongside the benefits.

Whilst taking this medicine, it is important that your doctor sees you at regular appointments to track your condition. It may be necessary to perform blood tests at these appointments to measure any unwanted effects. Similarly, they may need to check your heart rhythm. In turn, they can then adjust your prescription if they think it necessary.

If you, or your child, are currently using any of the following drugs, then you should not start taking Pimozide. Doing so could greatly increase the chance of certain side effects occurring.

  • Dolasetron mesylate (Anzemet)

Taking Pimozide can potentially lead to changes in your heart rhythm, this includes conditions such as QT prolongation. It could lead to fainting, changes in the way your heart beats, or other serious side effects. If you experience pounding, fast, or uneven heartbeats at any time, then contact your doctor immediately.

It may cause a condition known as tardive dyskinesia, which is a movement disorder. If you, or your child, experience any of the following symptoms, then contact your doctor right away and let them know.

  • Worm-like or rapid movements of the tongue

If you experience any of the following symptoms, then inform your doctor straight away. It could be a sign of neuroleptic malignant syndrome (NMS) which is a serious condition to have.

  • Low or high blood pressure

If you notice any signs of a fever, sore throat, or child, then stop using this medicine and inform your doctor. It could be that your low blood cell count has dropped low and that you have an infection.

Unless you first clear it with your doctor, you should not immediately stop taking this medicine. Instead, it is usually recommended that you start gradually reducing the amount of medicine over time. This avoids your condition being made worse and gives your body plenty of time to adjust.

Taking Pimozide will likely add to the effects you feel from alcohol and CNS depressants. CNS depressants are medicines that cause your nervous system to work more slowly and could possibly cause drowsiness. Examples of these include;

  • Tranquilizers, sedatives, or sleeping medicine

Whilst using Pimozide, check with your doctor before taking any of the drugs listed above.

When taking this medicine, or if having the dosage increased many patients may experience drowsiness, dizziness, blurred vision, lower levels of alertness, or muscle stiffness. Even if you take this medicine at night, you may feel the effects upon waking. For this reason, you should take time to understand how this medicine affects you before you perform sensitive tasks like driving or operating machinery. You should get someone to help you get around whilst you initially adjust to this medicine.

Some patients may experience this lightheadedness, fainting or dizziness when getting up suddenly from lying down or sitting. You can help reduce this by getting up slowly. If you find this problem is continuing, then you can check with your doctor.

If you require dentistry or are having any sort of surgery, you should tell the dentist or doctor that you are taking this medicine. Taking this alongside other surgery medicines could increase the effects of the CNS depressants.

You may experience a certain amount of mouth dryness. To help relieve this, you can use a saliva substitute, eat sugarless candy or gum, or melt some ice in your mouth. If this problem continues for longer than 2 weeks, then you should ask your dentist or doctor for further advice. This continuing dryness could increase the chance of problems like fungus infections, tooth decay, and gum disease.

Finally, do not take any other drugs unless they have first been cleared by your doctor. This includes all prescription and nonprescription drugs, along with any supplements or herbal remedies.

Storage

You should keep your Pimozide safely stored in a sealed container, left at room temperature. It should not be allowed to freeze and should be kept away from moisture, direct light, and heat. Keep it safely away from children, as it can be dangerous. Once you have finished using the medicine, or if you find any is out of date at all, you should dispose of any remaining in a safe and sensible manner. Your doctor can advise on the best way to do this.

Summary

If you are suffering from Tourette's syndrome and find that other medicines are failing to help prevent tics than Pimozide could be a very useful drug for you to take. However, it is not given to all such patients and instead is only available via a prescription. Yoru doctor will need to assess you fully before deciding whether or not it is indeed the right drug to give you. Above you can find full details of all possible side effects and interactions that may occur. If you think you are experiencing some of the more side effects, then you should contact your doctor immediately.

You should be careful with other drugs you take alongside pimozide. To ensure that you get maximum benefit and avoid any complications, first clear any new drugs through your doctor. Then, stick closely to the prescription they give you. If you think the drug is having little effect and that you would like more, you should discuss this with your doctor. Finally, if you have any other queries regarding Pimozide or other aspects of your condition, you should address these to your doctor.