Pimozide

CLINICAL USE

Antipsychotic

DOSE IN NORMAL RENAL FUNCTION

2–20 mg daily

PHARMACOKINETICS

Molecular weight :461.5

%Protein binding :99

%Excreted unchanged in urine : <1

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :55–150/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Start with low dose and increase according to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anaesthetics: enhanced hypotensive effect

Analgesics: increased risk of convulsions with tramadol; enhanced hypotensive and sedative effects with opioids

Anti-arrhythmics: increased risk of ventricular arrhythmias with anti-arrhythmics that prolong the QT interval – avoid concomitant use with amiodarone, disopyramide and procainamide (risk of ventricular arrhythmias)

Antibacterials: avoid concomitant use with macrolides and moxifloxacin (increased risk of ventricular arrhythmias)

Antidepressants: concentration increased by sertraline and possibly paroxetine – avoid with paroxetine; increased risk of ventricular arrhythmias with maprotiline and tricyclics – avoid concomitant use; increased plasma level of tricyclics

Anti-epileptics: antagonises anticonvulsant effect

Antifungals: avoid concomitant use with imidazoles and triazoles

Antimalarials: avoid concomitant use with artemether/lumefantrine; increased risk of ventricular arrhythmias with mefloquine and quinine – avoid concomitant use

Antipsychotics: increased risk of ventricular arrhythmias with phenothiazines – avoid concomitant use

Antivirals: concentration increased by amprenavir, atazanavir, efavirenz, indinavir, nelfinavir, ritonavir and saquinavir, increased risk of ventricular arrhythmias – avoid concomitant useAnxiolytics and hypnotics: increased sedative effectsAprepitant: avoid concomitant use

Atomoxetine: increased risk of ventricular arrhythmias

Beta-blockers: increased risk of ventricular arrhythmias with sotalol

Diuretics: increased risk of ventricular arrhythmias due to hypokalaemiaIvabradine: increased risk of ventricular arrhythmias

Sibutramine: increased risk of CNS toxicity – avoid concomitant use

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

ECG required before treatment. To be repeated annually.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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