by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Brigatinib induces CYP3A4 in vitro. Coadministration with CYP3A4 substrates, particularly those with a narrow therapeutic index, can result in decreased concentrations and loss of efficacy. If unable to avoid coadministration, monitor CYP3A4 substrate levels and adjust dose as needed.brimonidineMonitor Closely (1)brimonidine and pimozide both increase sedation. Use Caution/Monitor.Minor (1)brimonidine increases effects of pimozide by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.brivaracetamMonitor Closely (1)brivaracetam and pimozide both increase sedation. Use Caution/Monitor.bromocriptineSerious - Use Alternative (1)pimozide decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.brompheniramineMonitor Closely (1)brompheniramine and pimozide both increase sedation. Use Caution/Monitor.budesonideMinor (1)budesonide will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.buprenorphineMonitor Closely (1)buprenorphine and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine and pimozide both increase QTc interval. Contraindicated.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and pimozide both increase QTc interval. Contraindicated.buprenorphine subdermal implantMonitor Closely (1)buprenorphine subdermal implant and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine subdermal implant and pimozide both increase QTc interval. Contraindicated.buprenorphine transdermalMonitor Closely (1)buprenorphine transdermal and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine transdermal and pimozide both increase QTc interval. Contraindicated.buprenorphine, long-acting injectionMonitor Closely (2)pimozide increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate. buprenorphine, long-acting injection and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine, long-acting injection and pimozide both increase QTc interval. Contraindicated.bupropionContraindicated (1)bupropion will increase the level or effect of pimozide by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. Both bupropion and hydroxybupropion (major metabolite) are considered strong CYP2D6 inhibitors; additionally, bupropion and pimozide lower seizure thresholdbutabarbitalMonitor Closely (1)butabarbital and pimozide both increase sedation. Use Caution/Monitor.Minor (1)butabarbital will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.butalbitalMonitor Closely (1)butalbital and pimozide both increase sedation. Use Caution/Monitor.Minor (1)butalbital will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.butorphanolMonitor Closely (1)butorphanol and pimozide both increase sedation. Use Caution/Monitor.cabergolineSerious - Use Alternative (1)pimozide decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.caffeineMonitor Closely (1)pimozide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)pimozide, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.cannabidiolMonitor Closely (1)cannabidiol, pimozide. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.carbamazepineMonitor Closely (1)carbamazepine will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbinoxamineMonitor Closely (1)carbinoxamine and pimozide both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and pimozide both increase sedation. Use Caution/Monitor.cenobamateMonitor Closely (2)cenobamate, pimozide. Either increases effects of the other by sedation. Use Caution/Monitor. cenobamate will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.ceritinibSerious - Use Alternative (1)ceritinib and pimozide both increase QTc interval. Contraindicated.chasteberryMinor (1)chasteberry decreases effects of pimozide by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).chloral hydrateMonitor Closely (1)chloral hydrate and pimozide both increase sedation. Use Caution/Monitor.chloramphenicolSerious - Use Alternative (1)chloramphenicol will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and pimozide both increase sedation. Use Caution/Monitor.chloroquineSerious - Use Alternative (2)chloroquine increases toxicity of pimozide by QTc interval. Contraindicated. pimozide increases toxicity of chloroquine by QTc interval. Avoid or Use Alternate Drug.chlorpheniramineMonitor Closely (1)chlorpheniramine and pimozide both increase sedation. Use Caution/Monitor.chlorpromazineContraindicated (1)chlorpromazine and pimozide both increase QTc interval. Contraindicated.Monitor Closely (2)chlorpromazine and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. chlorpromazine and pimozide both increase sedation. Use Caution/Monitor.chlorzoxazoneMonitor Closely (1)chlorzoxazone and pimozide both increase sedation. Use Caution/Monitor.cimetidineContraindicated (1)cimetidine increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.Monitor Closely (1)cimetidine will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cinnarizineMonitor Closely (1)cinnarizine and pimozide both increase sedation. Use Caution/Monitor.ciprofloxacinMonitor Closely (1)ciprofloxacin and pimozide both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.cisatracuriumMonitor Closely (3)cisatracurium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cisatracurium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.citalopramContraindicated (1)citalopram and pimozide both increase QTc interval. Contraindicated.clarithromycinContraindicated (2)clarithromycin and pimozide both increase QTc interval. Contraindicated. clarithromycin increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.Monitor Closely (1)clarithromycin will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.clemastineMonitor Closely (1)clemastine and pimozide both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (1)pimozide, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineContraindicated (1)clomipramine and pimozide both increase QTc interval. Contraindicated.Monitor Closely (1)pimozide and clomipramine both increase sedation. Use Caution/Monitor.clonazepamMonitor Closely (1)clonazepam and pimozide both increase sedation. Use Caution/Monitor.clonidineMonitor Closely (1)clonidine, pimozide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clorazepateMonitor Closely (1)clorazepate and pimozide both increase sedation. Use Caution/Monitor.clozapineMonitor Closely (2)clozapine and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. clozapine and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and pimozide both increase QTc interval. Contraindicated.cobicistatContraindicated (2)cobicistat will increase the level or effect of pimozide by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. Potential for increased systemic exposure of pimozide resulting in increased risk for QT prolongation cobicistat will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Potential for increased systemic exposure of pimozide resulting in increased risk for QT prolongation.codeineMonitor Closely (1)codeine and pimozide both increase sedation. Use Caution/Monitor.conivaptanContraindicated (1)conivaptan increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.Minor (1)conivaptan will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cortisoneMinor (1)cortisone will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.crizotinibContraindicated (1)crizotinib and pimozide both increase QTc interval. Contraindicated. Pimozide is contraindicated with drugs that may prolong the QT interval. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.crofelemerMonitor Closely (1)crofelemer increases levels of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.cyclizineMonitor Closely (4)cyclizine decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cyclizine decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. cyclizine and pimozide both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (4)cyclobenzaprine decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cyclobenzaprine decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. cyclobenzaprine and pimozide both increase sedation. Use Caution/Monitor.cyclophosphamideMinor (1)cyclophosphamide will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyclosporineContraindicated (1)cyclosporine will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.cyproheptadineMonitor Closely (1)cyproheptadine and pimozide both increase sedation. Use Caution/Monitor.dabrafenibMonitor Closely (1)dabrafenib will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.dacomitinibSerious - Use Alternative (1)dacomitinib will increase the level or effect of pimozide by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. dantroleneMonitor Closely (1)dantrolene and pimozide both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)pimozide and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacinMonitor Closely (3)darifenacin decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. darifenacin decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Serious - Use Alternative (1)darifenacin increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.Minor (1)darifenacin will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.darunavirContraindicated (1)darunavir will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with phenytoin may result in loss of therapeutic effect and development of resistance to darunavir.dasatinibContraindicated (1)dasatinib increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.Serious - Use Alternative (1)dasatinib and pimozide both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)dasatinib will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.deferasiroxMonitor Closely (2)deferasirox will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. deferasirox increases levels of pimozide by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.degarelixSerious - Use Alternative (1)degarelix and pimozide both increase QTc interval. Contraindicated.desfluraneMonitor Closely (1)desflurane and pimozide both increase sedation. Use Caution/Monitor.desipramineContraindicated (1)desipramine and pimozide both increase QTc interval. Contraindicated.Monitor Closely (1)pimozide and desipramine both increase sedation. Use Caution/Monitor.deutetrabenazineMonitor Closely (3)pimozide and deutetrabenazine both increase sedation. Use Caution/Monitor. pimozide and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). pimozide and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.dexamethasoneMinor (1)dexamethasone will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and pimozide both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)pimozide increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine and pimozide both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)pimozide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)pimozide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextromethorphanMonitor Closely (1)dextromethorphan, pimozide. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).dextromoramideMonitor Closely (1)dextromoramide and pimozide both increase sedation. Use Caution/Monitor.DHEA, herbalSerious - Use Alternative (1)DHEA, herbal increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.Minor (1)DHEA, herbal will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.diamorphineMonitor Closely (1)diamorphine and pimozide both increase sedation. Use Caution/Monitor.diazepamMonitor Closely (1)diazepam and pimozide both increase sedation. Use