pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.methylprednisolonemethylprednisolone will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.metronidazolemetronidazole will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.miconazole vaginalmiconazole vaginal will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nafcillinnafcillin will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nelfinavirnelfinavir will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nevirapinenevirapine will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nifedipinenifedipine will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nilotinibnilotinib will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.oxcarbazepineoxcarbazepine will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.pentobarbitalpentobarbital will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.phenobarbitalphenobarbital will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.phenytoinphenytoin will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.posaconazoleposaconazole will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.prednisoneprednisone will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.primidoneprimidone will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.quinupristin/dalfopristinquinupristin/dalfopristin will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.rifapentinerifapentine will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ritonavirritonavir will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.rufinamiderufinamide will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinibpimozide will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalpimozide will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.sagepimozide and sage both increase sedation. Minor/Significance Unknown.secobarbitalsecobarbital will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.sulfamethoxazolesulfamethoxazole decreases levels of pimozide by unspecified interaction mechanism. Minor/Significance Unknown.topiramatetopiramate will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.verapamilverapamil will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zafirlukastzafirlukast will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.abametapirSerious - Use Alternative (2)abametapir will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir. abametapir will increase the level or effect of pimozide by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.abobotulinumtoxinAMonitor Closely (1)abobotulinumtoxinA increases effects of pimozide by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.acetazolamideMinor (1)acetazolamide will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.aclidiniumMonitor Closely (2)aclidinium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.acrivastineMonitor Closely (1)acrivastine and pimozide both increase sedation. Use Caution/Monitor.adagrasibSerious - Use Alternative (2)adagrasib will increase the level or effect of pimozide by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of adagrasib, a CYP2D6 inhibitor, with sensitive CYP2D6 substrates unless otherwise recommended in the prescribing information for these substrates. adagrasib, pimozide. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.albuterolMonitor Closely (1)pimozide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)albuterol and pimozide both increase QTc interval. Contraindicated.alfentanilMonitor Closely (1)alfentanil and pimozide both increase sedation. Use Caution/Monitor.alfuzosinMonitor Closely (1)pimozide and alfuzosin both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)alfuzosin and pimozide both increase QTc interval. Contraindicated.almotriptanMonitor Closely (1)almotriptan, 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).alprazolamMonitor Closely (1)alprazolam and pimozide both increase sedation. Use Caution/Monitor.amifampridineMonitor Closely (1)pimozide increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amiodaroneContraindicated (1)amiodarone and pimozide both increase QTc interval. Contraindicated.amisulprideContraindicated (2)amisulpride and pimozide both increase QTc interval. Contraindicated. amisulpride, pimozide. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.amitriptylineContraindicated (1)amitriptyline and pimozide both increase QTc interval. Contraindicated.Monitor Closely (1)pimozide and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalMonitor Closely (1)amobarbital and pimozide both increase sedation. Use Caution/Monitor.Minor (1)amobarbital will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.amoxapineContraindicated (1)amoxapine and pimozide both increase QTc interval. Contraindicated.Monitor Closely (2)pimozide and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. pimozide and amoxapine both increase sedation. Use Caution/Monitor.anagrelideSerious - Use Alternative (1)anagrelide and pimozide both increase QTc interval. Contraindicated.anastrozoleMinor (1)anastrozole will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.anticholinergic/sedative combosMonitor Closely (3)anticholinergic/sedative combos decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. anticholinergic/sedative combos decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.apalutamideSerious - Use Alternative (1)apalutamide will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.apomorphineSerious - Use Alternative (2)apomorphine and pimozide both increase QTc interval. Contraindicated. pimozide decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.aprepitantContraindicated (1)aprepitant increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.Serious - Use Alternative (1)aprepitant will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Risk of QT interval prolongation.arformoterolMonitor Closely (1)pimozide increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)arformoterol and pimozide both increase QTc interval. Contraindicated.aripiprazoleMonitor Closely (2)aripiprazole and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. aripiprazole and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)aripiprazole and pimozide both increase QTc interval. Contraindicated.armodafinilMonitor Closely (1)pimozide increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)armodafinil will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.arsenic trioxideContraindicated (1)arsenic trioxide and pimozide both increase QTc interval. Contraindicated.artemetherSerious - Use Alternative (1)artemether and pimozide both increase QTc interval. Contraindicated.artemether/lumefantrineContraindicated (1)artemether/lumefantrine and pimozide both increase QTc interval. Contraindicated.Minor (1)artemether/lumefantrine will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.asenapineMonitor Closely (1)asenapine and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and pimozide both increase QTc interval. Contraindicated.asenapine transdermalMonitor Closely (1)asenapine transdermal and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and pimozide both increase QTc interval. Contraindicated.atazanavirContraindicated (1)atazanavir will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Risk of QT interval prolongation.atogepantMonitor Closely (1)pimozide will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetineSerious - Use Alternative (1)atomoxetine and pimozide both increase QTc interval. Contraindicated.atracuriumMonitor Closely (3)atracurium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atracurium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropineMonitor Closely (3)atropine decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IMMonitor Closely (3)pimozide increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. atropine IV/IM decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine IV/IM decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.avapritinibMonitor Closely (2)pimozide will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. avapritinib and pimozide both increase sedation. Use Caution/Monitor.axitinibMonitor Closely (1)pimozide increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and pimozide both increase sedation. Use Caution/Monitor.azithromycinContraindicated (1)azithromycin increases toxicity of pimozide by decreasing metabolism. Contraindicated. Risk of prolonged QTc interval.Monitor Closely (1)azithromycin and pimozide both increase QTc interval. Modify Therapy/Monitor Closely.baclofenMonitor Closely (1)baclofen and pimozide both increase sedation. Use Caution/Monitor.bedaquilineMonitor Closely (1)pimozide and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsMonitor Closely (3)belladonna alkaloids decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna alkaloids decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opiumMonitor Closely (4)belladonna and opium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna and opium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. belladonna and opium and pimozide both increase sedation. Use Caution/Monitor.benperidolMonitor Closely (2)benperidol and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. benperidol and pimozide both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/acetaminophen and pimozide both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)benzhydrocodone/acetaminophen, pimozide. Either increases toxicity 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.benzphetamineMonitor Closely (1)pimozide increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropineMonitor Closely (1)pimozide increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .berotralstatMonitor Closely (1)berotralstat will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor or titrate substrate dose when berotralstat is coadministered with narrow therapeutic index drugs that are CYP3A substrates.bosentanMinor (1)bosentan will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.bremelanotideSerious - Use Alternative (1)bremelanotide will decrease the level or effect of pimozide by Other (see comment). Avoid or Use Alternate Drug. Bremelanotide may slow gastric emptying and potentially reduces the rate and extent of absorption of concomitantly administered oral medications. Avoid use when taking any oral drug that is dependent on threshold concentrations for efficacy. Interactions listed are representative examples and do not include all possible clinical examples.brexanoloneMonitor Closely (1)brexanolone, pimozide. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazoleMonitor Closely (1)brexpiprazole and pimozide both increase sedation. Use Caution/Monitor.brigatinibSerious - Use Alternative (1)brigatinib will decrease the level or effect of pimozide