AdultPediatricGeriatricDosage Forms & Strengths capsule 34mg tablet 10mg Parkinson Disease Psychosis Indicated for treatment of hallucinations and delusions associated with Parkinson disease psychosis 34 mg PO qDay (without titration) Dosage Modifications Coadministration with strong CYP3A4 inhibitors Decrease dose to 10 mg PO qDay Coadministration with strong CYP3A4 inducers Monitor for reduced efficacy; an increase in pimavanserin dosage may be needed Renal impairment Mild-to-moderate (CrCl ≥30 mL/min): No dosage adjustment required Severe (CrCl <30 mL/min) or end stage renal disease: Use with caution Hepatic impairment No dosage adjustment recommended Safety and efficacy not establishedElderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; pimavanserin is not approved for dementia-related psychosis unrelated to Parkinson disease (see Black Box Warnings)Interaction CheckerEnter a drug name and pimavanserinNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (1)lefamulinlefamulin will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.Serious - Use Alternative (118)abametapirabametapir will increase the level or effect of pimavanserin 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.adagrasibadagrasib, pimavanserin. 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.alfuzosinalfuzosin and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.amiodaronepimavanserin and amiodarone both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.amisulprideamisulpride and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amobarbitalamobarbital will decrease the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.anagrelidepimavanserin and anagrelide both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.apalutamideapalutamide will decrease the level or effect of pimavanserin 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.apomorphineapomorphine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.aripiprazolearipiprazole and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.arsenic trioxidepimavanserin and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.artemetherartemether and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrinepimavanserin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.asenapinepimavanserin and asenapine both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.asenapine transdermalasenapine transdermal and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.atazanaviratazanavir will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.atomoxetineatomoxetine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.bedaquilinebedaquiline and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, pimavanserin. 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.buprenorphinebuprenorphine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalbuprenorphine transdermal and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionbuprenorphine, long-acting injection and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.ceritinibceritinib and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.ceritinib will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chloramphenicolchloramphenicol will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.citalopramcitalopram and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.clarithromycinclarithromycin will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.clarithromycin and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.clozapineclozapine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.cobicistatcobicistat will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.conivaptanconivaptan will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.crizotinibcrizotinib and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.dasatinibdasatinib and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.degarelixdegarelix and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.desfluranedesflurane and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.disopyramidedisopyramide and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.dofetilidedofetilide and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.dolasetrondolasetron and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.donepezildonepezil and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.efavirenzefavirenz and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.eliglustateliglustat and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.elvitegravir/cobicistat/emtricitabine/tenofovir DFelvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.encorafenibencorafenib and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Encorafenib is associated with dose-dependent QTc interval prolongation. Avoid with drugs known to prolong QT interval.entrectinibpimavanserin and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.eribulineribulin and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.escitalopramescitalopram increases toxicity of pimavanserin by QTc interval. Avoid or Use Alternate Drug.fexinidazolefexinidazole and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels and/or prolong QT interval.fexinidazole will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.fingolimodfingolimod and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.fosamprenavirfosamprenavir will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.gemifloxacingemifloxacin and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.gilteritinibgilteritinib and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.glasdegibpimavanserin and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.granisetrongranisetron and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.grapefruitgrapefruit will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.hydrocodonehydrocodone, pimavanserin. 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.hydroxychloroquine sulfatehydroxychloroquine sulfate and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.hydroxyzinehydroxyzine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.ibutilideibutilide and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.idelalisibidelalisib will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.iloperidoneiloperidone and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.imatinibimatinib will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.indinavirindinavir will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.inotuzumabinotuzumab and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.isofluraneisoflurane and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.isoniazidisoniazid will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.itraconazoleitraconazole will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 10 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.itraconazole and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.ivosidenibivosidenib will decrease the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.ketoconazoleketoconazole will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 10 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.levodopa inhaledpimavanserin decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Atypical (2nd generation) antipsychotics inhibit dopamine D2 receptors in varying degrees (clozapine and quetiapine are lower risk). .levoketoconazolelevoketoconazole will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 10 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.lithiumlithium and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.lopinavirlopinavir will increase the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Decrease dose to 17 mg/day if pimavanserin is coadministered with strong CYP3A4 inhibitors.lopinavir and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.lorlatiniblorlatinib will decrease the level or effect of pimavanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.macimorelinmacimorelin and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.metoclopramide intranasalpimavanserin, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.pimavanserin increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome.mifepristonemifepristone and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.mifepristone will increase the level or effect