Drug Information: Orap® (Pimozide)
(pi’ moe zide)
Why is this medication prescribed?
Orap® (Pimozide) is used to control tics (unusual movements or sounds that the patient may be able to hold back for a short time but cannot really control) caused by Tourette’s disorder. Pimozide should only be used in patients who cannot take other medications or who have taken other medications without good results. Pimozide should only be used to treat severe tics that stop the patient from learning, working, or performing normal activities. Pimozide is in a class of medications called antipsychotics. It works by decreasing abnormal excitement in the brain.
How should this medicine be used?
Pimozide comes as a tablet to take by mouth. It is usually taken with or without food once a day at bedtime or twice a day. To help you remember to take pimozide, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pimozide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor will probably start you on a low dose of pimozide and gradually increase your dose, not more than once 2 or 3 days.
Pimozide controls Tourette’s disorder but does not cure it. It may take some time before you feel the full benefit of pimozide. Continue to take pimozide even if you feel well. Do not stop taking pimozide without talking to your doctor. You may experience a serious reaction if you suddenly stop taking pimozide. Your doctor will probably decrease your dose gradually.
Other uses for this medicine
Pimozide is also used sometimes to treat schizophrenia, and certain behavior, personality, movement, and psychiatric disorders in adults. Pimozide should not be prescribed for other uses in children. Talk to your doctor about the possible risks of using this medication for your condition.
What special precautions should I follow?
Before taking pimozide,
* tell your doctor and pharmacist if you are allergic to pimozide, other medications for mental illness, or any other medications.
* do not take antibiotics such as azithromycin (Zithromax, Z-Pak), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E.E.S., E-Mycin, Erythrocin), and troleandomycin (TAO); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); dofetilide (Tikosyn); chlorpromazine (Ormazine, Thorazine); cyclosporine (Neoral, Sandimmune); danazol (Danocrine); delavirdine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac); dolasetron (Anzemet); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); gatifloxacin (Tequin); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Fortovase, Invirase), and ritonavir (Norvir); levomethadyl (ORLAAM); medication for irregular heartbeat such as amiodarone (Cordarone), disopyramide (Norpace), procainamide (Procanabid, Pronestyl), quinidine (Cardioquin, Quinaglute, Quinidex), and sotalol (Betapace); mefloquine (Lariam); mesoridazine (Serentil); metronidazole (Flagyl); moxifloxacin (Avelox); nefazadone (Serzone); oral contraceptives (birth control pills); pentamidine (Nebu-Pent); probucol (Lorelco); sertraline (Zoloft); sparfloxacin (Zagam); tacrolimus (Prograf); thioridazine (Mellaril); verapamil (Calan, Covera, Isoptin, Verelan); zafirlukast (Accolate); zileuton (Zyflo); and ziprasidone (Geodon) while taking pimozide.
* tell your doctor if you are taking medications that may cause tics, including amphetamines such as amphetamine (Adderall) and dextroamphetamine (Dexadrine, Dextrostat); pemoline (Cylert); and methyphenidate (Concerta, Ritalin). Your doctor may tell you to stop taking your medication for a while before you start taking pimozide. This will let your doctor see if your tics were caused by the other medication and can be treated by stopping it.
* tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: antidepressants (mood elevators); diuretics (‘water pills’); medications for anxiety, mental illness, pain, and seizures; sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you have or have ever had breast cancer; an irregular heartbeat; Parkinson’s disease; glaucoma; problems with urination; seizures; low levels of potassium or magnesium in your blood; and heart, prostate, liver, or kidney disease,
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pimozide, call your doctor.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking pimozide.
* you should know that pimozide may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
* remember that alcohol can add to the drowsiness caused by this medication.
* you should know that pimozide may make it harder for your body to cool down when it gets very hot. Tell your doctor if you plan to do vigorous exercise or be exposed to extreme heat.
What special dietary instructions should I follow?
Talk to your doctor about drinking grapefruit juice while taking this medicine.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
Pimozide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
* dry mouth
* unusual hunger or thirst
* muscle tightness
* changes in posture
* difficulty falling or staying asleep
* changes in behavior
* changes in taste
* eyes sensitive to light
* changes in vision
* decreased sexual ability
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
* unusual movements of your body or face that you cannot control
* high fever
* muscle stiffness
* fast heartbeat
* shuffling walk
* difficulty moving any part of your body
* difficulty speaking
At high doses, pimozide has caused tumors in mice. This does not necessarily mean that pimozide will also cause tumors in humans. Pimozide may also cause other serious side effects. Talk to your doctor about the risks of taking this medication.
Pimozide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
* difficulty moving body
* shuffling walk
* blurred vision
* upset stomach
* difficulty breathing
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body’s response to pimozide.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Last Revised – 07/01/2003
American Society of Health-System Pharmacists, Inc. Disclaimer – http://www.nlm.nih.gov/medlineplus/ashpdisclaimer.html