Potentiates other CNS depressants like alcohol, anaesthetics, brabiturates, antihistiminics and benzodiapines.

Synergistic with anticholinergics, antidepressants and narcotic analgesics.

Potentiates sedation,anticholinergic and respiratory depressive effects.

Antacids delay absorption.

Propranolol and cimetidine decrease hepatic metabolism and increase efficacy and toxicity.

Supression of severely compromising motor and phonic tics in patients with Tourettes disorder.

 Antipsychotic agents group - Include-

Chlorpromazine, Promazine, Thioflupromazine,Mesoridazine, Thioridazine ,Acetophenazine Perphenazine,Prochlorperazine, Fluphenazine, Trifluoperazine, Chlorprothixene, Thiothixene Haloperidol,Pimozide,Molindone,Loxapine,Clozapine ,Olanzapine,Quetiapine , Ziprasidone, Paliperidone, Risperidone, Aripiprazole

Refer Chlorpromazine

Neuroleptic malignant syndrome. Extrapyrimidal reactions, nervousness, irritability, insomnia, drowsiness, weakness, dizziness.

Raised transaminases, LDH and serum cholestrol levels.

Prolonged QT interval.History of cardiac arrhythmias.Hypersens.

Special precautions:

Endogenous depression, Parkinsons syndrome.

Epilepy, pregnancy electrolytic imbalance. Hepatic or renal impairment.

ECG control before and during treatment. Review if repolarisation changes occur.

Indications:

Supression of severely compromising motor and phonic tics in patients with Tourette's disorder.

Dosage:

Introduce the drug slowly and gradually . Initial - 1 to 2mg a day in divided doses, thereafter increase dose every other day. Maintenance- Less than 0.2mg/kg/day in divided doses or 10mg per day whichever is less. Do not exceed 10mg/day. Sudden unexpected deaths have occured in patients taking a high Pimozide dose.

PIMOZIDE-

       AVOID CONCURRENT USE WITH ERYTHROMYCIN

1. May cause drowsiness; use with caution while driving or performing other tasks requiring
    alertness.

2. Inform patient of  the risks of developing tardive dyskinesia with chronic use.

3. Do not exceed the prescribed dose. Sudden unexpected deaths have occured in patients
    taking high doses of pimozide for conditions other than Tourettes disorder.

4.Allergies-
   Tell your doctor if you have ever had any unusual or allergic reaction to pimozide
   Also tell your doctor if you are allergic to any other substances, such as foods, presevatives or dyes.
  
5.Pregnancy -
   Studies in rats and  rabbits given more than the usual humam dose of pimozide  have shown  fewer  pregnancies,   slowed  development of fetus,  and toxic  effects  in the mother and fetus.    
 
6.Breast feeding- 
   Not know  whether  pimozide  passes  into breast mllk. 

7. Children -
    More sensitive to effects of  of pimozide. Increase chances of side effects during treatment. Pimozide should not be     used in children  for any  medical problem other than Tourettes syndrome 
    in children

8 .Elderly- 
    Constiptaion, dizziness,  or fainting , drowsiness, dryness  of mouth,  and trembling  of the hands and warmth, runny  nose,  swelling of the face, fingers, ankles or feet,  trembling or shaking, trouble  swallowing, trouble seeing,  unusual  weak  feeling, voice change, vomiting.      

9. Other medicines -
   Tell your doctor if you are taking any of the following- 
   
   Amoxipine or
   Methyldopa or
   Metoclopramide or
   Metyrosine or
   Promethazine or
   Rauwolfia alkaloids or
   Trimeprazine - taking these medicines with pimozide  may increase  the chance of serious  side effects

   Amphetamines or
   Methylphenidate or
   Pemoline  - taking these medicines  with pimozide  may cover  up  the cause of tics
   
   Anticholinergics-   taking these medicies  qwith pimozide  may cause an increased chance of certai side efects
   such as dryness of mouth, constipation, and uusual excitement

   Antispychotics  or
   Dispyramide or
   Maprotilie or
   Procainamideor
   Quinidine or
   Tricyclic antidepressants - taking thse medicines  with pimozide may increase  the chance of serious effects  on   rhytmm of the heart

   Central nervous system- using these medicines  with pimozide may increase  the CNS depressant effects
        
10. Other medical problems -

   Tell your doctor if you have any other medical problems especially -

    Breast cancer or  
    Heart disease -  pimozide  may make the condition worse
    Kidey disease or
    Liver disease  - higher blood levels  of pimozide  may occur,increasing the chnce of side effects
    Tics  other than  those  caused by Tourettes syndrome- pimozide  should  not be used  because  of the risk of    serious side efects
   
11. Missed dose -
     If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time
     for the next dose, skip the missed dose. Do not double doses.

12. Storage -
      Keep out of reach of children. Store away from heat or direct sunlight. Do not store
      the capsule in bathroom, near the kitchen sink, or in other damp places.

13. Outdated medicines -
     Do not keep outdated medicine or medicine no longer needed. Be sure that any
     discarded medicine is out of reach of children.

Pharmacology:

Pimozide is neuroleptic which blocks CNS dopaminergic receptors. It has no norepinephrine receptors. Its ability to supress motor and phonic tics in Tourettes disorder is thought to be a function of its dopaminergic block

Pharmacokinetics:

More than 50% of the dose of pimozide is absorbed after oral administration. Peak serum levels occur 6 to 8 hours after dosing. pimozide is metabolisedin liver; mean elimination half-life is approx 55 hours.

Pregnancy:

Administer pimozide to woman only if potential benefits outweigh risks.

Lactation:

Excercise caution, and administer weighing risk/benefits.