Azithromycin
Contraindicated
Database
Significantly increased risk of severe QT prolongation and Torsades de Pointes (TdP).
Concomitant use is contraindicated. Choose an alternative antibiotic or antipsychotic.
Source: DDInter
Drug reference
Pimozide
Atypical Antipsychotic · Psychoses and schizophrenia
Atypical AntipsychoticPsychoses and schizophrenia
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactionssee all 12 →
- AzithromycinContraindicatedDatabaseDDInter
- ClarithromycinContraindicatedDatabaseDDInter
- Escitalopram OxalateContraindicatedDatabase
- FluconazoleContraindicatedDatabaseDDInter
Mechanism
First-generation antipsychotic drugs act predominantly by blocking dopamine D2 receptors in the brain. They are not selective for any of the four dopamine pathways in the brain.
Indications
SchizophreniaMonosymptomatic hypochondriacal psychosi
Dosing
- Adult
- Initially 2 mg daily, adjusted according to response, then increased in steps of 2–4 mg at intervals of not less than 1 week; usual dose 2–20 mg daily by mouth.
- Geriatric
- Initially 1 mg daily, adjusted according to response, increased in steps of 2–4 mg at intervals of not less than 1 week; usual dose 2–20 mg daily by mouth.
- Max dose
- 20 mg daily
Side effects
Common
Extrapyramidal symptomsElevated prolactinSexual dysfunctionReduced bone mineral densityMenstrual disturbancesBreast enlargementGalactorrhoeaTachycardiaArrhythmiasHypotensionSedative effectsAntimuscarinic effects
Serious
- QT-interval prolongation
- Sudden death
- Neuroleptic malignant syndrome (hyperthermia, fluctuating level of consciousness, muscle rigidity, autonomic dysfunction)
Drug interactions
Clarithromycin
Contraindicated
Database
Cardiac arrhythmias may occur.
Never combine.
Source: DDInter
Escitalopram Oxalate
Contraindicated
Database
QT prolongation, Torsades de Pointes, cardiac arrhythmias
Contraindicated due to risk of QT prolongation and serious cardiac events.
Fluconazole
Contraindicated
Database
Increased pimozide plasma concentrations, leading to QT prolongation and increased risk of serious ventricular arrhythmias
Concomitant use is contraindicated. Avoid completely.
Source: DDInter
Fluoxetine
Contraindicated
Database
Increased risk of QTc prolongation and ventricular arrhythmias.
CONTRAINDICATED. Do not co-administer. A washout period of at least 5 weeks is required after discontinuing fluoxetine before starting pimozide.
Source: DDInter
Ketoconazole
Contraindicated
Database
Fatal cardiac arrhythmia
Contraindicated.
Source: DDInter
Letermovir
Contraindicated
Database
CYP3A4 inhibition
Contraindicated
Source: Kimi deep-research + Cla
Paroxetine
Contraindicated
Database
Increased risk of QT prolongation and ventricular arrhythmias
Concomitant use is contraindicated.
Source: DDInter
Posaconazole
Contraindicated
Database
Increased levels + additive QT
Contraindicated
Source: Kimi deep-research + Cla
Roxithromycin
Contraindicated
Database
Increased pimozide levels, leading to QT prolongation and potentially fatal ventricular arrhythmias (e.g., Torsades de Pointes).
Concomitant use is contraindicated. Avoid completely.
Sertraline
Contraindicated
Database
Increased risk of QT prolongation and cardiac arrhythmias (e.g., Torsades de Pointes)
Concomitant use is contraindicated. Sertraline significantly increases pimozide exposure.
Source: DDInter
Abarelix
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Other Atypical Antipsychotic drugs
Ask House about Pimozide
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Katzung, BNF, Nelson·Verified: 2026-05-10 · House clinical team