Pimavanserin

Pimavanserin is a prescription medication used to treat hallucinations and delusions in patients with Parkinson’s disease. 

Pimavanserin belongs to a group of drugs called atypical antipsychotics. These work to by altering the activity of certain natural substances in the brain.

This medication is available in tablet form and is typically taken once daily, with or without food. 

Common side effects of pimavanserin include swelling in ankles, legs, and feet, nausea, and confusion. 

Pimavanserin is a prescription medication used to treat hallucinations and delusions associated with psychosis experienced by some people with Parkinson’s disease.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Pimavanserin may be found in some form under the following brand names:

• Nuplazid

Serious side effects have been reported with pimavanserin. See "Drug Precautions" section.

Common side effects include:

• swelling in the ankles, legs, and feet
• nausea
• confusion
• hallucinations
• constipation
• trouble walking

This is not a complete list of pimavanserin side effects. Ask your doctor or pharmacist for more information.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. 

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• medications that block a protein in the body (CYP3A4) such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), delavirdine (Rescriptor), and nefazodone

• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin, and St John's wort

This is not a complete list of pimavanserin drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with pimavanserin including:

• Increased risk of death in elderly patients with dementia-related psychosis
  • Pimavanserin is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis
• QT Interval Prolongation. This is a condition when changes in the electrical activity of your heart occur, causing irregular heartbeats that can be life threatening. Talk to your healthcare provider about other medicines you are taking before you start taking pimavanserin. Tell your healthcare provider right away if you have any signs or symptoms of QT prolongation:
  • feeling faint
  • lightheadedness
  • dizziness
  • feeling like your heart is beating irregularly or quickly

Do not take pimavanserin if you are allergic to pimavanserin or to any of its ingredients.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of pimavanserin, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking pimavanserin, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to pimavanserin or to any of its ingredients
• have or have a history of any heart problems including any heart rhythm problems
• have reduced kidney function. pimavanserin is not recommended if you have severe kidney problems
• have reduced liver function. Pimavanserin is not recommended if you have liver problems

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

There are no data on pimavanserin use in pregnant women. That said, the risk for major congenital malformations or miscarriage can not be assessed. In animal studies, no problems in regards to the baby's development were seen.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if pimavanserin crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with the use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using pimavanserin.

Take pimavanserin exactly as prescribed.

Pimavanserin comes in tablet form and is taken by mouth, once a day, with or without food.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose of pimavanserin for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis is two tablets (34 mg) once a day.

If you are taking certain medications, this dose may need to be reduced to one tablet (17 mg) once a day. Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

If you take too much pimavanserin, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Keep pimavanserin and all other medicines out of reach of children.
• Store pimavanserin at room temperature 20°C to 25°C (68°F to 77°F)

WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS

• Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.
• Nuplazid is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis.