Serivan 17

Indications

Pimavanserin is used to treat hallucinations (seeing or hearing things that are not there) and delusions (fixed false beliefs) linked to psychosis in people with Parkinson's disease.

How It Works

Pimavanserin acts mainly as an inverse agonist and antagonist at serotonin 5-HT2A receptors in the brain, and to a lesser extent at 5-HT2C receptors. Over-activity at these receptors is thought to drive psychotic symptoms in Parkinson's disease. Unlike most antipsychotics, Pimavanserin does not block dopamine receptors, so it does not usually worsen the movement problems of Parkinson's disease.

Dosage and Administration

Take exactly as prescribed by your doctor. The usual adult dose is 34 mg once daily, which may be taken as two 17 mg tablets or one 34 mg capsule, with or without food. A lower dose may be used if you take certain other medicines. It may take several weeks to see the full benefit. Do not stop without talking to your doctor.

Interactions

• Avoid other medicines that prolong the QT interval of the heart, such as Amiodarone, Sotalol, Quinidine, Haloperidol, Citalopram, Moxifloxacin and some antimalarials.
• Strong CYP3A4 inhibitors such as Ketoconazole, Itraconazole or Clarithromycin raise Pimavanserin levels; the dose is usually halved.
• Strong CYP3A4 inducers such as Rifampicin, Carbamazepine or Phenytoin lower its effect and should be avoided.

Contraindications

• Allergy to Pimavanserin or any ingredient.
• Use with caution or avoid in people with a known long QT interval or a history of serious heart rhythm problems.

Side Effects

Common side effects include swelling of the legs or ankles, nausea, constipation, confusion, unsteady walking and tiredness. Some people may have hallucinations that change in character during early treatment.

Older people with dementia-related psychosis who take antipsychotic medicines have a higher risk of death; Pimavanserin is not approved for dementia-related psychosis that is not linked to Parkinson's disease.

Get urgent medical help if you faint, have a fast or irregular heartbeat, palpitations, chest pain, severe confusion, or signs of allergy such as swelling of the face, lips or throat, or difficulty breathing.

Pregnancy and Lactation

There is very little information on use in pregnancy or breastfeeding. Use only if your doctor decides the benefit is greater than the possible risk, and tell your doctor if you are pregnant, planning a pregnancy or breastfeeding.

Precautions and Warnings

• Your doctor may check an ECG and blood salt levels (potassium, magnesium) before and during treatment, especially if you have heart disease.
• Tell your doctor about all other medicines you take, including those bought without a prescription.
• It may cause unsteadiness; take care to avoid falls.
• Not approved for use in children.

Overdose

An overdose may cause drowsiness, confusion and dangerous heart rhythm changes. Seek emergency medical care straight away. Treatment is supportive with heart monitoring; there is no specific antidote.

Therapeutic Class

Atypical antipsychotic, selective serotonin 5-HT2A inverse agonist.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.