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Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Drowsiness
- Difficulty sleeping (insomnia)
- Anxiety
- Disturbances of the gut such as constipation, nausea, indigestion
- Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects)
- Dry mouth
- Dizziness
- Weakness
- Increased sweating
- Headache
- Sexual problems, such as decreased sex drive and impotence
- Low blood pressure (hypotension)
- Disturbance in body temperature regulation
- Abnormal heart beats (arrhythmias)
- High blood prolactin (milk producing hormone) level (hyperprolactinaemia). Rarely this may lead to symptoms such as breast enlargement, production of milk or menstrual disturbances
- Decreased level of sodium in the blood (hyponatraemia)
- Seizures (fits)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The following medicines must not be used in combination with this medicine, as they may increase the blood level of pimozide and so increase the risk of abnormal heart rhythms:

- azole antifungals, eg ketoconazole, itraconazole, fluconazole
- macrolide antibiotics, eg clarithromycin, erythromycin, telithromycin
- nefazodone
- protease inhibitors for HIV infection , eg nelfinavir, ritonavir
- the antidepressants sertraline, citalopram or escitalopram.

Other medicines that may be associated with an abnormal heart rhythm (prolonged QT interval on the heart monitoring trace or ECG) should not be taken in combination with pimozide. These include the following:

- certain antiarrhythmics (medicines to treat abnormal heart beats), eg amiodarone, quinidine, procainamide, disopyramide, sotalol
- certain antimalarials, eg choroquine, quinine, mefloquine
- certain other antipsychotics, eg sertindole, thioridazine, trifluoperazine, chlorpromazine
- cisapride
- maprotiline
- terfenadine
- tricyclic antidepressants, eg amitriptyline.

Sibutramine is not recommended for use in combination with this medicine.

There may be an increased risk of drowsiness and sedation if any of the following (which can also cause drowsiness) are taken with pimozide:

- alcohol
- benzodiazepines, eg diazepam, temazepam
- strong opioid painkillers, eg morphine, codeine
- sedating antihistamines, eg chlorphenamine
- sleeping tablets, eg zopiclone

This medicine may enhance the blood pressure-lowering effects of certain medicines used to treat high blood pressure (antihypertensives). If you are taking medicines for high blood pressure you should tell your doctor if you feel dizzy or faint after starting treatment with this medicine, as your blood pressure medicines may need adjusting.

If this medicine is taken in combination with medicines that can disturb the normal levels of electrolytes (salts, such as potassium and sodium) in your blood, there may be an increased risk of side effects on the heart. These types of medicines, for example diuretics such as bendroflumethiazide or furosemide, are not recommended for use with pimozide. If you need treatment with a diuretic, a potassium-sparing diuretic such as spironolactone is preferred.

There may be an increased risk of abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects) if metoclopramide is used in combination with pimozide.

Pimozide may reduce the efficacy of antiepileptic medicines.

Pimozide may oppose the effects of levodopa and other dopamine agonist medicines used to treat Parkinson's disease.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain pimozide as the active ingredient.

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