There are some medical conditions that are sometimes not well controlled by the usual medications. Tourette disorder is one such condition. So, in such cases, when other treatments have not yielded the expected results, a special drug that doctors use is called Pimozide. It also comes under the brand name Orap. Today, we will talk in detail about this drug, what it does, and what things to be careful about.
What kind of medicine is Pimozide?
Simply put, Pimozide is a medication that is used to manage the symptoms of a condition called Tourette's disorder. A person with this condition may experience uncontrollable vocal tics and motor tics. Imagine how disruptive this can be to daily activities.
So what this Pimozide does is it affects the way the brain works and reduces those uncontrollable sounds and movements. It belongs to a class of drugs called antipsychotics. Don't be scared by the name, this class of drugs is used to treat a wide variety of mental health conditions.
Things you need to tell your doctor before starting this medication
Before your doctor decides to prescribe Pimozide for you, it is very important to know your complete health history. Be sure to tell your doctor if you have any of the following conditions:
| Your health condition | Description |
|---|---|
| Heart disease | Any type of heart disease or a history of irregular heartbeat. |
| Blood pressure and blood count | If you have low blood pressure, low white blood cells, platelets, or red blood cells (low blood counts). |
| Minerals in the blood | If the level of potassium or magnesium in the blood is low. |
| Other medical conditions | Diabetes, kidney or liver disease, Parkinson's disease, seizures, prostate problems, intestinal obstruction, difficulty swallowing, muscle control problems, or dementia. |
| Habits and allergies | If you are a frequent drinker, have an allergic reaction to Pimozide or other medicines, foods, or dyes. |
| Pregnancy | If you are pregnant, trying to get pregnant, or breastfeeding. |
How should I use this medicine?
This medicine should be taken orally with a glass of water. Take the dose prescribed by your doctor at the prescribed time. Follow the instructions on the medicine label exactly.
Very important: Do not take this medication with grapefruit juice for any reason. It can severely affect the effectiveness of the medication.
It is important to take the medicine on time. Also, do not stop taking the medicine suddenly without consulting your doctor. Doing so may cause other problems.
What if I miss a dose of medication?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at the same time.
What to do if you take too much medicine?
If you think you have taken too much medicine, don't delay. Immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other things that may interact with this medicine (Drug Interactions)
Pimozide is a medication that has a high potential for interaction with other medications. Therefore, it is essential to tell your doctor about all medications you are taking, including vitamins and herbal remedies.
| Do not take Pimozide with this medicine. | |
|---|---|
| Some antibiotics | Like Azithromycin, Clarithromycin, Erythromycin |
| Some medications for depression (Antidepressants) | SSRI drugs such as Citalopram, Fluoxetine, Sertraline, Nefazodone |
| Antifungals | Like Fluconazole, Ketoconazole, Itraconazole |
| Medications for heart rhythm disorders | Like Amiodarone, Sotalol, Quinidine |
| Other medications | Metoclopramide, Droperidol, Thioridazine, Ziprasidone, some drugs for HIV/Hepatitis, and other drugs that prolong the QT interval of the heart beat |
| These things can also cause problems (be careful) | |
| Alcohol | Taking it with alcohol may increase drowsiness and dizziness. |
| Grapefruit juice | This directly affects the effectiveness of the medicine. |
| Other drug classes | Medicines such as cough, cold, allergy medicine (antihistamines), painkillers, sleeping pills, blood pressure medicine, epilepsy medicine, and Levodopa for Parkinson's disease. |
Things to be careful about when taking medicine
- Regular check-ups: When using this medicine, it is very important to see your doctor regularly to check how you are doing. Tell him if your symptoms are getting worse or if they are not getting better.
- Drowsiness and dizziness: This medicine may make you feel drowsy and dizzy. Therefore, do not drive or operate machinery until you know how this medicine affects you. Be careful when getting up from a sitting position or sitting down suddenly, especially if you are an elderly person.
- Alcohol: Drinking alcohol can make drowsiness and dizziness worse. Therefore, it is best to avoid alcohol while taking this medication.
- Blood sugar: If you have diabetes, this medication may increase your blood sugar levels. So, talk to your doctor about whether you need to make changes to your diet or diabetes medication.
- Body temperature: This medicine may affect the way your body controls its temperature. This means that your body may not be able to respond to extreme cold or extreme heat. Therefore, wear warm clothes when it is very cold. Also, be careful of extreme heat and sun. Drink plenty of water. If you feel that you are having difficulty controlling your body temperature, talk to your doctor immediately.
Possible side effects
Like any medication, Pimozide can cause side effects. Some are serious, while others are common. It is important to be aware of these.
| Serious side effects that should be reported to the doctor/hospital immediately | |
|---|---|
| Allergic Reaction | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Changes in heart rate | Fast or irregular heartbeat, dizziness, fainting, chest pain, difficulty breathing. |
| Neuroleptic Malignant Syndrome (NMS) | Very high fever, muscle stiffness, excessive sweating, and confusion. This is a very dangerous condition. |
| Extrapyramidal Symptoms (EPS) | Uncontrollable body movements, muscle stiffness or twitching, tremors, restlessness, difficulty walking. |
| Signs of infection | Fever, chills, cough, sore throat, etc. |
| Things that are usually not serious, but should be reported to the doctor if they persist | |
| Constipation | Dry mouth |
| Dizziness | Drowsiness |
Take-Home Message
- Pimozide is a specific medication for Tourette's disorder. It is used when other medications have not worked.
- Before starting this medication, tell your doctor about all your health conditions and all other medications you are taking.
- Never take this medicine with grapefruit juice.
- If you experience any serious side effects such as high fever, muscle stiffness, or irregular heartbeat, seek medical advice immediately or go to a hospital's Emergency Treatment Unit (ETU).
- Never stop taking medication without your doctor's advice.
- It is very important to stay in regular contact with your doctor to monitor your progress.
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