CriticalFirst-generation antipsychotic, diphenylbutylpiperidine derivative×Class Ia antiarrhythmic (sodium channel blocker with intermediate kinetics)
Updated · Methodology
Mechanism
Quinidine is a strong CYP2D6 inhibitor (secondary pimozide pathway) and itself a QT prolonger. Double torsades risk. FDA Orap Section 4.
Symptoms
QT prolongation by day 3, syncope, torsades de pointes.
Management
Combination contraindicated. If antiarrhythmic is needed in a pimozide patient, discuss catheter ablation or rate control with a beta-blocker without QT effect.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Pimozide tablet (Par Health USA, LLC) – Prescribing Information (2011)– FDA Orap label, Section 4 Contraindications; DailyMed setid 70b079e2-a1f7-4a93-8685-d60a4d7c1280
- AEMPS: Ficha técnica: Orap (pimozida) (nº registro 49503), sección 4.3 (2018)– AEMPS, CIMA, nº registro 49503, revisión 06/2018, secciones 4.3, 4.4 y 4.5