CriticalFirst-generation antipsychotic, diphenylbutylpiperidine derivative×HIV protease inhibitor / pharmacokinetic booster
Updated · Methodology
Mechanism
Ritonavir is the strongest ARV CYP3A4 inhibitor. Pimozide concentration rises 15-fold. FDA Orap Section 4 strict contraindication.
Symptoms
QT prolongation, syncope, torsades de pointes.
Management
Combination contraindicated. For HIV in a pimozide patient, switch ARV to a regimen without ritonavir or cobicistat (e.g., dolutegravir + 2 NRTIs).
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: Ritonavir (nº registro 81039), sección 4.5 (2025)– AEMPS, CIMA, nº registro 81039, sección 4.5